1.02 - Speech Understanding Flashcards by Jamie Bevill

Individuals “with an impairment in hearing will know that someone is speaking, but the message will be ______ or ______ such that the listener misses many acoustic cues.”

Distorted

Diminished

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“Speech ______ and ______ are affected by the ability to hear and decode the acoustic information in speech. “

Perception

Production

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For children with hearing impairments who are developing speech: “Often this will result in errors in their own ______.”

Speech production

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What is Conversational Fluency?

How smoothly conversation flows

Do you respond quickly and appropriately

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Why would an adult or child with HL experience reduced conversational fluency?

(5)

Not understanding the question

Must pause to figure out what is going on

Conversation dies if you miss a word or a sound

This is even worse in those who are afraid to guess because they might be wrong

This can cause depression and withdraw

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Why is conversational fluency important ?

It shows the consequences of hearing loss

If we can’t have fluent conversation, it effects our relationships

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Why is conversational fluency a beneficial goal and measurement tool for determining the effectiveness of AR intervention?

We may not reach 100%, but we want to move them in that direction

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Is Word/Speech Recognition Testing synonymous w/ word understanding, word or sentence discrimination?

Yes

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Does Word/Speech Recognition Testing help determine success with amplification?

Yes

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Does Word/Speech Recognition Testing help counsel patients by showing them how their speech understanding compares to persons with normal hearing?

Yes

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Does Word/Speech Recognition Testing help compare unaided performance to aided (implants, hearing aids, ALD’s) performance?

Yes

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Does Word/Speech Recognition Testing help assess performance over time? How?

Yes

We can monitor the patient before and after treatments - this lets us know the effectiveness

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Can Word/Speech Recognition Testing help determine the need for auditory training and/or speechreading training?

Yes

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Can Word/Speech Recognition Testing help determines placement in a training curriculum?

Yes

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Can Word/Speech Recognition Testing help demonstrate the benefits of visual information?

Yes

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Can Word/Speech Recognition Testing help show differences due to environment-related listening issues? (Background noise, rapid or degraded speech)

Yes

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Can Word/Speech Recognition Testing be used as an index for appropriateness of educational placement? (Size of class, room, what to put in IEP, etc.)

Yes

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Can Word/Speech Recognition Testing be used to measure outcome/benefit following intervention?

Yes

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What is Audibility?

Detection of overall speech

Discrimination of phonemes

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What is Intelligibility?

Detection of individual phonemes

Identification of phonemes

Discrimination and identification of phoneme combinations (words and sentences)

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If it’s not audible, it’s not ______.

Intelligible

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To be intelligible, it has to be ______.

Above threshold

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Measuring speech recognition provides a prediction of ______.

The limitations caused by the HL

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Speech recognition holds a significant relationship to “______”

Conversational fluency

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How does cochlear processing influence understanding for HI Listeners?

What does the cochlea do with the information that it has received Something like loss of hair cells will affect cochlear processing

How does central auditory processing disorders influence understanding for HI Listeners?

These patients will have difficulty in quiet and in noise | This can only be diagnosed 7 years and up due to heavy language use of testing materials

What are three categories of factors that contribute to Disruptions in Communication?

Speaker/ Message Communication Environment Receiver / Listener

How does the Speaker/Message contribute to Disruptions in Communication?

Conveyance Of The Message (Is the speaker clear?) Message Itself (Can everyone understand vocabulary?_

How does the Communication Environment contribute to Disruptions in Communication?

Auditory or Visual Quiet Or Noisy How can people modify their environment to get the greatest improvement?

How does the Receiver/Listener contribute to Disruptions in Communication? (3)

Hearing Cognition Behavior

What works better in noise: audition, vision, or vision + audition?

Audition + Vision

Does the Variability in Speech Understanding affect Rehabilitation Planning & Clinical Decision Making?

Yes

Does the Variability in Speech Understanding affect Aided Performance & Benefit?

Yes

Do listening devices perfect hearing?

No. They just aid

Can you restore audibility to a dead region of the cochlea? Why or why not?

No You need receptors to transmit the information

Does variability in Speech Understanding affect Oral Speech & Language Learning?

Yes

Does variability in Speech Understanding affect Developmental Potential?

Yes

Does variability in Speech Understanding affect Rate Of Progress?

Yes

Does variability in Speech Understanding affect Degree Of Success?

Yes

What do we need to consider when selecting test materials? | 7

Patient variables Stimulus units Presentation conditions Response format Type of voice Challenges Test battery Approach

What patient variables should we consider when selecting test materials?

Need to use materials that fit the vocabulary of the patient Materials need to be age-appropriate

What stimulus units should we consider when selecting test materials?

Are we using a picture, auditory, auditory + vision

What presentation conditions should we consider when selecting test materials?

In quiet or in noise?

What response format should we consider when selecting test materials?

Open vs. closed set

What type of voice should we consider when selecting test materials? (3)

Live voice Recorded voice Synthesized or altered speech

Why is it important to use a test battery approach?

So that you are not left trying to pick the best of two test results

Do open & closed sets use single words or sentences?

Both

What are some benefits of using live voice?

Some children will only respond to live voice For some elderly patients, we can't slow down the recording enough No equipment is required The tester can vary the rate of presentation

What are some benefits to using recorded voice?

