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

描述（由申请人提供）： 在美国，25%到35%的成年人可以从助听器中受益，多达25，000，000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语音，以证明他们的成本是合理的。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。这是言语感知训练可以提高识别能力，否则不成功的助听器用户可以成为成功的点。包括我们自己在内的几个研究小组都报告说，由于各种类型的训练，语音识别在统计上有了显著的改善。但没有人回答三个关键问题。(1)通过长期的系统训练，语音识别能力能有多大的提高？(2)需要多少小时的培训才能达到这个极限？(3)成功进行语音识别训练的最佳训练材料是什么：口语短语和句子，语音的组成部分，还是语音部分和整体？该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的强化言语感知训练研究来解决这些问题。培训将使用过去八年开发和测试的言语感知评估和培训系统进行。SPATS结合了英语口语中100多个最常见的音节成分（起始、核心和结尾）的训练和有意义句子的识别训练。对助听器和耳蜗植入用户的临床试验表明，经过12至24小时的SPATS训练后，语音识别测试的训练后分数有所提高，与其他系统的结果相似。这些数据以及来自非言语听觉训练研究的证据表明，如果训练持续30-40小时，将取得临床上重要的收益。虽然这一培训量可能被认为是对听力受损者的不可能的要求，但与用于学习许多其他技能的时间相比，这并不那么令人生畏。在30- 40小时内，一个钢琴学生可以演奏几个音阶，并可能用双手掌握她的第一首初级作品，一个截肢者最终成为滑雪者，他设法穿过房间，一个外语学生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该被拒绝，因为30-40小时的训练不适合当前的临床实践模式。如果助听器使用者的语言接收能力可以通过这种训练得到重大改善，许多使用者会选择做出这种努力，并愿意为此付费。

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.