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  1. Nashrah Maamor, Nurul Huda Bani, Wan Syafira Ishak, Siti Zamratol Mai-Sarah Mukari, Kalaivani Chellapan
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):215-215.
    MyJurnal
    This paper describes the systematic process followed in the development of culturally appropriate equalized speech-in-noise sentences suitable for use in an adaptive Speech-In-Noise training protocol for adults in Malaysia. The process involved three iterative phases of development. They were (1) analysis, (2) design and (3) development phases. In the analysis phase, important variables that needed to be considered for speech-in-noise materials were identified through literature review and discussion with the experts in the field. Next, in the design phase, the compilation and formation of sentences, evaluation of naturalness and recording of the speech materials were done. The last phase was the development phase which involved the evaluation of performance intensity function and equalization of intelligibility. The final outcome of these phases were 171 sentences with equal intelligibility that can be used interchangeably in a speech-in-noise training protocol for adults in Malaysia.
    Matched MeSH terms: Speech Intelligibility
  2. Amri NA, Quar TK, Chong FY, Bagatto M
    Int J Audiol, 2022 11;61(11):924-931.
    PMID: 34859745 DOI: 10.1080/14992027.2021.2005832
    OBJECTIVE: This study examined the accuracy of hearing aid output to DSL v5.0 Child targets in a group of children who wear hearing aids, and the impact on their auditory outcomes.

    DESIGN: For each participant, the output of the initial hearing aid fitting was compared to DSL v5.0 Child prescriptive targets and again after the fitting was adjusted using coupler-based verification and RECD measures. Outcomes for initial and adjusted fittings were examined using the Speech Intelligibility Index (SII), Parent's Evaluation of Aural/Oral Performance of Children (PEACH) rating scale, and speech perception tests in quiet and noise.

    STUDY SAMPLE: Sixty-eight children aged 3 months to 17 years with moderate to profound hearing loss participated in the study.

    RESULTS: Fit-to-targets improved significantly after hearing aids were adjusted to match targets to within 5 dB RMSE. Adjusted hearing aids provided increased aided audibility compared to initial fittings and resulted in improved speech perception scores and parent-reported hearing performance. Fifty percent of the children aged 6 to 17 years preferred their adjusted fitting compared to 10% who preferred their initial fitting.

    CONCLUSIONS: Improvement in fit-to-target to a validated paediatric prescriptive formula using best practice procedures can result in improved auditory outcomes and possible self-reported satisfaction.

    Matched MeSH terms: Speech Intelligibility
  3. Chong FY, Jenstad LM
    Disabil Rehabil Assist Technol, 2018 08;13(6):600-608.
    PMID: 29072542 DOI: 10.1080/17483107.2017.1392619
    PURPOSE: Single-microphone noise reduction (SMNR) is implemented in hearing aids to suppress background noise. The purpose of this article was to provide a critical review of peer-reviewed studies in adults and children with sensorineural hearing loss who were fitted with hearing aids incorporating SMNR.

    METHOD: Articles published between 2000 and 2016 were searched in PUBMED and EBSCO databases.

    RESULTS: Thirty-two articles were included in the final review. Most studies with adult participants showed that SMNR has no effect on speech intelligibility. Positive results were reported for acceptance of background noise, preference, and listening effort. Studies of school-aged children were consistent with the findings of adult studies. No study with infants or young children of under 5 years old was found. Recent studies on noise-reduction systems not yet available in wearable hearing aids have documented benefits of noise reduction on memory for speech processing for older adults.

    CONCLUSIONS: This evidence supports the use of SMNR for adults and school-aged children when the aim is to improve listening comfort or reduce listening effort. Future research should test SMNR with infants and children who are younger than 5 years of age. Further development, testing, and clinical trials should be carried out on algorithms not yet available in wearable hearing aids. Testing higher cognitive level for speech processing and learning of novel sounds or words could show benefits of advanced signal processing features. These approaches should be expanded to other populations such as children and younger adults. Implications for rehabilitation The review provides a quick reference for students and clinicians regarding the efficacy and effectiveness of SMNR in wearable hearing aids. This information is useful during counseling session to build a realistic expectation among hearing aid users. Most studies in the adult population suggest that SMNR may provide some benefits to adult listeners in terms of listening comfort, acceptance of background noise, and release of cognitive load in a complex listening condition. However, it does not improve speech intelligibility. Studies that examined SMNR in the paediatric population suggest that SMNR may benefit older school-aged children, aged between 10 and 12 years old. The evidence supports the use of SMNR for adults and school-aged children when the aim is to improve listening comfort or reduce listening effort.

