Effect of Computer-Assisted Speech Training (CAST) on Speech Recognition and Subjective Benefit for Hearing Aid Users with Severe to Profound Pre-Lingual Hearing Loss
Date Issued
2008
Date
2008
Author(s)
Hsieh, Duen-Lii
Abstract
Background: Hearing impairment is a common complaint in ENT clinic, especially sensorineural hearing loss. If the hearing loss is mild, closely followup of the hearing is suggested. If the hearing loss is too severe to communicate, hearing aid would be suggested. However, the efficacy of speech recognition with hearing aid varies from one to another. Therefore, the rehabilitation after wearing a hearing aid is important. Currently, the rehabilitation resources for hearing aid users are far from sufficient. Thus, in addition to develop new generation hearing aids, seeking for better rehabilitation quality is another important issue.urpose: Computer-assisted speech training (CAST) is a speech training system developed by House Ear Institute for cochlear implant users. The training targets on vowel, consonant, tone and pure tone can be performed after the software program is installed into a personal computer. The supervisors can monitor the time and score of self testing on internet. The purpose of this study is to apply this system to hearing aid users with prelingual severe to profound hearing loss. If positive results can be achieved, there will be a promising method of rehabilitation for hearing aid users to improve speech performance.ethods: Fifteen hearing aid users with prelingual severe to profound hearing loss were included into this study. Another 6 hearing aid users with similar background were included for control group. Pure tone audiogram, speech recognition tests including Mandarin monosyllabic word, Mandarin disyllabic spondee-word, vowel, consonant and Chinese tone recognition were performed before training. Subjective benefit questionnaire, or client oriented score of improvement (COSI) was filled out. The software was installed into the personal computer and the subjects were asked to perform the training program 3 days a week, 1 hour per day, for a period of 12 weeks. Every 4 weeks the subjects were called back for speech recognition tests. COSI was completed after the whole training period. The control group received speech recognition tests and filled out COSI without performing the training program. Compare the scores of the tests before and after the training program and the difference between subject and control groups.esult: Twelve of 15 subjects completed the twelve-week training period, speech recognition tests and COSI whereas 3 of them dropped out due to poor compliance. Tone recognition test was completed in only 10 subjects because this test was not introduced in the very first of the study. All 6 people in the control group completed four speech recognition tests and COSI. Results showed the training group had significant improvement in monosyllabic word recognition test after training 8 weeks with CAST (p < 0.0001). However, the improvement failed to present after training 12 weeks. In addition, the training group also had significant improvement in consonant recognition test after training 12 weeks with CAST (p = 0.0139). Otherwise, no significant improvement was noted in disyllabic spondee-word, vowel and tone recognition tests, comparing with pre-training scores. The result of COSI showed higher improvement score in training group but didn’t have statistical significance. The final score of COSI between training and control groups didn’t show statistical difference, either. The data of speech recognition test was analyzed by multiple marginal regression models for repeatedly measured response variable using the generalized estimation equations (GEE) method. The data of COSI was analyzed by multiple linear regression model. These regression analyses were performed using the SAS statistical software (Version 9.1.3, SAS Institute Inc., Cary, NC, USA). Two-sided p < 0.05 was considered statistically significant.onclusion: The result showed computer assisted speech training (CAST) system have some benefit in training hearing aid users with prelingual severe to profound hearing loss. However, the effect is not significant compared with previous studies. Thus, when applying CAST to this kind of hearing aid users, carefully assess the functional gain of hearing aid and make sure the compliance is good should be mandatory.
Subjects
CAST
hearing aid
cochlear implant
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