Measuring Speech Perception
Madell, Jane R., Volta Voices
Put simply, speech perception testing focuses not on if individuals can hear but what they can hear. Speech perception data help audiologists assess children's higher level auditory processing skills and evaluate intervention outcomes to help family members and caregivers manage children's hearing loss. Because evaluating speech perception is the only way to comprehensively assess auditory functioning, it should be included as part of every audiologic evaluation.
Speech perception testing in children can:
* help determine the benefit received from hearing technology such as hearing aids, cochlear implants and FM systems,
* demonstrate improved functioning over time,
* identify problems that develop such as reduced functioning or equipment failure,
* identify specific perception errors that require remediation (such as confusing "mouse" with "mouth"),
* demonstrate habilitation and rehabilitation needs, such as specific listening activities to work on during therapy and
* assist parents and professionals when making educational management decisions such as appropriate classroom placement and which classroom support services are necessary.
Speech Perception Testing
A comprehensive hearing assessment includes an audiological evaluation as well as a technology evaluation, and speech perception is measured in both situations (see "Exploring the Pure Tone Audiogram" on page 10 for more information on pediatric hearing tests and the pure tone audiogram).
Audiologists use speech perception testing to measure a person's auditory abilities and often utilize more than one test to obtain a complete picture (Madell, 2002; Madell and Flexer, 2008; in press). There are a number of different tests to choose from, and test selection should be based on the child's age and language abilities.
When to Measure Speech Perception
Speech perception should be measured when hearing loss is diagnosed, at every re-evaluation, when selecting or changing technology or technology settings, or if a parent, user or hearing health or education professional is concerned about functioning. At the Beth Israel - New York Eye and Ear Cochlear Implant Center, children with hearing loss ages birth to 6 have their functional hearing re-evaluated four times a year. Older children ages 6 to 16 are evaluated twice yearly and adults, annually.
Every hearing evaluation should include speech perception testing. As soon as possible, testing should be accomplished using age- and linguistically appropriate standardized speech perception tests at normal and soft conversational levels, both in quiet and in competing noise (Madell, 2002; Madell and Flexer, 2008; in press). For example, audiologists rely on speech reception tests such as NU-CHIPS (children ages 3 and older) and WIPI (children ages 4 and older), which utilize picture cards representing spondaic words, two-syllable words spoken with equal emphasis on each syllable, to test speech reception in very young children with limited expressive and receptive language skills. Another example is the Ling Six Sound Test, a common test used to assess functional listening skills in both children and adults. Used by hearing health and education professionals as well as parents, the test measures the listener's ability to identify six phonemes.
How to Measure Speech Perception
For prelingual children with hearing loss who, because of their age, cannot undergo standardized tests, speech awareness thresholds may be obtained for low (ba), mid-high (sh) and high (s) frequency stimuli to ensure these children are hearing at a soft enough level across the frequency range.
Speech perception testing in postlingual children can be performed using stimuli such as nonsense syllables, words or sentences. Sentences are the easiest tasks for newer listeners because they can use their knowledge of language to fill in the blanks for sentence parts not heard. …