Multi-site study of speech perception training for hearing-aid users

描述(由申请人提供)： 在美国，可能受益于助听器的成年人中，有25%到35%的人，多达2500万人，要么拒绝考虑这些设备，要么在试用后拒绝使用。许多试图使用助听器的人认为，他们无法很好地理解言语，无法证明自己的花费是合理的。虽然助听器技术的发展改善了这种情况，但最近的研究提出了另一种答案。语音感知训练可以提高人们的识别能力，使原本不成功的助听器使用者能够获得成功。包括我们自己在内的几个研究小组报告称，由于各种类型的培训，语音识别能力在统计上有了显著改善。但没有一个人回答了三个至关重要的问题。(1)通过长期的系统训练可以在语音识别方面取得多大的进步？(2)需要多少小时的训练才能达到这个极限？(3)成功的语音识别训练的最佳训练材料是什么：口语短语和句子，词性，还是词性和整体？拟议的项目在六个主要的听觉研究和临床服务中心进行，将通过对助听器用户进行密集的言语感知培训研究来解决这些问题。培训将使用言语感知评估和培训系统(SPATS)进行，该系统在过去八年中已经开发和测试。SPATS将对100多个最常见的英语口语音节成分(音节、核心和尾音)的培训与识别有意义的句子的培训结合在一起。对助听器和人工耳蜗使用者进行的临床试验表明，在经过12到24小时的SPATS训练后，训练后的语音识别测试成绩有所提高，与其他系统的结果相似。这些数据，加上来自非语言听觉训练研究的证据，表明如果训练总共持续30-40个小时，将会取得临床上重要的收获。虽然这种数量的训练可能被认为是不可能对听障人士提出的要求，但与用于学习许多其他技能的时间相比，这并不是那么令人望而却步。在30-40个小时内，一个学钢琴的学生可以弹几个音阶，可能已经用两只手掌握了她的第一首基本曲子，一个最终成为滑雪者的截肢者已经成功地穿过一个房间，一个外语学生已经学会了慢慢地阅读一个非常简单的故事。助听器使用者的言语感知训练不应立即被拒绝，因为30-40小时的训练不符合当前临床实践的模式。如果可以证明助听器使用者的语言接收能力可以通过这种培训获得重大改善，许多使用者会选择做出这一努力，并愿意为此买单。

DESCRIPTION (provided by applicant): Between 25 and 35% of the adults in the US who could benefit from hearing aids, as many as 25,000,000 persons, either refuse to consider those devices or reject them after a trial. Many of those who try to use hearing aids decide that they are not able to understand speech well enough with them to justify their cost. While developments in hearing-aid technology have improved this situation, recent research suggests another answer. It is that speech perception training may improve recognition abilities to the point that otherwise unsuccessful hearing-aid users can become successful. Several research groups, including our own, have reported statistically significant improvements in speech recognition as a result of various types of training. But none have answered three vital questions. (1) How great an improvement in speech recognition can be achieved through prolonged systematic training? (2) How many hours of training are required to approach that limit? (3) What are the optimal training materials for successful speech recognition training: spoken phrases and sentences, the constituent parts of speech, or both speech parts and wholes? The proposed project, conducted at six major centers for auditory research and clinical service, will address these questions through an intensive speech perception training study of hearing-aid users. Training will be done using the Speech Perception Assessment and Training System (SPATS), which has been developed and tested over the past eight years. SPATS combines the training of over 100 of the most common syllable constituents of spoken English (onsets, nuclei and codas) with training on the recognition of meaningful sentences. Clinical trials with both hearing-aid and cochlear-implant users have shown improved post-training scores on speech recognition tests, following 12 to 24 hours of SPATS training, similar to results reported for other systems. Those data, together with evidence from non-speech auditory training research, suggest that clinically important gains would be made if the training continued for a total of 30-40 hours. While this amount of training may be considered an impossible demand to make of hearing-impaired persons, it is less forbidding when compared to the time devoted to learning many other skills. In 30- 40 hours a piano student can play a few scales and may have mastered her first elementary piece using two hands, an amputee who will eventually become a skier has managed to walk across a room, and a foreign-language student has learned to read a very simple story, slowly. Speech perception training for hearing-aid users should not be rejected out of hand because 30-40 hours of training does not fit the model of current clinical practice. If major improvements in speech reception by the hearing-aid user can be shown to be achievable through such training, many users would elect to make that effort and be willing to pay for it.