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Remote Microphone System Use at Home: Impact on Caregiver Talk

American Speech-Language-Hearing Association
Journal of Speech, Language, and Hearing Research
Authors:
Carlos Benitez-Barrera at University of Wisconsin–Madison
Carlos Benitez-Barrera
Gina P. Angley
Gina P. Angley
Gina P. Angley
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Anne Marie Tharpe at Vanderbilt University
Anne Marie Tharpe
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Abstract and Figures

Purpose The purpose of this study was to investigate the effects of home use of a remote microphone system (RMS) on the spoken language production of caregivers with young children who have hearing loss. Method Language Environment Analysis recorders were used with 10 families during 2 consecutive weekends (RMS weekend and No-RMS weekend). The amount of talk from a single caregiver that could be made accessible to children with hearing loss when using an RMS was estimated using Language Environment Analysis software. The total amount of caregiver talk (close and far talk) was also compared across both weekends. In addition, caregivers' perceptions of RMS use were gathered. Results Children, with the use of RMSs, could potentially have access to approximately 42% more words per day. In addition, although caregivers produced an equivalent number of words on both weekends, they tended to talk more from a distance when using the RMS than when not. Finally, caregivers reported positive perceived communication benefits of RMS use. Conclusions Findings from this investigation suggest that children with hearing loss have increased access to caregiver talk when using an RMS in the home environment. Clinical implications and future directions for research are discussed.
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JSLHR
Research Article
Remote Microphone System Use at Home:
Impact on Caregiver Talk
Carlos R. Benítez-Barrera,
a
Gina P. Angley,
a
and Anne Marie Tharpe
a
Purpose: The purpose of this study was to investigate the
effects of home use of a remote microphone system (RMS)
on the spoken language production of caregivers with young
children who have hearing loss.
Method: Language Environment Analysis recorders were
used with 10 families during 2 consecutive weekends
(RMS weekend and No-RMS weekend). The amount of
talk from a single caregiver that could be made accessible
to children with hearing loss when using an RMS was
estimated using Language Environment Analysis software.
The total amount of caregiver talk (close and far talk) was
also compared across both weekends. In addition, caregivers’
perceptions of RMS use were gathered.
Results: Children, with the use of RMSs, could
potentially have access to approximately 42% more
words per day. In addition, although caregivers
produced an equivalent number of words on both
weekends, they tended to talk more from a distance
when using the RMS than when not. Finally, caregivers
reported positive perceived communication benefits of
RMS use.
Conclusions: Findings from this investigation suggest
that children with hearing loss have increased access
to caregiver talk when using an RMS in the home
environment. Clinical implications and future directions
for research are discussed.
Access to linguistic input and social interactions
are essential to the development of children’s
language. There is a positive relationship between
the number of words to which children are exposed and
their subsequent vocabulary (Hart & Risley, 1995). More-
over, children who are exposed to more words have better
processing efficiency than those with less word exposure
(Hurtado, Marchman, & Fernald, 2008). This word learning
process requires access to the acoustic patterns of words,
thus leading to the recognition of conditional probabilities
of phoneme sequences that result in word identification
(Aslin, Saffran, & Newport, 1998).
However, young children with hearing loss might not
have consistent access to this necessary high-quality linguis-
tic input, which is critical for receptive and expressive lan-
guage development (e.g., Hoff & Naigles, 2002; Quittner
et al., 2013). Although multiple factors can affect a child’s
access to linguistic input, it is reasonable to conclude that
compromised exposure to high-quality speech input con-
tributes, at least in part, to the well-known deficits in speech,
language, and vocabulary development in children with
hearing loss (Ching & Dillon, 2013; Geers, Strube, Tobey,
& Moog, 2011; Stelmachowicz, Pittman, Hoover, Lewis,
& Moeller, 2004; Tomblin, Oleson, Ambrose, Walker, &
Moeller, 2014). Well-fit hearing aids that are worn consis-
tently (> 10 hours a day), thus providing enhanced audi-
bility, have been shown to help ameliorate some of these
language deficits (Tomblin et al., 2015).
