Speech-recognition tests are widely used in both clinical and research audiology. The purpose of this study was the development of a novel speech-recognition test that combines concepts of different speech-recognition tests to reduce training effects and allows for a large set of speech material. The new test consists of four different words per trial in a meaningful construct with a fixed structure, the so-called phrases. Various free databases were used to select the words and to determine their frequency. Highly frequent nouns were grouped into thematic categories and combined with related adjectives and infinitives. After discarding inappropriate and unnatural combinations, and eliminating duplications of (sub-)phrases, a total number of 772 phrases remained. Subsequently, the phrases were synthesized using a text-to-speech system. The synthesis significantly reduces the effort compared to recordings with a real speaker. After excluding outliers, measured speech-recognition scores for the phrases with 31 normal-hearing participants at fixed signal-to-noise ratios (SNR) revealed speech-recognition thresholds (SRT) for each phrase varying up to 4 dB. The median SRT was -9.1 dB SNR and thus comparable to existing sentence tests. The psychometric function\'s slope of 15 percentage points per dB is also comparable and enables efficient use in audiology. Summarizing, the principle of creating speech material in a modular system has many potential applications.

OBJECTIVE: To propose an instrument for assessing speech recognition in the presence of competing noise. To define its application strategy for use in clinical practice. To obtain evidence of criterion validity and present reference values.
METHODS: The study was conducted in three stages: Organization of the material comprising the Word-with-Noise Test (Stage 1); Definition of the instrument\'s application strategy (Stage 2); Investigation of criterion validity and definition of reference values for the test (Stage 3) through the evaluation of 50 normal-hearing adult subjects and 12 subjects with hearing loss.
RESULTS: The Word-with-Noise Test consists of lists of monosyllabic and disyllabic words and speech spectrum noise (Stage 1). The application strategy for the test was defined as the determination of the Speech Recognition Threshold with a fixed noise level at 55 dBHL (Stage 2). Regarding criterion validity, the instrument demonstrated adequate ability to distinguish between normal-hearing subjects and subjects with hearing loss (Stage 3). Reference values for the test were established as cut-off points expressed in terms of signal-to-noise ratio: 1.47 dB for the monosyllabic stimulus and -2.02 dB for the disyllabic stimulus. Conclusion: The Word-with-Noise Test proved to be quick to administer and interpret, making it a useful tool in audiological clinical practice. Furthermore, it showed satisfactory evidence of criterion validity, with established reference values.
OBJECTIVE: Propor um instrumento para a avaliação do reconhecimento de fala na presença de ruído competitivo. Definir sua estratégia de aplicação, para ser aplicado na rotina clínica. Obter evidências de validade de critério e apresentar seus valores de referência.
UNASSIGNED: Estudo realizado em três etapas: Organização do material que compôs o Teste de Palavras no Ruído (Etapa 1); Definição da estratégia de aplicação do instrumento (Etapa 2); Investigação da validade de critério e definição dos valores de referência para o teste (Etapa 3), por meio da avaliação de 50 sujeitos adultos normo-ouvintes e 12 sujeitos com perda auditiva.
RESULTS: O Teste de Palavras no Ruído é composto por listas de vocábulos mono e dissilábicos e um ruído com espectro de fala (Etapa 1). Foi definida como estratégia de aplicação do teste, a realização do Limiar de Reconhecimento de Fala com ruído fixo em 55 dBNA (Etapa 2). Quanto à validade de critério, o instrumento apresentou adequada capacidade de distinção entre os sujeitos normo-ouvintes e os sujeitos com perda auditiva (Etapa 3). Foram definidos como valores de referência para o teste, os pontos de corte expressos em relação sinal/ruído de 1,47 dB para o estímulo monossilábico e de -2,02 dB para o dissilábico.
UNASSIGNED: O Teste de Palavras no Ruído demonstrou ser rápido e de fácil aplicação e interpretação dos resultados, podendo ser uma ferramenta útil a ser utilizada na rotina clínica audiológica. Além disso, apresentou evidências satisfatórias de validade de critério, com valores de referência estabelecidos.

