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Purpose: Listening is the gateway to learning in the mainstream classroom; however, classrooms are noisy environments, making listening challenging. Therefore, speech-in-noise tests that realistically incorporate the complexity of the classroom listening environment are needed. The aim of this article was to review the speech stimuli, noise stimuli, presentation mode, and presentation levels of current classroom speech-in-noise tests to determine how representative they are of real-world classroom listening., Method: A comprehensive search of Scopus database following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted to identify classroom speech-in-noise tests used in the research literature. The search term was classroom AND (listening OR (speech AND (perception OR intelligibility OR recognition OR discrimination) AND noise) OR speech-in-noise) AND (test OR task OR measure OR assessment) AND children in the article title, abstract, and key word fields ., Results: A total of 97 papers met the criteria to be included in the review. While the speech and noise stimuli were generally presented at realistic speech and noise levels, the speech materials were not representative of real-world classroom listening. Additionally, unrealistic noise and presentation modes were used in several studies., Conclusion: This review will help researchers choose appropriate speech-in-noise test stimuli in future research and also help researchers understand what to consider when creating new speech-in-noise tests for classroom listening., Supplemental Material: https://doi.org/10.23641/asha.27659619.

Objectives: This study assessed hearing aid benefits for people with a normal audiogram but hearing-in-noise problems in everyday listening situations., Design: Exploratory double-blinded case-control study whereby participants completed retrospective questionnaires, ecological momentary assessments, speech-in-noise testing, and mental effort testing with and without hearing aids. Twenty-seven adults reporting speech-in-noise problems but normal air conduction pure-tone audiometry took part in the study. They were randomly separated into an experimental group that trialed mild-gain hearing aids with advanced directional processing and a control group fitted with hearing aids with no gain or directionality., Results: Self-reports showed mild-gain hearing aids reduce hearing-in-noise difficulties and provide a better hearing experience (i.e., improved understanding, participation, and mood). Despite the self-reported benefits, the laboratory tests did not reveal a benefit from the mild-gain hearing aids, with no group differences on speech-in-noise tests or mental effort measures. Further, participants found the elevated cost of hearing aids to be a barrier for their adoption., Conclusions: Hearing aids benefit the listening experience in some listening situations for people with normal audiogram who report hearing difficulties in noise. Decreasing the price of hearing aids may lead to greater accessibility to those seeking remediation for their communication needs., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: University is an important time for learning; therefore, it is vital that the classroom acoustic environment is conducive for all students. The aim of this scoping review was to determine what is known from the literature about the effect of classroom acoustic conditions on university students' listening, learning, and well-being and identify future research needs., Method: This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. After a search of four online databases, a total of 29 articles met the criteria to be included in the review., Results: The scoping review revealed that poor classroom acoustic conditions such as increased noise, decreased signal-to-noise ratio, increased reverberation time, decreased clarity, or decreased speech transmission index largely have a negative effect on university students' listening, learning, and well-being. Nonnative speakers were more adversely affected than native speakers. Students with hearing loss were also more adversely affected, though these students were only included in two studies., Conclusions: It would be beneficial for acoustic modifications to be made in classrooms to enhance students' listening, learning, and well-being. Limitations of the reviewed studies and future research needs are discussed.

Purpose: Being able to hear the teacher clearly is an important factor for children's learning. However, classrooms often have suboptimal listening conditions. Sound-field amplification systems (SFAS) can help improve classroom listening conditions by increasing the level of the teacher's speech compared to the background noise throughout the classroom. The aim of this review article was to review the effect of SFAS on children in primary school., Method: A comprehensive search of four online databases (ERIC, PubMed, Scopus, and Web of Science) was conducted. The search terms were classroom sound-field amplification and classroom amplified distribution system. Twenty-one articles were deemed relevant for the review plus an additional six from their references., Results: Most articles were published between 1996 and 2015. Only one article was published since 2016. A range of child populations were studied including typically developing children and children with difficulties and disabilities such as hearing loss, developmental language disorders, attention-deficit/hyperactivity disorder, emotional and behavior disorders, Down syndrome, and developmental disabilities. There were several different measures that were used to evaluate the effectiveness of SFAS including speech perception assessments, language assessments, academic and comprehension assessments, classroom observations, interviews, and questionnaires. Improvements with SFAS were found for speech perception, listening comprehension and auditory analysis, language outcomes, academic outcomes, and behavior., Conclusion: SFAS can benefit children's listening and learning; however, the child's background, classroom reverberation time (limit to < 1 s), and layout and type of learning activities, especially in modern classrooms, need to be taken into consideration.

Objective: To assess test-retest reliability of the Listening in Spatialised Noise - Universal test (LiSN-U)., Design: Test-retest reliability study. Participants completed the LiSN-U twice, four to eight weeks apart. Study sample: Test-retest reliability was analysed for 23 adults and 109 children., Results: ANOVA showed significant group average score improvement on LiSN-U spatially-separated and co-located conditions on retest (by 1.3 and 0.9 dB, respectively), but not on the difference between them (spatial advantage). Critical difference scores for children were -3.6 dB for the spatially-separated condition, -5.8 dB for the co-located condition, and 5.5 dB for spatial advantage. Critical difference scores for adults were -2.0 dB for the spatially-separated condition, -4.9 dB for the co-located condition, and 5.4 dB for spatial advantage. A correlation analysis was run to determine the relationship between test and retest speech reception thresholds. The correlation was r  = 0.63, p  < 0.001 for the spatially-separated condition, r  = 0.50, p  < 0.001 for the co-located condition, and r  = 0.37, p  < 0.001 for the spatial advantage measure., Conclusions: The LiSN-U, which is potentially useable for speakers of any language, shows mean test-retest difference and test-retest reliability comparable to other tests that have proven useful in clinical practice.

