title: Evaluation of wideband frequency responses and nonlinear frequency compression for children with cookie-bite audiometric configurations.
abstract: BACKGROUND
  Previous research has suggested that use of nonlinear frequency compression (NLFC) can improve audibility for high-frequency sounds and speech recognition of children with moderate to profound high-frequency hearing loss. Furthermore, previous studies have generally found no detriment associated with the use of NLFC. However, there have been no published studies examining the effect of NLFC on the performance of children with cookie-bite audiometric configurations. For this configuration of hearing loss, frequency-lowering processing will likely move high-frequency sounds to a lower frequency range at which a greater degree of hearing loss exists.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate and compare the effects of wideband amplification and NLFC on high-frequency audibility and speech recognition of children with cookie-bite audiometric configurations.
  
  
  METHODS
  This study consisted of a within-participant design with repeated measures across test conditions.
  
  
  METHODS
  Seven children, ages 6-13 yr, with cookie-bite audiometric configurations and normal hearing or mild hearing loss at 6000 and 8000 Hz, were recruited.
  
  
  METHODS
  Participants were fitted with Phonak Nios S H2O III behind-the-ear hearing aids and Oticon Safari 300 behind-the-ear hearing aids.
  
  
  METHODS
  The participants were evaluated after three 4-to 6-wk intervals: (1) Phonak Nios S H2O III without NLFC, (2) Phonak Nios S H2O III with NLFC, and (3) Oticon Safari 300 with wideband frequency response extending to 8000 Hz. The order in which each technology was used was counterbalanced across participants. High-frequency audibility was evaluated by assessing aided thresholds (dB SPL) for warble tones and the high-frequency phonemes /sh/ and /s/. Speech recognition in quiet was measured with the University of Western Ontario (UWO) Plurals Test, the UWO Distinctive Features Difference (DFD) Test, and the Phoneme Perception Test vowel-consonant-vowel nonsense syllable test. Sentence recognition in noise was evaluated with the Bamford-Kowal-Bench Speech-In-Noise (BKB-SIN) Test.
  
  
  METHODS
  Repeated-measures analyses of variance were used to analyze the data collected in this study. The results across the three different conditions were compared.
  
  
  RESULTS
  No difference in performance across conditions was observed for detection of high-frequency warble tones and the speech sounds /sh/ and /s/. No significant difference was seen across conditions for speech recognition in quiet when measured with the UWO Plurals Test, the UWO-DFD Test, and the Phoneme Perception Test vowel-consonant-vowel nonsense syllable test. Finally, there were also no differences across conditions on the BKB-SIN Test.
  
  
  CONCLUSIONS
  These results suggest that NLFC does not degrade or improve audibility for and recognition of high-frequency speech sounds as well as sentence recognition in noise when compared with wideband amplification for children with cookie-bite audiometric configurations.
authors.affiliation: Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Andrew
authors.initials: A
authors.lastname: John
authors.affiliation: Hearts for Hearing, Oklahoma City, OK.
authors.forename: Jace
authors.initials: J
authors.lastname: Wolfe
authors.affiliation: School of Communication Sciences and Disorders and National Centre for Audiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Scollie
authors.affiliation: Department of Speech and Hearing Sciences, University of North Texas, Denton, TX.
authors.forename: Erin
authors.initials: E
authors.lastname: Schafer
authors.affiliation: Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Mary
authors.initials: M
authors.lastname: Hudson
authors.affiliation: Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Whitney
authors.initials: W
authors.lastname: Woods
authors.affiliation: Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Julie
authors.initials: J
authors.lastname: Wheeler
authors.affiliation: Hearts for Hearing, Oklahoma City, OK.
authors.forename: Krystal
authors.initials: K
authors.lastname: Hudgens
authors.affiliation: Hearts for Hearing, Oklahoma City, OK.
authors.forename: Sara
authors.initials: S
authors.lastname: Neumann
mesh_terms: D000293:Adolescent; D001299:Audiometry / Q000379:methods*; D002648:Child; D005260:Female; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010700:Phonetics; D013067:Speech Perception / Q000502:physiology*