UNASSIGNED: The speech reception threshold (SRT), synonymous with the speech recognition threshold, denotes the minimum hearing level required for an individual to discern 50% of presented speech material. This threshold is measured independently in each ear with a repetitive up-down adjustment of stimulus level starting from the initial SRT value derived from pure tone thresholds (PTTs), measured via pure-tone audiometry (PTA). However, repetitive adjustments in the test contributes to increased fatigue for both patients and audiologists, compromising the reliability of the hearing tests.
UNASSIGNED: Determining the first (initial) sound level closer to the finally determined SRT value, is important to reduce the number of repetitions. The existing method to determine the initial sound level is to average the PTTs called pure tone average (PTAv).
UNASSIGNED: We propose a novel method using a machine learning approach to estimate a more optimal initial sound level for the SRT test. Specifically, a convolutional neural network with 1-dimensional filters (1D CNN) was implemented to predict a superior initial level than the conventional methods.
UNASSIGNED: Our approach produced a reduction of 37.92% in the difference between the initial stimulus level and the final SRT value.
UNASSIGNED: This outcome substantiates that our approach can reduce the repetitions for finding the final SRT, and, as the result, the hearing test time can be reduced.

This study aimed to preliminarily investigate the associations between performance on the integrated Digit-in-Noise Test (iDIN) and performance on measures of general cognition and working memory (WM). The study recruited 81 older adult hearing aid users between 60 and 95 years of age with bilateral moderate to severe hearing loss. The Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) was used to screen older adults for mild cognitive impairment. Speech reception thresholds (SRTs) were measured using 2- to 5-digit sequences of the Mandarin iDIN. The differences in SRT between five-digit and two-digit sequences (SRT5-2), and between five-digit and three-digit sequences (SRT5-3), were used as indicators of memory performance. The results were compared to those from the Digit Span Test and Corsi Blocks Tapping Test, which evaluate WM and attention capacity. SRT5-2 and SRT5-3 demonstrated significant correlations with the three cognitive function tests (rs ranging from -.705 to -.528). Furthermore, SRT5-2 and SRT5-3 were significantly higher in participants who failed the MoCA-BC screening compared to those who passed. The findings show associations between performance on the iDIN and performance on memory tests. However, further validation and exploration are needed to fully establish its effectiveness and efficacy.

OBJECTIVE: Early detection and effective management of hearing loss constitute the key to improving the quality of life of individuals with hearing loss. However, in standardized pure tone audiometry, it is sometimes difficult for elderly patients to understand and follow all instructions. Audiologists also require time, expertise, and patience to ensure that an elderly can identify the faintest levels of stimuli during a hearing test. Therefore, this study aimed to devise and validate a formula to predict the pure tone threshold at each frequency across 0.5-4 kHz (PTTs) using speech reception threshold.
METHODS: The 1226 audiograms of hearing-impaired individuals aged 60-90 years were reviewed. The random sample function randomly assigned 613 participants to the training and testing sets each. A linear model was created to predict the PTT value at each frequency based on variables significant at all frequencies across 0.5-4 kHz. The adjusted-R2 value was considered to indicate the performance of the predictive model. Pearson\'s correlation coefficient was used to describe the relationship between the actual and predicted PTT at 0.5, 1, 2, and 4 kHz among the testing set to measure the performance of the proposed model.
RESULTS: The predictive model was devised using variables based on the speech recognition threshold (SRT) after adjusting with age in the training set. The overall prediction accuracy demonstrated a higher adjusted-R2 ranging from 0.74 to 0.89 at frequencies of 0.5, 1, and 2 kHz, whereas a low percentage of explained variance was observed at 4 kHz (adjusted-R2 = 0.41). This predictive model can serve as an adjunctive clinical tool for guiding determination of the PTTs. Moreover, the predicted PTTs can be applied in the hearing aid programming software to set appropriate hearing aid gain using standard prescriptive formulas.