Consistency Standardization lets us know what is definitely client change Test can transfer from one clinic to another with similar results

What are some disadvantages to using live voice?

There is a lack of consistency in... - Vocal Pitch - Intonation - Rate - Clarity

What are some disadvantages to using recorded voice?

You need special equipment

What problem does the learning effect create? How can this be solved?

Performance improves as the patient learns the test items Use equivalent lists of words

What problem does test-retest variability create? How can this be fixed?

Clients' performance varies from day to day Test of two consecutive days

What problem does clinical significance create? How can this be fixed?

Deciding whether two scores are significantly different Use a within-subject statistical procedure

Speech Recognition Testing Should Ideally ______ and ______.

Show how the person performs in natural situations Be independent of confounding variables

What are some confounding variables that might influence Speech Recognition Testing? (4)

Cognitive skills Language skills Reading skills Speech skills

What are some variables that might cause bilingual individuals to perform differently from monolingual speakers?

The age their second language acquired (if this is the test language) Spanish-English bilingual listeners may be more adversely affected by background noise Fewer materials available for non-English-speaking patients

Does the frequency perception of normal ear extend beyond audiometric test frequencies?

Yes

What is the frequency perception of the normal ear?

20 Hz -20,000 Hz!

When might we test the higher frequency ranges for patients? Why?

When they are taking something ototoxic like chemotheraputic drugs To hopefully prevent high frequency HL before it effects speech comprehension

Why do we select 250-8000 Hz for audiometry?

Speech sounds range from 100-8000 Hz

What are the key frequencies for speech intelligibility? What percent of speech is in this range?

1000-2500 Hz (especially 2000 Hz) Contributes 95% of speech intelligibility

What percent of does loudness play into speech intelligibility? Where does the least amount of energy occur?

Contributes only 5% to the power of speech (loudness) Least amount of energy occurs above 1000Hz

What is the intensity range of a normal ear?

~0 – 140dB SPL

What is 0 dB

Average threshold of hearing for normal adults

The normal ear is capable of discriminating ______ in ______.

Minor differences Sound characteristics

What is the Intensity of Speech?

Typical overall loudness levels of speech at a distance of 1 meter (3 feet)

What is a “Soft Conversational Level”?

~25-30 dB HL | 45-50 dB SPL

What is a “Normal Conversational Level”?

~40-50 dB HL | 60-70 dB SPL

What is a “Loud Conversational Level”?

~60-65 dB HL | 80-85 dB SPL

There is a range of ______ from soft to loud connected speech

40 dB

SPL drops ______ with each doubling of distance.

6 dB

______ affects the hearing impaired.

Distance from the speaker

______ is used in the real world. ______ used for hearing testing.

dB SPL dB HL

Speech Understanding can be predicted from what kinds of Audiograms?

Speech spectrum audiograms Speech “banana” audiograms “Count the Dot” audiograms

What is an example of a sound at 0-25 dB HL?

Barely audible Threshold

What is an example of a sound at 30 dB HL?

Whisper at 5 feet

What is an example of a sound at 50 dB HL?

Average conversation

What is an example of a sound at 90-110 dB HL?

Loud car horn, a person yelling

What is an example of a sound at 100-110 dB HL?

Motorcycle engine

What is an example of a sound at 150-170 dB HL?

Jet engine

What does AI stand for?

Articulation Index

Who came up with the Articulation Index? When? Where was it published?

Mueller and Killion 1990 The Hearing Journal

What is the Articulation Index?

An expression of the proportion of the average speech signal that is audible to a given patient. It consists of dividing the speech signal into several speech bands Each band is weighted according to the theoretical contribution of that band to speech intelligibility

The frequency region around ______ is rated the highest due to its importance in speech understanding.

2000 Hz

What is the Count-the Dot Method? | 5

Hearing is tested at points along the speech banana Dots are given at any point past threshold There are 100 total dots. If 65 out of 100 dots are available, then your score is 65. Software can now calculate this

What is the purpose of the Count-the-Dot method?

They wanted to look at what what most important Different frequencies are weighted differently according to their importance for understanding speech

What are three uses for the Count-the-Dot method?

To predict from the audiogram the amount of the patient’s communication handicap for normal conversational speech To predict the benefit that will be obtained from a hearing aid To compare the benefit of two different hearing aids

What does SII stand for?

Speech Intelligibility Index

The frequencies _______ can be extremely important for recognizing the /s/ and /z/ especially in ______.

8000-9000 Hz Female speakers

Do hearing loss characteristics influence speech understanding for hearing impaired listeners?

Yes

Does the etiology of HL influence speech understanding for hearing impaired listeners?

Yes

Does the age of onset influence speech understanding for hearing impaired listeners?

Yes

Does the age of intervention influence speech understanding for hearing impaired listeners?

Yes

Do language and cognitive functioning influence speech understanding for hearing impaired listeners?

Yes

Do memory processes influence speech understanding for hearing impaired listeners?

Yes

Does attention influence speech understanding for hearing impaired listeners?

Yes

Does the age of the patient influence speech understanding for hearing impaired listeners?

Yes

Major goal of Aural Rehabilitation is to improve ______ and overall _______.

Communication fluency Communication competence