{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:23:08Z","timestamp":1787984588934,"version":"build-2784847793"},"reference-count":36,"publisher":"American Academy of Audiology","issue":"4","funder":[{"name":"Phonak, LLC"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:p><jats:bold>Abstract<\/jats:bold>  <jats:bold>Background<\/jats:bold>\u2003For children with hearing loss, the primary goal of hearing aids is to provide improved access to the auditory environment within the limits of hearing aid technology and the child's auditory abilities. However, there are limited data examining\n aided speech recognition at very low (40 decibels A [dBA]) and low (50\u2009dBA) presentation levels. <jats:bold>Purpose<\/jats:bold>\u2003Due to the paucity of studies exploring aided speech recognition at low presentation levels for children with hearing loss, the present study aimed to (1) compare\n aided speech recognition at different presentation levels between groups of children with \u201cnormal\u201d hearing and hearing loss, (2) explore the effects of aided pure tone average and aided Speech Intelligibility Index (SII) on aided speech recognition at low presentation levels for\n children with hearing loss ranging in degree from mild to severe, and (3) evaluate the effect of increasing low-level gain on aided speech recognition of children with hearing loss. <jats:bold>Research Design<\/jats:bold>\u2003In phase 1 of this study, a two-group, repeated-measures design was used to\n evaluate differences in speech recognition. In phase 2 of this study, a single-group, repeated-measures design was used to evaluate the potential benefit of additional low-level hearing aid gain for low-level aided speech recognition of children with hearing loss. <jats:bold>Study Sample<\/jats:bold>\u2003The\n first phase of the study included 27 school-age children with mild to severe sensorineural hearing loss and 12 school-age children with \u201cnormal\u201d hearing. The second phase included eight children with mild to moderate sensorineural hearing loss. <jats:bold>Intervention<\/jats:bold>\u2003Prior\n to the study, children with hearing loss were fitted binaurally with digital hearing aids. Children in the second phase were fitted binaurally with digital study hearing aids and completed a trial period with two different gain settings: (1) gain required to match hearing aid output to prescriptive\n targets (i.e., primary program), and (2) a 6-dB increase in overall gain for low-level inputs relative to the primary program. In both phases of this study, real-ear verification measures were completed to ensure the hearing aid output matched prescriptive targets. <jats:bold>Data Collection and\n Analysis<\/jats:bold>\u2003Phase 1 included monosyllabic word recognition and syllable-final plural recognition at three presentation levels (40, 50, and 60\u2009dBA). Phase 2 compared speech recognition performance for the same test measures and presentation levels with two differing gain prescriptions.\n <jats:bold>Conclusion<\/jats:bold>\u2003In phase 1 of the study, aided speech recognition was significantly poorer in children with hearing loss at all presentation levels. Higher aided SII in the better ear (55\u2009dB sound pressure level input) was associated with higher Consonant-Nucleus-Consonant word\n recognition at a 40\u2009dBA presentation level. In phase 2, increasing the hearing aid gain for low-level inputs provided a significant improvement in syllable-final plural recognition at very low-level inputs and resulted in a nonsignificant trend toward better monosyllabic word recognition\n at very low presentation levels. Additional research is needed to document the speech recognition difficulties children with hearing aids may experience with low-level speech in the real world as well as the potential benefit or detriment of providing additional low-level hearing aid gain.<\/jats:p>","DOI":"10.1055\/a-1692-9670","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:03:07Z","timestamp":1636588987000},"page":"196-205","source":"Crossref","is-referenced-by-count":3,"title":["Low-Level Speech Recognition of Children with Hearing Aids"],"prefix":"10.3766","volume":"33","author":[{"given":"Jace","family":"Wolfe","sequence":"first","affiliation":[{"name":"Hearts for Hearing Foundation, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mila","family":"Duke","sequence":"additional","affiliation":[{"name":"Hearts for Hearing Foundation, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Schafer","sequence":"additional","affiliation":[{"name":"Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Jones","sequence":"additional","affiliation":[{"name":"Phonak LLC, Warrenville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Rakita","sequence":"additional","affiliation":[{"name":"Phonak LLC, Warrenville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Dunn","sequence":"additional","affiliation":[{"name":"Phonak LLC, Warrenville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarrod","family":"Battles","sequence":"additional","affiliation":[{"name":"Hearts for Hearing