BACKGROUND: Binaural hearing enables better speech comprehension in noisy environments and is necessary for acoustic spatial orientation. This study investigates speech discrimination in noise with separated signal sources and measures sound localization. The aim was to study characteristics and reproducibility of two selected measurement techniques which seem to be suitable for description of the aforementioned aspects of binaural hearing.
METHODS: Speech reception thresholds (SRT) in noise and test-retest reliability were collected from 55 normal-hearing adults for a spatial setup of loudspeakers with angles of ± 45° and ± 90° using the Oldenburg sentence test. The investigations of sound localization were conducted in a semicircle and fullcircle setup (7 and 12 equidistant loudspeakers).
RESULTS: SRT (S-45N45: -14.1 dB SNR; S45N-45: -16.4 dB SNR; S0N90: -13.1 dB SNR; S0N-90: -13.4 dB SNR) and test-retest reliability (4 to 6 dB SNR) were collected for speech intelligibility in noise with separated signals. The procedural learning effect for this setup could only be mitigated with 120 training sentences. Significantly smaller SRT values, resulting in better speech discrimination, were found for the test situation of the right compared to the left ear. RMS values could be gathered for sound localization in the semicircle (1,9°) as well as in the fullcircle setup (11,1°). Better results were obtained in the retest of the fullcircle setup.
CONCLUSIONS: When using the Oldenburg sentence test in noise with spatially separated signals, it is mandatory to perform a training session of 120 sentences in order to minimize the procedural learning effect. Ear-specific SRT values for speech discrimination in noise with separated signal sources are required, which is probably due to the right-ear advantage. A training is recommended for sound localization in the fullcircle setup.
UNASSIGNED: HINTERGRUND: Binaurales Hören ermöglicht das bessere Sprachverstehen in geräuschvollen Umgebungen und stellt eine Voraussetzung für die akustische Raumorientierung dar. Deshalb soll im Rahmen dieser Studie das Sprachverstehen im Störschall bei separierten Signalquellen und das Richtungshören untersucht werden. Ziel war es dabei, Kennwerte und Reproduzierbarkeiten für zwei ausgewählte Testverfahren, welche für die Beschreibung der beiden genannten Aspekte des binauralen Hörens als geeignet scheinen, zu erheben.
METHODS: Bei 55 normalhörenden Erwachsenen wurden die Sprachverständlichkeitsschwellen im Störschall („speech reception thresholds“ [SRT]) und die Test-Retest-Reliabilität bei räumlich getrennten Signalquellen im 45°- und 90°-Winkel für den Oldenburger Satztest erhoben. Die Untersuchung des Richtungshörens erfolgte für den Halb- und Vollkreis (7 und 12 äquidistante Lautsprecher).
UNASSIGNED: Es wurden SRT (S−45N45: −14,1 dB SNR, S45N−45: −16,4 dB SNR, S0N90: −13,1 dB SNR, S0N−90: −13,4 dB SNR) und die Test-Retest-Reliabilität (4 bis 6 dB SNR) für das Sprachverstehen im Störschall bei separierten Schallquellen erhoben. Der prozedurale Lerneffekt konnte erst bei Einsatz von 120 Trainingssätzen minimiert werden. Es wurde eine signifikant niedrigere SRT für die Prüfsituation des rechten Ohrs im Vergleich zum linken ermittelt. Für das Richtungshören im Halbkreis konnten RMS-Werte von (1,9°) und für den Vollkreis von (11,1°) erhoben werden. Hierbei zeigten sich in der Wiederholungsmessung des Vollkreises bessere Ergebnisse.
UNASSIGNED: Beim Einsatz des Oldenburger Satztests im Störschall mit separierten Signalquellen besteht die Notwendigkeit eines ausgedehnten Trainings mit mehr als 120 Sätzen, um den prozeduralen Lerneffekt zu minimieren. Es sind seitenspezifische SRT-Werte erforderlich, welche vermutlich durch den Right-Ear-Advantage-Effekt bedingt sind. Für die Durchführung des Richtungshörens im Vollkreis wird ein Training empfohlen.

A practical speech audiometry tool is the digits-in-noise (DIN) test for hearing screening of populations of varying ages and hearing status. The test is usually conducted by a human supervisor (e.g., clinician), who scores the responses spoken by the listener, or online, where software scores the responses entered by the listener. The test has 24-digit triplets presented in an adaptive staircase procedure, resulting in a speech reception threshold (SRT). We propose an alternative automated DIN test setup that can evaluate spoken responses whilst conducted without a human supervisor, using the open-source automatic speech recognition toolkit, Kaldi-NL. Thirty self-reported normal-hearing Dutch adults (19-64 years) completed one DIN + Kaldi-NL test. Their spoken responses were recorded and used for evaluating the transcript of decoded responses by Kaldi-NL. Study 1 evaluated the Kaldi-NL performance through its word error rate (WER), percentage of summed decoding errors regarding only digits found in the transcript compared to the total number of digits present in the spoken responses. Average WER across participants was 5.0% (range 0-48%, SD = 8.8%), with average decoding errors in three triplets per participant. Study 2 analyzed the effect that triplets with decoding errors from Kaldi-NL had on the DIN test output (SRT), using bootstrapping simulations. Previous research indicated 0.70 dB as the typical within-subject SRT variability for normal-hearing adults. Study 2 showed that up to four triplets with decoding errors produce SRT variations within this range, suggesting that our proposed setup could be feasible for clinical applications.

