Speech

Modernising Children’s Hearing Aid Services

Speech TestingSpeech Testing

Wave 4 EJB 17/05/04


Speech testsSpeech tests

To inform on quality of hearing aid fittingTo inform on quality of hearing aid fittingTradition of neglectTradition of neglect

Falls between audiology and habilitationParticularly in Pre School HA User

Used more by CI teamsUsed more by CI teams


DetectionDetectionDiscrimination Discrimination Word recognitionWord recognitionSpeech understandingSpeech understanding

Areas of InterestAreas of Interest


One example is the Ling 5 (or 6!!) sounds One example is the Ling 5 (or 6!!) sounds

oo - ah - ee - (mm) - sh – ssoo - ah - ee - (mm) - sh – ssGives information across the speech Gives information across the speech

frequency rangefrequency rangeAuditory Speech Sound Evaluation (ASSE)Auditory Speech Sound Evaluation (ASSE)

Sound DetectionSound Detection


These tests should provide information useful These tests should provide information useful for hearing aid fitting and possibly fine tuningfor hearing aid fitting and possibly fine tuning

But no research to suggest exactly how But no research to suggest exactly how fittings might be altered by speech test fittings might be altered by speech test scoresscores

Examples (Closed set tests)Examples (Closed set tests) McCormick Automated Toy Test CCT (Consonant Cluster Task) Maltby Speech Perception Test Manchester Picture Test FAAF

Sound DiscriminationSound Discrimination


ExamplesExamples

Open set word testsOpen set word testsManchester Junior wordsManchester Junior wordsCambridge junior wordsCambridge junior wordsAB word listsAB word lists

Word RecognitionWord Recognition


ExamplesExamplesSentence TestsSentence TestsBKB sentence listsBKB sentence lists

?Familiarity

Speech UnderstandingSpeech Understanding


First wave evaluation study 3 (mild-moderate-First wave evaluation study 3 (mild-moderate-severe, age 7-15) used severe, age 7-15) used FAAFFAAF ( (Four Alternative Four Alternative Auditory FeatureAuditory Feature Test developed by Haggard Test developed by Haggard and Foster 1987)and Foster 1987)

In study 7 (severe/profoundly deaf group) if In study 7 (severe/profoundly deaf group) if child was unable to perform on FAAF at above child was unable to perform on FAAF at above chance levels, The chance levels, The CCT CCT ((Consonant Cluster Consonant Cluster Task further Task further developed by Marriage) was used. developed by Marriage) was used.

““Standardised” test conditions through a Standardised” test conditions through a calibrated system were importantcalibrated system were important

First Wave EvaluationFirst Wave Evaluation


Difference between analogue and DSP p>0.0001


Speech Testing IssuesSpeech Testing Issues

AcclimatisationAcclimatisation Familiarity of materialFamiliarity of material Degree of Hearing Loss (esp Severe/Profound)Degree of Hearing Loss (esp Severe/Profound) Uses – Counselling ?Uses – Counselling ? Uses - Fine tuning ? Uses - Fine tuning ? Uses – Changes to HA Provision ?Uses – Changes to HA Provision ? Further work required (esp Pre School)Further work required (esp Pre School) Calibration/Test ParametersCalibration/Test Parameters First wave – ambivalentFirst wave – ambivalent


Auditory Speech Sound EvaluationAuditory Speech Sound Evaluation(ASSE) Test(ASSE) Test


Govaerts PJ, Belgium www.deoorgroep.netBelgium www.deoorgroep.net

ASSE is a set of supraliminal auditory tests

Test children with no or very limited speech

Part of Paediatric Auditory Performance Test

A speech and language independent test to measure the supraliminal auditory capacity

All sounds that are used are balanced speech sounds common in many languages

Auditory Speech Sound EvaluationAuditory Speech Sound Evaluation


Consonant Cluster Task (CCT) Consonant Cluster Task (CCT) TestTest

(Demo)(Demo)


Further developed by Marriage Further developed by Marriage The test involves 4 alternative monosyllabic The test involves 4 alternative monosyllabic

real words represented by pictures. They real words represented by pictures. They have the same vowel but different consonants have the same vowel but different consonants e.g. “hen, peg, bed, egg”e.g. “hen, peg, bed, egg”

There are 9 blocks of 6 presentationsThere are 9 blocks of 6 presentations The test can be given in quiet or competing The test can be given in quiet or competing

noise conditions, and input level can be noise conditions, and input level can be changed.changed.

There were no significant differences using There were no significant differences using this or FAAF in Study 7, the children did score this or FAAF in Study 7, the children did score better on the DSP hearing aids, but numbers better on the DSP hearing aids, but numbers were small so not significant.were small so not significant.