    Matched MeSH terms: Speech Intelligibility
  4. Hossain ME, Jassim WA, Zilany MS
    PLoS One, 2016;11(3):e0150415.
    PMID: 26967160 DOI: 10.1371/journal.pone.0150415
    Sensorineural hearing loss occurs due to damage to the inner and outer hair cells of the peripheral auditory system. Hearing loss can cause decreases in audibility, dynamic range, frequency and temporal resolution of the auditory system, and all of these effects are known to affect speech intelligibility. In this study, a new reference-free speech intelligibility metric is proposed using 2-D neurograms constructed from the output of a computational model of the auditory periphery. The responses of the auditory-nerve fibers with a wide range of characteristic frequencies were simulated to construct neurograms. The features of the neurograms were extracted using third-order statistics referred to as bispectrum. The phase coupling of neurogram bispectrum provides a unique insight for the presence (or deficit) of supra-threshold nonlinearities beyond audibility for listeners with normal hearing (or hearing loss). The speech intelligibility scores predicted by the proposed method were compared to the behavioral scores for listeners with normal hearing and hearing loss both in quiet and under noisy background conditions. The results were also compared to the performance of some existing methods. The predicted results showed a good fit with a small error suggesting that the subjective scores can be estimated reliably using the proposed neural-response-based metric. The proposed metric also had a wide dynamic range, and the predicted scores were well-separated as a function of hearing loss. The proposed metric successfully captures the effects of hearing loss and supra-threshold nonlinearities on speech intelligibility. This metric could be applied to evaluate the performance of various speech-processing algorithms designed for hearing aids and cochlear implants.
    Matched MeSH terms: Speech Intelligibility*
  5. Mohd Ibrahim H, Mohamed Yusoff FH, Ahmad K, Van Dort S
    Med J Malaysia, 2015 Dec;70(6):321-5.
    PMID: 26988203 MyJurnal
    INTRODUCTION: Little is known about the treatment outcomes of children with cleft lip and/or palate (CLP) receiving surgical care for primary lip and palate closure in Malaysia.

    OBJECTIVES: This study examined the speech and hearing status of Malay-speaking children with CLP residing in Kuala Lumpur.

    METHODS: Parents whose children were between the age of 5 and 7 years were recruited via the Cleft Lip and Palate Association of Malaysia (CLAPAM) registry. Parents completed a survey and the children completed a speech and hearing assessment at the Audiology and Speech Sciences Clinic, Universiti Kebangsaan Malaysia.

    OUTCOMES: Speech measures include nasality rating, nasalance scores, articulation errors and speech intelligibility rating, while hearing measures include hearing thresholds and tympanometry results for each child.

    RESULTS: Out of 118 registered members who fulfilled the inclusion criteria, 21 agreed to participate in the study. The overall speech and hearing status of children in this sample were poor. Only four (19%) participants had normal speech intelligibility rating and normal hearing bilaterally. In terms of overall cleft management, only four (19%) participants were seen by a cleft team while seven (33%) had never had their hearing tested prior to this study.

    CONCLUSION: Participants in this sample had poor outcomes in speech and hearing and received uncoordinated and fragmented cleft care. This finding calls for further large scale research and collaborative efforts into improving and providing centralised, multidisciplinary care for children born with CLP.

    Matched MeSH terms: Speech Intelligibility
  6. Othman IA, Abdullah A, See GB, Umat C, Tyler RS
    J Int Adv Otol, 2020 Dec;16(3):297-302.
    PMID: 33136006 DOI: 10.5152/iao.2020.8563
    OBJECTIVES: This study aimed to report the auditory performance in children with cochleovestibular malformation (CVM)/cochlear nerve deficiency (CND) who were implanted early at the Universiti Kebangsaan Malaysia Medical Centre, using Categorical Auditory Performance (CAP)-II score and Speech Intelligibility Rating (SIR) scales, and to compare the outcome of their matched counterparts.

