title: Effect of minimal/mild hearing loss on children's speech understanding in a simulated classroom.
abstract: OBJECTIVE
  While classroom acoustics can affect educational performance for all students, the impact for children with minimal/mild hearing loss (MMHL) may be greater than for children with normal hearing (NH). The purpose of this study was to examine the effect of MMHL on children's speech recognition comprehension and looking behavior in a simulated classroom environment. It was hypothesized that children with MMHL would perform similarly to their peers with NH on the speech recognition task but would perform more poorly on the comprehension task. Children with MMHL also were expected to look toward talkers more often than children with NH.
  
  
  METHODS
  Eighteen children with MMHL and 18 age-matched children with NH participated. In a simulated classroom environment, children listened to lines from an elementary-age-appropriate play read by a teacher and four students reproduced over LCD monitors and loudspeakers located around the listener. A gyroscopic headtracking device was used to monitor looking behavior during the task. At the end of the play, comprehension was assessed by asking a series of 18 factual questions. Children also were asked to repeat 50 meaningful sentences with three key words each presented audio-only by a single talker either from the loudspeaker at 0 degree azimuth or randomly from the five loudspeakers.
  
  
  RESULTS
  Both children with NH and those with MMHL performed at or near ceiling on the sentence recognition task. For the comprehension task, children with MMHL performed more poorly than those with NH. Assessment of looking behavior indicated that both groups of children looked at talkers while they were speaking less than 50% of the time. In addition, the pattern of overall looking behaviors suggested that, compared with older children with NH, a larger portion of older children with MMHL may demonstrate looking behaviors similar to younger children with or without MMHL.
  
  
  CONCLUSIONS
  The results of this study demonstrate that, under realistic acoustic conditions, it is difficult to differentiate performance among children with MMHL and children with NH using a sentence recognition task. The more cognitively demanding comprehension task identified performance differences between these two groups. The comprehension task represented a condition in which the persons talking change rapidly and are not readily visible to the listener. Examination of looking behavior suggested that, in this complex task, attempting to visualize the talker may inefficiently utilize cognitive resources that would otherwise be allocated for comprehension.
authors.affiliation: Listening and Learning Laboratory, Boys Town National Research Hospital, Omaha, Nebraska, USA.
authors.forename: Dawna E
authors.initials: DE
authors.lastname: Lewis
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Valente
authors.forename: Jody L
authors.initials: JL
authors.lastname: Spalding
mesh_terms: D000162:Acoustics; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D016022:Case-Control Studies; D002648:Child; D002652:Child Behavior; D034381:Hearing Loss / Q000503:physiopathology*; D006801:Humans; D009622:Noise; D012574:Schools; D012720:Severity of Illness Index; D013017:Sound Localization / Q000502:physiology; D013067:Speech Perception / Q000502:physiology*