Consonant Cluster Task (CCT)Consonant Cluster Task (CCT)


CCT ApplicationCCT Application Closed Set, 4 Alternative Picture Based TestClosed Set, 4 Alternative Picture Based Test

Familiar Material from Reed TestFamiliar Material from Reed Test

Nonsense/Non Words excludedNonsense/Non Words excluded

All 4 items have same vowel soundAll 4 items have same vowel sound

E.g. “Owl”, “House”, “Cow”, “Mouse”E.g. “Owl”, “House”, “Cow”, “Mouse”

Easier contrasts than APT1Easier contrasts than APT1

CCT from ? age 3 yearsCCT from ? age 3 years


CCT PresentationCCT Presentation Level should avoid floor (score < 25%) or ceiling (score > Level should avoid floor (score < 25%) or ceiling (score >

95%) effects95%) effects

Performance/intensity function may be steepPerformance/intensity function may be steep

Useful to test at conversation (e.g. 65 dB) quiet (e.g. 50 Useful to test at conversation (e.g. 65 dB) quiet (e.g. 50 dB) and loud (e.g. 80 dB) levelsdB) and loud (e.g. 80 dB) levels

Pre-recorded better than live presentation for comparison Pre-recorded better than live presentation for comparison (? not viable for young children)(? not viable for young children)

Can be presented in speech shaped noise at an Can be presented in speech shaped noise at an appropriate speech/noise ratioappropriate speech/noise ratio


CCT Test ProcedureCCT Test Procedure CD Player & 2 Channel Audiometer + LoudspeakerCD Player & 2 Channel Audiometer + Loudspeaker

Speech Channel 1 & Noise Channel 2

Calibrate using Track 1

Picture Card 1- familiarise with live voicePicture Card 1- familiarise with live voice

Start CDStart CD

Each Picture Card

6 presentation each picture card

Score on confusion matrix score sheet


CCT InterpretationCCT Interpretation

Total number of correct responsesTotal number of correct responses

Observation of errors in confusion matrixObservation of errors in confusion matrix

Assess difficulty child has discriminationAssess difficulty child has discrimination


APT1 ApplicationAPT1 Application

Closed Set, 4 Alternative Picture Based TestClosed Set, 4 Alternative Picture Based Test

All 4 items have same vowel soundAll 4 items have same vowel sound

E.g. “Boat”, “Coat”, “Goat”, “Note”E.g. “Boat”, “Coat”, “Goat”, “Note”

More difficult contrasts than CCTMore difficult contrasts than CCT

2 Sets Vowel & 8 Consonant confusion contrast2 Sets Vowel & 8 Consonant confusion contrast

APT1 from ? age 5 yearsAPT1 from ? age 5 years


Four Alternative Auditory Feature Four Alternative Auditory Feature (FAAF) Test(FAAF) Test

(Demo & Practical)(Demo & Practical)


FAAF TestFAAF Test A speech in noise test to measure speech intelligibility, A speech in noise test to measure speech intelligibility,

and benefit from a hearing aid.and benefit from a hearing aid.

Different speech levels and speech:noise ratios Different speech levels and speech:noise ratios

The test is presented in a sound field room, from a The test is presented in a sound field room, from a loudspeaker 1.5m in front of the patient. loudspeaker 1.5m in front of the patient.

The test can be carried out unaided in two interleaved The test can be carried out unaided in two interleaved conditions, and aided in four interleaved conditions.conditions, and aided in four interleaved conditions.

Responses can be via a touch screenResponses can be via a touch screen


FAAF EquipmentFAAF Equipment FAAF Software (available from IHR)

Laptop computer

Compatible Sound Card (internal or USB)

Suitable loudspeaker (and external amplifier)

Child-friendly mouse or...

Touch Screen hardware/software (e.g. KeyTech ca £150)


FAAF ParametersFAAF Parameters

Parameters for test can be changed

May reduce test time

Exercise caution

Effect of noise reduction systems on DSP aids


[Feedback] Flashes=0 Flash_Time=100 Flash_Colour=50,100,50 [Sound_Output] Presentation=Speakers Noise_file_1=c:\faaf\waves\faafspn.wav Noise_file_2=c:\faaf\waves\faafspn.wav hardware_switch=off Max_Speech_Level=80 Max_Noise_Level=100 Ramp_time=100 Pre_stimulus_noise_time=200 Post_stimulus_noise_time=100

FAAF ParametersFAAF Parameters

Can edit .ini file in program directory

“4” is default, “0” will mean no feedback for incorrect answer (shorten test, less “negative” for child)

Time (ms) that noise is on before speech (default is 500)


FAAF Suggested InstructionsFAAF Suggested Instructions Four words will appear on the screen

You will hear “Can you hear X clearly?” where X is a simple word

Touch / use the mouse to indicate the word you think you heard

This will be repeated but with a different word

If you are not sure, try and choose the word you think was said

There will be noise in the background most of the time, try to ignore it

“Touch here to continue” will appear after each set of 4 sentences

When you see this, it means that the speech and/or noise will get quieter or louder so be prepared for this

This isn’t a “test” and it can be difficult even for someone with good hearing


Typical FAAF ScreenTypical FAAF Screen Grey item is child’s response Green item is correct answer


FAAF Aided TestFAAF Aided Test

This test contains 80 sentences

20 Sentences in each condition

Condition 1 S:N=+10 S=60 N=50




Note scores on test form / PMS


name: ed Patient number: a Date: Sat Dec 13 11:27:21 2003 ---------------------------------------------------------------------- 1. Aided FAAF in noise test using "acdtest.ini" on Sat Dec 13 11:30:29 2003 1,bang,bad,bag,ban,3,3,1,1,60,50,2,2 2,lad,land,lands,lads,3,3,1,1,60,50,2,2 3,how,hang,ham,high,2,2,1,1,60,50,2,2 ... 19,cab,tab,dab,gab,1,1,1,1,60,50,2,2 20,bag,back,bat,bad,3,3,1,1,60,50,2,2

FAAF Typical Data Log FileFAAF Typical Data Log File Summarise test parameters (.ini file) usedRecords test items,levels,responses for each presentation

Documents

Speech