Foundation, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Neumann","sequence":"additional","affiliation":[{"name":"Hearts for Hearing Foundation, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacy","family":"Manning","sequence":"additional","affiliation":[{"name":"Hearts for Hearing Foundation, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2087","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.1080\/14992027.2017.1385865","article-title":"Learning from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study: summary of 5-year findings and implications","volume":"57","author":"T YC Ching","year":"2018","journal-title":"Int J Audiol"},{"issue":"S 01","key":"ref2","doi-asserted-by":"crossref","first-page":"76S","DOI":"10.1097\/AUD.0000000000000219","article-title":"Language outcomes in young children with mild to severe hearing loss","volume":"36","author":"J B Tomblin","year":"2015","journal-title":"Ear Hear"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/AUD.0b013e3182a76768","article-title":"Linguistic input, electronic media, and communication outcomes of toddlers with hearing loss","volume":"35","author":"S E Ambrose","year":"2014","journal-title":"Ear Hear"},{"issue":"S 01","key":"ref4","doi-asserted-by":"crossref","first-page":"48S","DOI":"10.1097\/AUD.0000000000000209","article-title":"Quantity and quality of caregivers' linguistic input to 18-month and 3-year-old children who are hard of hearing","volume":"36","author":"S E Ambrose","year":"2015","journal-title":"Ear Hear"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/1525740113518062","article-title":"Parental support for language development during joint book reading for young children with hearing loss","volume":"35","author":"J L DesJardin","year":"2014","journal-title":"Comm Disord Q"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1017\/S0305000919000667","article-title":"Talk with me! Parental linguistic input to toddlers with moderate hearing loss","volume":"47","author":"E Dirks","year":"2020","journal-title":"J Child Lang"},{"key":"ref7","volume-title":"Meaningful Differences in the Everyday Experience of Young American Children","author":"B Hart","year":"1995"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.cogpsych.2010.08.002","article-title":"Sources of variability in children's language growth","volume":"61","author":"J Huttenlocher","year":"2010","journal-title":"Cognit Psychol"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1111\/j.1467-8624.2012.01805.x","article-title":"A longitudinal investigation of the role of quantity and quality of child-directed speech in vocabulary development","volume":"83","author":"M L Rowe","year":"2012","journal-title":"Child Dev"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/deafed\/ens025","article-title":"Quantity of parental language in the home environments of hard-of-hearing 2-year-olds","volume":"17","author":"M VanDam","year":"2012","journal-title":"J Deaf Stud Deaf Educ"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/AUD.0000000000000460","article-title":"Comparison of different hearing aid prescriptions for children","volume":"39","author":"J E Marriage","year":"2018","journal-title":"Ear Hear"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/01.HJ.0000342436.70730.a8","article-title":"A comparison of manufacturer-specific prescriptive procedures for infants","volume":"61","author":"R Seewald","year":"2008","journal-title":"Hear J"},{"issue":"S 01","key":"ref14","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.3109\/14992020903148038","article-title":"Evaluation of the NAL-NL1 and DSL v4.1 prescriptions for children: preference in real world use","volume":"49","author":"S Scollie","year":"2010","journal-title":"Int J Audiol"},{"issue":"S 01","key":"ref15","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.3109\/14992020903121159","article-title":"Children's speech perception and loudness ratings when fitted with hearing aids using the DSL v.4.1 and the NAL-NL1 prescriptions","volume":"49","author":"S D Scollie","year":"2010","journal-title":"Int J Audiol"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3109\/03005369509086580","article-title":"Measured and calculated insertion gains in young children","volume":"29","author":"A F Snik","year":"1995","journal-title":"Br J Audiol"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1097\/AUD.0000000000000823","article-title":"Aided hearing moderates the academic outcomes of children with mild to severe hearing loss","volume":"41","author":"J B Tomblin","year":"2020","journal-title":"Ear Hear"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/108471380500900404","article-title":"Clinical protocols for hearing instrument fitting in the desired sensation level method","volume":"9","author":"M Bagatto","year":"2005","journal-title":"Trends Amplif"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1055\/s-0041-1741117","article-title":"NAL-NL1 procedure for fitting nonlinear hearing aids: characteristics and comparisons with other procedures","volume":"12","author":"D Byrne","year":"2001","journal-title":"J Am Acad Audiol"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/108471380500900403","article-title":"The