    MATERIALS AND METHODS: A total of 14 children with CVM/CND with unilateral cochlear implant (CI) implanted before the age of 4 years old were matched and compared with 14 children with normal inner ear structures. Their improvement in auditory performance was evaluated twice using CAP-II score and SIR scales at 6-month intervals, with the baseline evaluation done at least 6 months after implantation.

    RESULTS: The average age of implantation was 31±8 and 33±7 months for the control group and the case (CVM/CND) group, respectively. Overall, there were no significant differences in outcome when comparing the entire cohort of case subjects and their matched control subjects in this study. However, the improvement in CAP-II scores and SIR scales among the case subjects in between the first and second evaluations was statistically significant (p=0.040 and p=0.034, respectively). With longer duration of CI usage, children with CVM/CND showed significant speech perception outcome evident by their SIR scales (p=0.011).

    CONCLUSION: Children with radiographically malformed inner ear structures who were implanted before the age of 4 years have comparable performance to their matched counterparts, evident by their similar improvement of CAP-II scores and SIR scales over time. Hence, this group of children benefited from cochlear implantation.

    Matched MeSH terms: Speech Intelligibility
  7. Salim SS, Mustafa MB, Asemi A, Ahmad A, Mohamed N, Ghazali KB
    Res Dev Disabil, 2016 Sep;56:41-59.
    PMID: 27262125 DOI: 10.1016/j.ridd.2016.05.013
    BACKGROUND: The speech pronunciation practice (SPP) system enables children with speech impairments to practise and improve their speech pronunciation. However, little is known about the surrogate measures of the SPP system.

    AIMS: This research aims to measure the success and effectiveness of the SPP system using three surrogate measures: usage (frequency of use), performance (recognition accuracy) and satisfaction (children's subjective reactions), and how these measures are aligned with the success of the SPP system, as well as to each other.

    METHODS AND PROCEDURES: We have measured the absolute change in the word error rate (WER) between the pre- and post-training, using the ANOVA test. Correlation co-efficiency (CC) analysis was conducted to test the relation between the surrogate measures, while a Structural Equation Model (SEM) was used to investigate the causal relations between the measures.

    OUTCOMES AND RESULTS: The CC test results indicate a positive correlation between the surrogate measures. The SEM supports all the proposed gtheses. The ANOVA results indicate that SPP is effective in reducing the WER of impaired speech.

    CONCLUSIONS AND IMPLICATIONS: The SPP system is an effective assistive tool, especially for high levels of severity. We found that performance is a mediator of the relation between "usage" and "satisfaction".

    Matched MeSH terms: Speech Intelligibility
  8. Quar TK, Soli SD, Chan YF, Ishak WS, Abdul Wahat NH
    Int J Audiol, 2017 02;56(2):92-98.
    PMID: 27686009 DOI: 10.1080/14992027.2016.1210828
    OBJECTIVE: This study was conducted to evaluate the speech perception of Malaysian Chinese adults using the Taiwanese Mandarin HINT (MHINT-T) and the Malay HINT (MyHINT).

    DESIGN: The MHINT-T and the MyHINT were presented in quiet and noise (front, right and left) conditions under headphones. Results for the two tests were compared with each other and with the norms for each test.

    STUDY SAMPLE: Malaysian Chinese native speakers of Mandarin (N = 58), 18-31 years of age with normal hearing.

    RESULTS: On average, subjects demonstrated poorer speech perception ability than the normative samples for these tests. Repeated measures ANOVA showed that speech reception thresholds (SRTs) were slightly poorer on the MHINT-T than on the MyHINT for all test conditions. However, normalized SRTs were poorer by 0.6 standard deviations for MyHINT as compared with MHINT-T.

    CONCLUSIONS: MyHINT and MHINT-T can be used as norm-referenced speech perception measures for Mandarin-speaking Chinese in Malaysia.

    Matched MeSH terms: Speech Intelligibility
  9. Chur-Hansen A, Vernon-Roberts J
    Acad Med, 1999 Jul;74(7):829-34.
    PMID: 10429593
    PURPOSE: To explore the use of standardized patients for evaluating medical student's proficiency in speaking English.