It is widely recognized that listening in the presence
of background noise is challenging for children with hearing
loss (e.g., Crandell, 1993; Stickney, Zeng, Litovsky, &
Assmann, 2004), thereby potentially limiting acoustic access
to desired speech. Despite the use of well-fit hearing aids,
a signal-to-noise ratio (SNR) of at least +15 dB is neces-
sary for optimum speech perception by children with hear-
ing loss (American National Standards Institute/Acoustical
Society of America, 2010). Numerous hearing technologies
have been recommended to improve the ability of children
to hear in adverse listening conditions by enhancing the
SNR, including different microphone types (e.g., fixed direc-
tional, fully adaptive directional), and various signal pro-
cessing approaches (e.g., digital noise reduction). However,
the most effective technology for this purpose used with
a
Department of Hearing and Speech Sciences, Vanderbilt University
School of Medicine, Nashville, TN
Correspondence to Carlos R. Benitez-Barrera:
carlos.r.benitez@vanderbilt.edu
Editor-in-Chief: Frederick (Erick) Gallun
Editor: Steve Aiken
Received May 3, 2017
Revision received August 20, 2017
Accepted September 15, 2017
https://doi.org/10.1044/2017_JSLHR-H-17-0168
Disclosure: This article was funded by Phonak, who provided equipment for use in
this study.
Journal of Speech, Language, and Hearing Research •Vol. 61 •399–409 •February 2018 •Copyright © 2018 American Speech-Language-Hearing Association 399
... An alternative approach is the use of remote microphone systems (RMSs) to reduce extraneous noise and bring the parent's voice into the hearing bubble even when at a distance. A study using Language Environment Analysis Software (LENA) showed that with the use of RMS, children could have access to approximately 42% more words per day (Benitez-Barrera et al., 2018), and the amount of child-directed speech increases with use of RMS (Benitez- Barrera et al., 2019). In addition, caregivers reported positive perceived communication benefits of RMS, and they tended to talk more from a distance when using the RMS (Benitez- Barrera et al., 2018). ...
... A study using Language Environment Analysis Software (LENA) showed that with the use of RMS, children could have access to approximately 42% more words per day (Benitez-Barrera et al., 2018), and the amount of child-directed speech increases with use of RMS (Benitez- Barrera et al., 2019). In addition, caregivers reported positive perceived communication benefits of RMS, and they tended to talk more from a distance when using the RMS (Benitez- Barrera et al., 2018). Remote microphone technologies are especially beneficial once children are in daycare, preschool or elementary school, and can provide substantial benefits for children with slight-mild hearing loss. ...
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... This creates the impression that the microphone wearer is speaking directly into the ear, which results in a significantly improved SNR. Benítez- Barrera et al. (2018) demonstrated that children using an RMS at home have access to approximately 42% more words throughout the day when using the RMS compared to when they do not use it. They conducted this study by comparing the word count recorded by a LENA device worn by caregivers to the word count recorded by a LENA worn by children with HL. ...
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View
... This creates the impression that the microphone wearer is speaking directly into the ear, which results in a significantly improved SNR. Benítez- Barrera et al. (2018) demonstrated that children using an RMS at home have access to approximately 42% more words throughout the day when using the RMS compared to when they do not use it. They conducted this study by comparing the word count recorded by a LENA device worn by caregivers to the word count recorded by a LENA worn by children with HL. ...
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Article
  • Sep 2015
Objectives: The primary objective of this study was to examine the quantity and quality of caregiver talk directed to children who are hard of hearing (CHH) compared with children with normal hearing (CNH). For the CHH only, the study explored how caregiver input changed as a function of child age (18 months versus 3 years), which child and family factors contributed to variance in caregiver linguistic input at 18 months and 3 years, and how caregiver talk at 18 months related to child language outcomes at 3 years. Design: Participants were 59 CNH and 156 children with bilateral, mild-to-severe hearing loss. When children were approximately 18 months and/or 3 years of age, caregivers and children participated in a 5-min semistructured, conversational interaction. Interactions were transcribed and coded for two features of caregiver input representing quantity (number of total utterances and number of total words) and four features representing quality (number of different words, mean length of utterance in morphemes, proportion of utterances that were high level, and proportion of utterances that were directing). In addition, at the 18-month visit, parents completed a standardized questionnaire regarding their child's communication development. At the 3-year visit, a clinician administered a standardized language measure. Results: At the 18-month visit, the CHH were exposed to a greater proportion of directing utterances than the CNH. At the 3-year visit, there were significant differences between the CNH and CHH for number of total words and all four of the quality variables, with the CHH being exposed to fewer words and lower quality input. Caregivers generally provided higher quality input to CHH at the 3-year visit compared with the 18-month visit. At the 18-month visit, quantity variables, but not quality variables, were related to several child and family factors. At the 3-year visit, the variable most strongly related to caregiver input was child language. Longitudinal analyses indicated that quality, but not quantity, of caregiver linguistic input at 18 months was related to child language abilities at 3 years, with directing utterances accounting for significant unique variance in child language outcomes. Conclusions: Although caregivers of CHH increased their use of quality features of linguistic input over time, the differences when compared with CNH suggest that some caregivers may need additional support to provide their children with optimal language learning environments. This is particularly important given the relationships that were identified between quality features of caregivers' linguistic input and children's language abilities. Family supports should include a focus on developing a style that is conversational eliciting as opposed to directive.
