1.02 - Speech Understanding Flashcards
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
“Speech ______ and ______ are affected by the ability to hear and decode the acoustic information in speech. “
Perception
Production
For children with hearing impairments who are developing speech: “Often this will result in errors in their own ______.”
Speech production
What is Conversational Fluency?
How smoothly conversation flows
Do you respond quickly and appropriately
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
Why is conversational fluency important ?
It shows the consequences of hearing loss
If we can’t have fluent conversation, it effects our relationships
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
Is Word/Speech Recognition Testing synonymous w/ word understanding, word or sentence discrimination?
Yes
Does Word/Speech Recognition Testing help determine success with amplification?
Yes
Does Word/Speech Recognition Testing help counsel patients by showing them how their speech understanding compares to persons with normal hearing?
Yes
Does Word/Speech Recognition Testing help compare unaided performance to aided (implants, hearing aids, ALD’s) performance?
Yes
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
Can Word/Speech Recognition Testing help determine the need for auditory training and/or speechreading training?
Yes
Can Word/Speech Recognition Testing help determines placement in a training curriculum?
Yes
Can Word/Speech Recognition Testing help demonstrate the benefits of visual information?
Yes
Can Word/Speech Recognition Testing help show differences due to environment-related listening issues? (Background noise, rapid or degraded speech)
Yes
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
Can Word/Speech Recognition Testing be used to measure outcome/benefit following intervention?
Yes
What is Audibility?
Detection of overall speech
Discrimination of phonemes
What is Intelligibility?
3
Detection of individual phonemes
Identification of phonemes
Discrimination and identification of phoneme combinations (words and sentences)
If it’s not audible, it’s not ______.
Intelligible
To be intelligible, it has to be ______.
Above threshold
Measuring speech recognition provides a prediction of ______.
The limitations caused by the HL
Speech recognition holds a significant relationship to “______”
Conversational fluency
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
