Investigating the contribution of extended high-frequency hearing loss to poor speech-in-noise perception in clinically normal hearing children and young adults

临床定义正常听力的人经常报告在具有挑战性的环境中听力困难。 他们经常离开听力诊所，没有诊断来解释他们在噪音中听力的困难。 对成人的研究表明，扩展高频（EHF; > 8 kHz）听力，超过目前的测试， 临床测听范围，有助于噪声中的言语感知。小孩子最敏感的是 EHF，这种敏感性在余生中逐渐丧失。以前的研究发现， 流行性出血热听力损失（EHFHL）与噪声中言语理解困难（SiN）之间存在显著关系 临床听力正常的成年人。然而，据我们所知，没有研究调查这种关系 听力正常的儿童和青少年。本研究旨在通过以下方式弥补这一差距： 调查儿童和年轻人（8至30岁）EHFHL与SiN感知受损之间的关系 y/o），临床听力正常（≤ 20 dB HL，0.25 - 0.8 kHz）。有三个具体目标。在目标1中， 用标准（0.25-8）建立EHFHL与听力困难主观报告之间的关系 kHz）和EHF（9 - 16 kHz）测听。成人和儿童版本的言语，空间和素质（SSQ） 问卷将测量自我和父母报告的噪音听力困难。在目标2中，我们将确定 EHFHL对使用声场噪声数字（sfDIN）测试的空间语音感知的影响。在目标3中， 我们将评估低频相关的EHFHL和它们可能对SiN的影响。目标（啁啾瞬态- 诱发耳声发射）和行为（频谱-时间调制任务）的阈上测量 听力将用于确定标准频率（≤ 8 kHz）下的阈上缺陷是否可解释 EHFHL和SiN之间的关联已经在成人中观察到，并预测为儿童。 这些实验的结果将增强我们对EHFHL对通信影响的理解 孩子的能力。如果EHFHL导致儿童在具有挑战性的环境中遇到困难， 假设，那么在听力学测试组合中包括EHF听力评估可以识别易感者， 从而导致听力损失的预防和早期干预。

People with clinically defined normal hearing frequently report difficulty hearing in challenging environments. They often leave audiology clinics with no diagnosis to explain the difficulty they experience listening in noise. Studies in adults demonstrate that extended high frequency (EHF; > 8 kHz) hearing, beyond the currently tested range of clinical audiometry, contributes to speech perception in noise. Young children are the most sensitive to EHFs, and this sensitivity is progressively lost throughout the remainder of life. Previous studies found a significant relationship between EHF hearing loss (EHFHL) and difficulty understanding speech-in-noise (SiN) in adults with clinically normal hearing. However, to our knowledge, no studies have investigated this relationship in typically-developing, normal-hearing children and youth. The present study aims to address this gap by investigating the association between EHFHL and impaired SiN perception in children and young adults (8 to 30 y/o) with clinically normal hearing (≤ 20 dB HL, 0.25 - 0.8 kHz). There are three specific aims. In Aim 1 we will establish the relationship between EHFHL and subjective reports of listening difficulties using standard (0.25-8 kHz) and EHF (9 - 16 kHz) audiometry. The adult and child versions of the Speech, Spatial and Qualities (SSQ) questionnaire will measure self- and parent-reported difficulty listening in noise. In Aim 2 we will determine the impact of EHFHL on the perception of spatial speech using the sound-field digits-in-noise (sfDIN) test. In Aim 3, we will evaluate low-frequency correlates of EHFHL and their possible effect on SiN. Objective (chirp transient- evoked otoacoustic emissions) and behavioral (spectro-temporal modulation task) measures of supra-threshold hearing will be used to determine whether supra-threshold deficits at standard frequencies (≤ 8 kHz) account for associations between EHFHL and SiN that have been observed for adults and are predicted for children. Outcomes of these experiments will enhance our understanding of the impact of EHFHL on communication abilities of children. If EHFHL contributes to the difficulty children experience in challenging environments, as we hypothesize, then including EHF hearing assessment in an audiologic test battery could identify susceptible individuals and in turn lead to prevention and early intervention for hearing loss.