OBJECTIVE: The Children\'s English and Spanish Speech Recognition (ChEgSS) test is a computer-based tool for assessing closed-set word recognition in English and in Spanish, with a masker that is either speech-shaped noise or competing speech. The present study was conducted to (1) characterize the psychometric properties of the ChEgSS test, (2) evaluate feasibility and reliability for a large cohort of Spanish/English bilingual children with normal hearing, and (3) establish normative data.
METHODS: Three experiments were conducted to evaluate speech perception in children (4-17 years) and adults (19-40 years) with normal hearing using the ChEgSS test. In Experiment 1, data were collected from Spanish/English bilingual and English monolingual adults at multiple, fixed signal-to-noise ratios. Psychometric functions were fitted to the word-level data to characterize variability across target words in each language and in each masker condition. In Experiment 2, Spanish/English bilingual adults were tested using an adaptive tracking procedure to evaluate the influence of different target-word normalization approaches on the reliability of estimates of masked-speech recognition thresholds corresponding to 70.7% correct word recognition and to determine the optimal number of reversals needed to obtain reliable estimates. In Experiment 3, Spanish/English bilingual and English monolingual children completed speech perception testing using the ChEgSS test to (1) characterize feasibility across age and language group, (2) evaluate test-retest reliability, and (3) establish normative data.
RESULTS: Experiments 1 and 2 yielded data that are essential for stimulus normalization, optimizing threshold estimation procedures, and interpreting threshold data across test language and masker type. Findings obtained from Spanish/English bilingual and English monolingual children with normal hearing in Experiment 3 support feasibility and demonstrate reliability for use with children as young as 4 years of age. Equivalent results for testing in English and Spanish were observed for Spanish/English bilingual children, contingent on adequate proficiency in the target language. Regression-based threshold norms were established for Spanish/English bilingual and English monolingual children between 4 and 17 years of age.
CONCLUSIONS: The present findings indicate the ChEgSS test is appropriate for testing a wide age range of children with normal hearing in either Spanish, English, or both languages. The ChEgSS test is currently being evaluated in a large cohort of patients with hearing loss at pediatric audiology clinics across the United States. Results will be compared with normative data established in the present study and with established clinical measures used to evaluate English- and Spanish-speaking children. Questionnaire data from parents and clinician feedback will be used to further improve test procedures.

Noise-induced hearing loss interacts with age, sex, and listening conditions to affect individuals\' perception of ecologically relevant stimuli like speech. The present experiments assessed the impact of age and sex on vocalization detection by noise-exposed mice trained to detect a downsweep or complex ultrasonic vocalization in quiet or in the presence of a noise background. Daily thresholds before and following intense noise exposure were collected longitudinally and compared across several factors. All mice, regardless of age, sex, listening condition, or stimulus type showed their poorest behavioral sensitivity immediately after the noise exposure. There were varying degrees of recovery over time and across factors. Old-aged mice had greater threshold shifts and less recovery compared to middle-aged mice. Mice had larger threshold shifts and less recovery for downsweeps than for complex vocalizations. Female mice were more sensitive, had smaller post-noise shifts, and had better recovery than males. Thresholds in noise were higher and less variable than thresholds in quiet, but there were comparable shifts and recovery. In mice, as in humans, the perception of ecologically relevant stimuli suffers after an intense noise exposure, and results differ from simple tone detection findings.

OBJECTIVE: The Oldenburg Sentence Test (OLSA) is a German matrix test designed to determine speech recognition thresholds (SRT). It is widely used for hearing-aids and cochlear implant fitting, but an age-adjusted standard is still lacking. In addition, knowing that the ability to concentrate is an important factor in OLSA performance, we hypothesized that OLSA performance would depend on the time of day it was administered. The aim of this study was to propose an age standardization for the OLSA and to determine its diurnal performance.
METHODS: The Gutenberg Health Study is an ongoing population-based study and designed as a single-centre observational, prospective cohort study. Participants were interviewed about common otologic symptoms and tested with pure-tone audiometry and OLSA. Two groups-subjects with and without hearing loss-were established. The OLSA was performed in two runs. The SRT was evaluated for each participant. Results were characterized by age in 5-year cohorts, gender and speech recognition threshold (SRT). A time stamp with an hourly interval was also implemented.
RESULTS: The mean OLSA SRT was - 6.9 ± 1.0 dB (group 1 male) and - 7.1 ± 0.8 dB (group 1 female) showing an inverse relationship with age in the whole cohort, whereas a linear increase was observed in those without hearing loss. OLSA-SRT values increased more in males than in females with increasing age. No statistical significance was found for the diurnal performance.
CONCLUSIONS: A study with 2900 evaluable Oldenburg Sentence Tests is a novelty and representative for the population of Mainz and its surroundings. We postulate an age- and gender-standardized scale for the evaluation of the OLSA. In fact, with an intergroup standard deviation (of about 1.5 dB) compared to the age dependence of 0.7 dB/10 years, this age normalization should be considered as clinically relevant.