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Frequency Modulation for Preschoolers with Hearing Loss
Article
  • Jul 2014
The aim of this research was to evaluate and explore the benefits of frequency-modulated (FM) technology with preschool children with hearing aids. The research was of a longitudinal prospective design, including both quantitative and qualitative analysis. This article will focus on the quantitative results only. Daily diaries, data-logging, and questionnaires were used to collect quantitative data. Five of the seven families were able to establish regular FM use in a range of environments and settings with the most frequent being at home, in the car, at the nursery, during shopping, and when outdoors. Situational analysis of FM use was established and compared over time using the FM Listening Evaluation for Children questionnaire. Improvements in listening in noise, auditory only, and distance were identified over time. The Language Developmental Snapshot was used to monitor language development over the duration of the study. Results indicated that children who were at risk at the start of the study were within normal levels or close by the end of the study. The current study provides a unique contribution to the existing literature and together with future research can be integral to the provision of FM/remote microphone technology as standard for preschool children with hearing aids.
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The Influence of Hearing Aids on the Speech and Language Development of Children With Hearing Loss
Article
  • Apr 2014
Importance Hearing loss (HL) in children can be deleterious to their speech and language development. The standard of practice has been early provision of hearing aids (HAs) to moderate these effects; however, there have been few empirical studies evaluating the effectiveness of this practice on speech and language development among children with mild-to-severe HL.Objective To investigate the contributions of aided hearing and duration of HA use to speech and language outcomes in children with mild-to-severe HL.Design, Setting, and Participants An observational cross-sectional design was used to examine the association of aided hearing levels and length of HA use with levels of speech and language outcomes. One hundred eighty 3- and 5-year-old children with HL were recruited through records of Universal Newborn Hearing Screening and referrals from clinical service providers in the general community in 6 US states.Interventions All but 4 children had been fitted with HAs, and measures of aided hearing and the duration of HA use were obtained.Main Outcomes and Measures Standardized measures of speech and language ability were obtained.Results Measures of the gain in hearing ability for speech provided by the HA were significantly correlated with levels of speech (ρ179 = 0.20; P = .008) and language: ρ155 = 0.21; P = .01) ability. These correlations were indicative of modest levels of association between aided hearing and speech and language outcomes. These benefits were found for children with mild and moderate-to-severe HL. In addition, the amount of benefit from aided hearing interacted with the duration of HA experience (Speech: F4,161 = 4.98; P < .001; Language: F4,138 = 2.91; P < .02). Longer duration of HA experience was most beneficial for children who had the best aided hearing. Conclusions and Relevance The degree of improved hearing provided by HAs was associated with better speech and language development in children. In addition, the duration of HA experience interacted with the aided hearing to influence outcomes. These results provide support for the provision of well-fitted HAs to children with HL. In particular, the findings support early HA fitting and HA provision to children with mild HL.
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Can 18-Month-Old Infants Learn Words by Listening In on Conversations?
Article
  • May 2006
Previous research has shown that children as young as 2 can learn words from 3rd-party conversations (Akhtar, Jipson, & Callanan, 2001). The focus of this study was to determine whether younger infants could learn a new word through overhearing. Novel object labels were introduced to 18-month-old infants in 1 of 2 conditions: directly by an experimenter or in the context of overhearing the experimenter use the word while interacting with another adult. The findings suggest that, when memory demands are not too high, 18-month-old infants can learn words through overhearing.
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Computation of Conditional Probability Statistics by 8-Month-Old Infants
Article
  • Jul 1998
A recent report demonstrated that 8-month-olds can seg- ment a continuous stream of speech syllables, containing no acoustic or prosodic cues to word boundaries, into wordlike units after only 2 min of listening experience (Saffran, Aslin, & Newport, 1996). Thus, a powerful learning mechanism capable of extracting statistical informa- tion from fluent speech is available early in development. The present study extends these results by documenting the particular type of statis- tical computation—transitional (conditional) probability—used by infants to solve this word-segmentation task. An artificial language corpus, consisting of a continuous stream of trisyllabic nonsense words, was presented to 8-month-olds for 3 min. A postfamiliarization test compared the infants' responses to words versus part-words (tri- syllabic sequences spanning word boundaries). The corpus was con- structed so that test words and part-words were matched in frequency, but differed in their transitional probabilities. Infants showed reliable discrimination of words from part-words, thereby demonstrating rapid segmentation of continuous speech into words on the basis of transi- tional probabilities of syllable pairs.
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