Speech Testing
Wave 4 EJB 17/05/04
Modernising Children’s Hearing Aid Services
Speech tests
To inform on quality of hearing aid fitting
Tradition of neglect
Falls between audiology and habilitation
Particularly in Pre School HA User
Used more by CI teams
Modernising Children’s Hearing Aid Services
Areas of Interest
Detection
Discrimination
Word recognition
Speech understanding
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Sound Detection
One example is the Ling 5 (or 6!!) sounds
oo - ah - ee - (mm) - sh – ss
Gives information across the speech
frequency range
Auditory Speech Sound Evaluation (ASSE)
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Sound Discrimination
 These tests should provide information useful
for hearing aid fitting and possibly fine tuning
 But no research to suggest exactly how
fittings might be altered by speech test
scores
 Examples (Closed set tests)
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McCormick Automated Toy Test
CCT (Consonant Cluster Task)
Maltby Speech Perception Test
Manchester Picture Test
FAAF
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Word Recognition
Examples
Open set word tests
Manchester Junior words
Cambridge junior words
AB word lists
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Speech Understanding
Examples
Sentence Tests
BKB sentence lists
?Familiarity
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First Wave Evaluation
First wave evaluation study 3 (mildmoderate-severe, age 7-15) used FAAF
(Four Alternative Auditory Feature Test
developed by Haggard and Foster 1987)
In study 7 (severe/profoundly deaf group) if
child was unable to perform on FAAF at
above chance levels, The CCT (Consonant
Cluster Task further developed by Marriage)
was used.
“Standardised” test conditions through a
calibrated system were important
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Difference
between
analogue
and DSP
p>0.0001
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Speech Testing Issues
 Acclimatisation
 Familiarity of material
 Degree of Hearing Loss (esp Severe/Profound)
 Uses – Counselling ?
 Uses - Fine tuning ?
 Uses – Changes to HA Provision ?
 Further work required (esp Pre School)
 Calibration/Test Parameters
 First wave – ambivalent
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Auditory Speech Sound Evaluation
(ASSE) Test
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Auditory Speech Sound Evaluation
Govaerts PJ, Belgium www.deoorgroep.net
ASSE is a set of supraliminal auditory tests
Test children with no or very limited speech
Part of Paediatric Auditory Performance Test
A speech and language independent test to
measure the supraliminal auditory capacity
All sounds that are used are balanced
speech sounds common in many languages
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Consonant Cluster Task (CCT) Test
(Demo)
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Consonant Cluster Task (CCT)
 Further developed by Marriage
 The test involves 4 alternative monosyllabic
real words represented by pictures. They
have the same vowel but different consonants
e.g. “hen, peg, bed, egg”
 There are 9 blocks of 6 presentations
 The test can be given in quiet or competing
noise conditions, and input level can be
changed.
 There were no significant differences using
this or FAAF in Study 7, the children did score
better on the DSP hearing aids, but numbers
were small so not significant.
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CCT Application
 Closed Set, 4 Alternative Picture Based Test
 Familiar Material from Reed Test
 Nonsense/Non Words excluded
 All 4 items have same vowel sound
 E.g. “Owl”, “House”, “Cow”, “Mouse”
 Easier contrasts than APT1
 CCT from ? age 3 years
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CCT Presentation
 Level should avoid floor (score < 25%) or ceiling
(score > 95%) effects
 Performance/intensity function may be steep
 Useful to test at conversation (e.g. 65 dB) quiet
(e.g. 50 dB) and loud (e.g. 80 dB) levels
 Pre-recorded better than live presentation for
comparison (? not viable for young children)
 Can be presented in speech shaped noise at an
appropriate speech/noise ratio
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CCT Test Procedure
 CD Player & 2 Channel Audiometer + Loudspeaker
 Speech Channel 1 & Noise Channel 2
 Calibrate using Track 1
 Picture Card 1- familiarise with live voice
 Start CD
 Each Picture Card
 6 presentation each picture card
 Score on confusion matrix score sheet
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CCT Interpretation
 Total number of correct responses
 Observation of errors in confusion matrix
 Assess difficulty child has discrimination
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APT1 Application
 Closed Set, 4 Alternative Picture Based Test
 All 4 items have same vowel sound
 E.g. “Boat”, “Coat”, “Goat”, “Note”
 More difficult contrasts than CCT
 2 Sets Vowel & 8 Consonant confusion contrast
 APT1 from ? age 5 years
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Four Alternative Auditory Feature
(FAAF) Test
(Demo & Practical)
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FAAF Test
 A speech in noise test to measure speech
intelligibility, and benefit from a hearing aid.
 Different speech levels and speech:noise ratios
 The test is presented in a sound field room, from
a loudspeaker 1.5m in front of the patient.
 The test can be carried out unaided in two
interleaved conditions, and aided in four
interleaved conditions.
 Responses can be via a touch screen
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FAAF Equipment
 FAAF Software (available from IHR)
 Laptop computer
 Compatible Sound Card (internal or USB)
 Suitable loudspeaker (and external amplifier)
 Child-friendly mouse or...
 Touch Screen hardware/software (e.g. KeyTech
ca £150)
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FAAF Parameters
 Parameters for test can be changed
 May reduce test time
 Exercise caution
 Effect of noise reduction systems on DSP aids
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FAAF Parameters
 Can edit .ini file in program directory
[Feedback]
Flashes=0
Flash_Time=100
Flash_Colour=50,100,50
“4” is default, “0” will mean
no feedback for incorrect
answer (shorten test, less
“negative” for child)
[Sound_Output]
Presentation=Speakers
Noise_file_1=c:\faaf\waves\faafspn.wav
Noise_file_2=c:\faaf\waves\faafspn.wav
hardware_switch=off
Max_Speech_Level=80
Max_Noise_Level=100
Ramp_time=100
Pre_stimulus_noise_time=200
Post_stimulus_noise_time=100
Time (ms) that
noise is on before
speech (default is
500)
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FAAF Suggested Instructions
 Four words will appear on the screen
 You will hear “Can you hear X clearly?” where X is a simple word
 Touch / use the mouse to indicate the word you think you heard
 This will be repeated but with a different word
 If you are not sure, try and choose the word you think was said
 There will be noise in the background most of the time, try to ignore it
 “Touch here to continue” will appear after each set of 4 sentences
 When you see this, it means that the speech and/or noise will get quieter
or louder so be prepared for this
 This isn’t a “test” and it can be difficult even for someone with good
hearing
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Typical FAAF Screen
 Grey item is child’s response
 Green item is correct answer
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FAAF Aided Test
 This test contains 80 sentences
 20 Sentences in each condition
 Condition 1 S:N=+10 S=60
N=50
 Condition 2 S:N=+5 S=60
N=55
 Condition 3 S:N=+10 S=70
N=60
 Condition 4 S:N=+5 S=70
N=65
 Note scores on test form / PMS
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FAAF Typical Data Log File
Summarise test parameters (.ini file) used
Records test items,levels,responses for each
presentation
name:
ed
Patient number: a
Date:
Sat Dec 13 11:27:21 2003
--------------------------------------------------------------------1. Aided FAAF in noise test using "acdtest.ini" on Sat Dec
13 11:30:29 2003
1,bang,bad,bag,ban,3,3,1,1,60,50,2,2
2,lad,land,lands,lads,3,3,1,1,60,50,2,2
3,how,hang,ham,high,2,2,1,1,60,50,2,2
...
19,cab,tab,dab,gab,1,1,1,1,60,50,2,2
20,bag,back,bat,bad,3,3,1,1,60,50,2,2
Modernising Children’s Hearing Aid Services