Assessing spoken word recognition in children who are deaf or hard of hearing: a translational approach

Under natural conditions, listeners use both auditory and visual speech cues to extract meaning from speech signals containing many sources of variability. However, traditional clinical tests of spoken word recognition routinely employ isolated words or sentences produced by a single talker in an auditory-only presentation format. The more central cognitive processes used during multimodal integration, perceptual normalization, and lexical discrimination that may contribute to individual variation in spoken word recognition performance are not assessed in conventional tests of this kind. In this article, we review our past and current research activities aimed at developing a series of new assessment tools designed to evaluate spoken word recognition in children who are deaf or hard of hearing. These measures are theoretically motivated by a current model of spoken word recognition and also incorporate "real-world" stimulus variability in the form of multiple talkers and presentation formats. The goal of this research is to enhance our ability to estimate real-world listening skills and to predict benefit from sensory aid use in children with varying degrees of hearing loss.