    METHOD: In 1995, using a language rating scale constructed by the authors, six standardized patients evaluated the English-language proficiencies of 127 second-year medical student undergraduates enrolled at the University of Adelaide, Australia, many of whom were from a non-English speaking background.

    RESULTS: An earlier standardized test (Screening Test for Adolescent Language) had identified approximately one third of the students as potentially experiencing difficulties in using English in their training. Students so identified were rated lower than were their peers by the standardized patients.

    CONCLUSION: The study proved useful both in identifying aspects of speech that can be reasonably rated by standardized patients and also in identifying students who might benefit from language interventions. Replication studies with the new instrument are required to further establish its reliability, validity, and generalizability across different student cohorts.

    Matched MeSH terms: Speech Intelligibility
  10. Bee-See G, Zulkefli NAM, Abdullah A, Umat C, Nor NK, Ismail J, et al.
    Braz J Otorhinolaryngol, 2024;90(4):101423.
    PMID: 38657449 DOI: 10.1016/j.bjorl.2024.101423
    OBJECTIVES: To determine the benefits of cochlear implantation in hearing loss children with multiple disabilities (MD) in terms of auditory outcomes, speech performance, and their quality of life.

    METHODS: This was a cross sectional study from January 2019 to December 2020 in which thirty-one children with hearing loss and multiple disabilities were evaluated. Their improvement in auditory and speech performances were assessed using Categories of Auditory Performance version II (CAP-II) and the Speech Intelligibility Rating (SIR) scales. The assessment was done at 6-month intervals, with the baseline evaluation done at least six months after activation of the implant. Parents were asked to fill the Parents Evaluation of Aural/Oral Performance of Children (PEACH) diary and Perceived Benefit Questionnaire (PBQ) to evaluate the child's quality of life.

    RESULTS: All 31 children have Global Developmental Delay (GDD), with 11 having an additional disability. Both mean CAP-II and SIR scores showed significant improvement with increased hearing age (p speech development.

    CONCLUSIONS: Cochlear implantation had shown benefits in children with multiple disabilities. Outcome measures should not only focus on auditory and speech performances but the improvement in quality of life. Hence, individualized each case with realistic expectation from families must be emphasized in this group of children.

    LEVEL OF EVIDENCE: Level 3.

    Matched MeSH terms: Speech Intelligibility
  11. Chu SY, Barlow SM, Lee J, Wang J
    Int J Speech Lang Pathol, 2017 12;19(6):616-627.
    PMID: 28425760 DOI: 10.1080/17549507.2016.1265587
    PURPOSE: This research characterised perioral muscle reciprocity and amplitude ratio in lower lip during bilabial syllable production [pa] at three rates to understand the neuromotor dynamics and scaling of motor speech patterns in individuals with Parkinson's disease (PD).

    METHOD: Electromyographic (EMG) signals of the orbicularis oris superior [OOS], orbicularis oris inferior [OOI] and depressor labii inferioris [DLI] were recorded during syllable production and expressed as polar-phase notations.

    RESULT: PD participants exhibited the general features of reciprocity between OOS, OOI and DLI muscles as reflected in the EMG during syllable production. The control group showed significantly higher integrated EMG amplitude ratio in the DLI:OOS muscle pairs than PD participants. No speech rate effects were found in EMG muscle reciprocity and amplitude magnitude across all muscle pairs.

    CONCLUSION: Similar patterns of muscle reciprocity in PD and controls suggest that corticomotoneuronal output to the facial nucleus and respective perioral muscles is relatively well-preserved in our cohort of mild idiopathic PD participants. Reduction of EMG amplitude ratio among PD participants is consistent with the putative reduction in the thalamocortical activation characteristic of this disease which limits motor cortex drive from generating appropriate commands which contributes to bradykinesia and hypokinesia of the orofacial mechanism.

    Matched MeSH terms: Speech Intelligibility
  12. Quar TK, Ching TY, Newall P, Sharma M
    Int J Audiol, 2013 May;52(5):322-32.
    PMID: 23570290 DOI: 10.3109/14992027.2012.755740
    The study aims to compare the performance of hearing aids fitted according to the NAL-NL1 and DSL v5 prescriptive procedure for children.
    Matched MeSH terms: Speech Intelligibility
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