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  1. Chong Foong Yen, Lee Onn Wah, Norfazilah Abdol, Rafidah Mazlan
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):179-185.
    MyJurnal
    A speech test that emphasizes on fricatives and affricates with high-frequency components is recommended for testing individuals with high-frequency hearing loss. Validation of the frequency-lowering feature in modern hearing aids are also important. There has been no recorded speech material in Malaysia that focuses on Mandarin fricatives and affricates. Therefore, the objective of this study was to develop a nonsense word test that contains Mandarin sibilant fricatives and affricates. A total of 180 vowel-consonant-vowel (vcv) nonsense syllables were recorded from a female and a male talker. These vcv syllables included six targeted Mandarin fricatives and affricates in three vowel contexts. Perceptual and acoustic analysis were conducted and selected vcv syllables were validated by 24 native Mandarin talkers with normal hearing through identification testing. Hundred and three syllables were rated as having a good or excellent sound quality and free from at least one of the idiosyncrasy elements. The average percentage of correct identification of vcv tokens for the female and male talkers were 85.38% and 82. 73%, respectively. Syllables that received the highest correct identification scores above the group mean were taken as the best exemplars. In total, 29 best exemplars were selected from 180 vcv syllables for the development of the Mandarin fricative-affricate nonsense word test. Future studies should include the development of performance-intensity function for individuals with normal hearing and a test manual so that the test can be used by non-native Mandarin clinicians.
  2. Lee OW, Mao D, Wunderlich J, Balasubramanian G, Haneman M, Korneev M, et al.
    Trends Hear, 2024;28:23312165241258056.
    PMID: 39053892 DOI: 10.1177/23312165241258056
    This study investigated the morphology of the functional near-infrared spectroscopy (fNIRS) response to speech sounds measured from 16 sleeping infants and how it changes with repeated stimulus presentation. We observed a positive peak followed by a wide negative trough, with the latter being most evident in early epochs. We argue that the overall response morphology captures the effects of two simultaneous, but independent, response mechanisms that are both activated at the stimulus onset: one being the obligatory response to a sound stimulus by the auditory system, and the other being a neural suppression effect induced by the arousal system. Because the two effects behave differently with repeated epochs, it is possible to mathematically separate them and use fNIRS to study factors that affect the development and activation of the arousal system in infants. The results also imply that standard fNIRS analysis techniques need to be adjusted to take into account the possibilities of multiple simultaneous brain systems being activated and that the response to a stimulus is not necessarily stationary.
  3. Mao D, Wunderlich J, Savkovic B, Jeffreys E, Nicholls N, Lee OW, et al.
    Sci Rep, 2021 Dec 14;11(1):24006.
    PMID: 34907273 DOI: 10.1038/s41598-021-03595-z
    Speech detection and discrimination ability are important measures of hearing ability that may inform crucial audiological intervention decisions for individuals with a hearing impairment. However, behavioral assessment of speech discrimination can be difficult and inaccurate in infants, prompting the need for an objective measure of speech detection and discrimination ability. In this study, the authors used functional near-infrared spectroscopy (fNIRS) as the objective measure. Twenty-three infants, 2 to 10 months of age participated, all of whom had passed newborn hearing screening or diagnostic audiology testing. They were presented with speech tokens at a comfortable listening level in a natural sleep state using a habituation/dishabituation paradigm. The authors hypothesized that fNIRS responses to speech token detection as well as speech token contrast discrimination could be measured in individual infants. The authors found significant fNIRS responses to speech detection in 87% of tested infants (false positive rate 0%), as well as to speech discrimination in 35% of tested infants (false positive rate 9%). The results show initial promise for the use of fNIRS as an objective clinical tool for measuring infant speech detection and discrimination ability; the authors highlight the further optimizations of test procedures and analysis techniques that would be required to improve accuracy and reliability to levels needed for clinical decision-making.
  4. Lee OW, Mao D, Savkovic B, Wunderlich J, Nicholls N, Jeffreys E, et al.
    Ear Hear, 2023 01 14;44(4):776-786.
    PMID: 36706073 DOI: 10.1097/AUD.0000000000001325
    OBJECTIVES: Cardiac responses (e.g., heart rate changes) due to an autonomous response to sensory stimuli have been reported in several studies. This study investigated whether heart rate information extracted from functional near-infrared spectroscopy (fNIRS) data can be used to assess the discrimination of speech sounds in sleeping infants. This study also investigated the adaptation of the heart rate response over multiple, sequential stimulus presentations.

    DESIGN: fNIRS data were recorded from 23 infants with no known hearing loss, aged 2 to 10 months. Speech syllables were presented using a habituation/dishabituation test paradigm: the infant's heart rate response was first habituated by repeating blocks of one speech sound; then, the heart rate response was dishabituated with the contrasting (novel) speech sound. This stimulus presentation sequence was repeated for as long as the infants were asleep.

    RESULTS: The group-level average heart rate response to the novel stimulus was greater than that to the habituated first sound, indicating that sleeping infants were able to discriminate the speech sound contrast. A significant adaptation of the heart rate responses was seen over the session duration.

    CONCLUSION: The dishabituation response could be a valuable marker for speech discrimination, especially when used in conjunction with the fNIRS hemodynamic response.

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