title: Improving speech-in-noise recognition for children with hearing loss: potential effects of language abilities, binaural summation, and head shadow.
abstract: OBJECTIVE
  This study examined speech recognition in noise for children with hearing loss, compared it to recognition for children with normal hearing, and examined mechanisms that might explain variance in children's abilities to recognize speech in noise.
  
  
  METHODS
  Word recognition was measured in two levels of noise, both when the speech and noise were co-located in front and when the noise came separately from one side. Four mechanisms were examined as factors possibly explaining variance: vocabulary knowledge, sensitivity to phonological structure, binaural summation, and head shadow.
  
  
  METHODS
  Participants were 113 eight-year-old children. Forty-eight had normal hearing (NH) and 65 had hearing loss: 18 with hearing aids (HAs), 19 with one cochlear implant (CI), and 28 with two CIs.
  
  
  RESULTS
  Phonological sensitivity explained a significant amount of between-groups variance in speech-in-noise recognition. Little evidence of binaural summation was found. Head shadow was similar in magnitude for children with NH and with CIs, regardless of whether they wore one or two CIs. Children with HAs showed reduced head shadow effects.
  
  
  CONCLUSIONS
  These outcomes suggest that in order to improve speech-in-noise recognition for children with hearing loss, intervention needs to be comprehensive, focusing on both language abilities and auditory mechanisms.
authors.affiliation: Department of Otolaryngology, The Ohio State University, Columbus, OH 43212, USA. nittrouer.1@osu.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Nittrouer
authors.forename: Amanda
authors.initials: A
authors.lastname: Caldwell-Tarr
authors.forename: Eric
authors.initials: E
authors.lastname: Tarr
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Lowenstein
authors.forename: Caitlin
authors.initials: C
authors.lastname: Rice
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Moberly
mesh_terms: D000161:Acoustic Stimulation; D000367:Age Factors; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D001309:Auditory Threshold; D016022:Case-Control Studies; D002648:Child; D002663:Child Language; D003054:Cochlear Implants; D012048:Correction of Hearing Impairment / Q000295:instrumentation; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D009622:Noise / Q000009:adverse effects*; D010470:Perceptual Masking; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation; D021641:Recognition, Psychology; D059629:Signal-To-Noise Ratio; D013017:Sound Localization; D013067:Speech Perception; D014825:Vocabulary