Desired Sensation Level multistage input\/output algorithm","volume":"9","author":"S Scollie","year":"2005","journal-title":"Trends Amplif"},{"key":"ref21","volume-title":"Speech Levels in Various Noise Environments (Report No. EPA-600\/1\u201377\u2013025)","author":"K S Pearsons","year":"1977"},{"key":"ref22","volume-title":"Children with hearing loss: developing listening and talking (p. 107)","author":"E B Cole","year":"2007"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1044\/jshd.4104.503","article-title":"Articulation functions and test-retest performance of normal-hearing children on three speech discrimination tests: WIPI, PBK-50, and NV Auditory Test No. 6","volume":"41","author":"M E Sanderson-Leepa","year":"1976","journal-title":"J Speech Hear Disord"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1044\/jshd.2701.62","article-title":"Revised CNC lists for auditory tests","volume":"27","author":"G E Peterson","year":"1962","journal-title":"J Speech Hear Disord"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1044\/1059-0889(2012\/11-0036)","article-title":"Development and evaluation of an English language measure of detection of word-final plurality markers: the University of Western Ontario Plurals Test","volume":"21","author":"D Glista","year":"2012","journal-title":"Am J Audiol"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1044\/1092-4388(2011\/10-0264)","article-title":"The Speech Intelligibility Index and the pure-tone average as predictors of lexical ability in children fit with hearing AIDS","volume":"55","author":"D J Stiles","year":"2012","journal-title":"J Speech Lang Hear Res"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"19S","DOI":"10.1097\/AUD.0b013e3181ffdb8b","article-title":"Factors contributing to speech perception scores in long-term pediatric cochlear implant users","volume":"32","author":"L S Davidson","year":"2011","journal-title":"Ear Hear"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"e75","DOI":"10.1097\/MAO.0000000000000910","article-title":"Sentence recognition in quiet and noise by pediatric cochlear implant users: relationships to spoken language","volume":"37","author":"L S Eisenberg","year":"2016","journal-title":"Otol Neurotol"},{"issue":"10","key":"ref31","doi-asserted-by":"crossref","first-page":"3525","DOI":"10.1044\/2020_JSLHR-20-00030","article-title":"Cognitive and linguistic contributions to masked speech recognition in children","volume":"63","author":"R W McCreery","year":"2020","journal-title":"J Speech Lang Hear Res"},{"issue":"05","key":"ref32","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1080\/14992027.2016.1266703","article-title":"Individual differences in language and working memory affect children's speech recognition in noise","volume":"56","author":"R W McCreery","year":"2017","journal-title":"Int J Audiol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.3389\/fnins.2019.01093","article-title":"Auditory, cognitive, and linguistic factors predict speech recognition in adverse listening conditions for children with hearing loss","volume":"13","author":"R W McCreery","year":"2019","journal-title":"Front Neurosci"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/AUD.0b013e3181734a02","article-title":"Children's speech recognition scores: the Speech Intelligibility Index and proficiency factors for age and hearing level","volume":"29","author":"S D Scollie","year":"2008","journal-title":"Ear Hear"},{"issue":"04","key":"ref35","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1044\/jslhr.4304.902","article-title":"The relation between stimulus context, speech audibility, and perception for normal-hearing and hearing-impaired children","volume":"43","author":"P G Stelmachowicz","year":"2000","journal-title":"J Speech Lang Hear Res"},{"issue":"03","key":"ref36","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/01.HJ.0000427527.55840.9b","article-title":"Building blocks: the trouble with functional gain in verifying pediatric hearing aids","volume":"66","author":"R McCreery","year":"2013","journal-title":"Hear J"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3109\/14992027.2010.521198","article-title":"Sentence perception in listening conditions having similar speech intelligibility indices","volume":"50","author":"S J Gustafson","year":"2011","journal-title":"Int J Audiol"},{"issue":"03","key":"ref38","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1044\/1092-4388(2008\/056)","article-title":"Short-term word-learning rate in children with normal hearing and children with hearing loss in limited and extended high-frequency bandwidths","volume":"51","author":"A L Pittman","year":"2008","journal-title":"J Speech Lang Hear Res"},{"issue":"04","key":"ref39","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1121\/1.1400757","article-title":"Effect of stimulus bandwidth on the perception of \/s\/ in normal- and hearing-impaired children and adults","volume":"110","author":"P G Stelmachowicz","year":"2001","journal-title":"J Acoust Soc Am"}],"container-title":["Journal of the American Academy of 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