Pediatric Hearing Loss and Speech Recognition in Quiet and in Different Types of Background Noise

Purpose Speech recognition deteriorates with hearing loss, particularly in fluctuating background noise. This study examined how hearing loss affects speech recognition in different types of noise to clarify how characteristics of the noise interact with the benefits listeners receive when listening in fluctuating compared to steady-state noise. Method Speech reception thresholds were measured for a closed set of spondee words in children (ages 5-17 years) in quiet, speech-spectrum noise, 2-talker babble, and instrumental music. Twenty children with normal hearing and 43 children with hearing loss participated; children with hearing loss were subdivided into groups with cochlear implant (18 children) and hearing aid (25 children) groups. A cohort of adults with normal hearing was included for comparison. Results Hearing loss had a large effect on speech recognition for each condition, but the effect of hearing loss was largest in 2-talker babble and smallest in speech-spectrum noise. Children with normal hearing had better speech recognition in 2-talker babble than in speech-spectrum noise, whereas children with hearing loss had worse recognition in 2-talker babble than in speech-spectrum noise. Almost all subjects had better speech recognition in instrumental music compared to speech-spectrum noise, but with less of a difference observed for children with hearing loss. Conclusions Speech recognition is more sensitive to the effects of hearing loss when measured in fluctuating compared to steady-state noise. Speech recognition measured in fluctuating noise depends on an interaction of hearing loss with characteristics of the background noise; specifically, children with hearing loss were able to derive a substantial benefit for listening in fluctuating noise when measured in instrumental music compared to 2-talker babble.