Purpose A proportion of people with a normal audiogram or mild hearing loss (NA-MHL) experience greater-than-expected difficulty hearing speech in noise. This preliminary exploratory study employed a design thinking approach to better understand the clinical pathway and treatment options experienced by this population. Method Exploratory survey data were analyzed from 233 people with NA-MHL who had consulted a clinician and 47 clinicians. Qualitative analysis was performed on interview data from 21 people with NA-MHL and seven clinicians. Results Results revealed that noisy environments, such as restaurants, were where many people experienced listening difficulties. Most people with NA-MHL were not offered a treatment option at their audiology appointment, and their satisfaction with the appointment was diverse. Many clients reported frustration at being told that their hearing was "normal." Data from clinicians showed that there is no standard test protocol for this population, and most felt that they did not have adequate training or resources to help NA-MHL clients. Conclusion This study discusses the research needs regarding the experience of those with NA-MHL, their help-seeking behaviors, and treatment options. Understanding these needs is the first step to designing projects to improve the quality of life of this population.

Objective: Otitis media resulting in conductive hearing loss is a major health issue for Aboriginal and Torres Strait Islander children, which can also lead to the child developing spatial processing disorder (SPD). This study examined the prevalence of hearing loss and deficits in speech understanding in noise, including SPD, in Aboriginal and Torres Strait Islander children from schools varying in remoteness and socio-educational advantage., Method: 288 Aboriginal and Torres Strait Islander children aged 4-14 years from three schools varying in remoteness and socio-educational advantage completed audiological assessment and the Listening in Spatialized Noise - Sentences test to assess for hearing loss and SPD. Children also completed Sound Scouts, a self-administered tablet-based hearing test which screens for these deficits. The prevalence of hearing issues was compared to what is expected from a typical population., Results: The proportion of children with hearing problems was related to the school's socio-educational advantage, with higher proportions in schools with a lower socio-educational advantage. Proportions of children with speech-in-noise deficits (including SPD) was related to the remoteness of the school, with higher proportions in schools that were more remote., Conclusions: The prevalence of hearing loss and SPD is much higher in Aboriginal and Torres Strait Islander children than described for non-Aboriginal populations, and is related to the socio-educational advantage or remoteness of the school. Resources are needed to reduce the incidence of hearing loss and health disparity in Aboriginal communities, especially those in remote areas with lower socio-educational advantages., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The types of reading difficulties experienced by children are highly heterogeneous in nature, which makes diagnosis and intervention difficult. Over the past 30 years, there has been much debate over the cause of dyslexia. The two most popular theories for phonological deficits in dyslexia are the rate-processing constraint hypothesis, which relates to short timescale processing, and the temporal sampling framework hypothesis, which relates to longer timescale processing., Purpose: To investigate the relationship between sublexical (i.e., nonword) reading skills and auditory spectral and temporal resolution patterns in children with reading difficulties using the Phoneme Identification Test (PIT) and the Parsing Syllable Envelopes Test (ParSE). These tests were developed to assess the rate-processing constraint and the temporal sampling framework hypotheses, respectively. We hypothesized that a proportion of children who have sublexical reading difficulties may have an underlying auditory-resolution deficit which may impact their ability to form letter-sound correspondences. We predicted that children's sublexical reading difficulties may not be explained by one theory, but instead that both theories may describe different types of reading difficulties found in different children. We also hypothesized that children with lexical (i.e., irregular word) reading difficulties but intact sublexical reading skills would not show atypical results on PIT or ParSE., Research Design: Behavioral experimental clinical study with children who have reading difficulties., Study Sample: Sixteen children with nonword, irregular word, or mixed reading difficulties diagnosed by the Castles and Coltheart Test 2., Data Collection and Analysis: Children completed a test battery consisting of a hearing screen and tests of reading, auditory resolution, phonological awareness, attention, spatial auditory processing, auditory memory, and intelligence. Categorization and correlational analyses were conducted., Results: All four children with a pure sublexical reading deficit also had an auditory-resolution deficit. Four of seven children with a mixed reading deficit had an auditory-resolution deficit. Only one of five children with a lexical reading deficit had an auditory-resolution deficit. Individual children's specific deficits were related to either rate processing (n = 5) or temporal sampling (n = 4), but never both. Children's nonword reading scores were strongly correlated with their performance on the PIT in noise, but not with the PIT in quiet or the ParSE. Children's irregular word scores were not significantly correlated with their performance on the PIT in quiet or in noise, or the ParSE, as hypothesized. Strong correlations were also found between children's nonword scores and their phonological awareness scores., Conclusions: The results of this study suggest that neither the rate-processing hypothesis nor the temporal sampling framework is the single cause of reading difficulties in children. Instead, both of these hypotheses are likely to account for different types of reading deficits found in children. This is an important finding as the specific mechanisms driving different reading impairments must be identified to create tools to better diagnose and treat different types of reading difficulties. Further investigation of the PIT and ParSE as potential diagnostic tools for specific auditory-resolution-based reading difficulties in a larger group of children is currently underway., (American Academy of Audiology.)

Background: Intensity peaks and valleys in the acoustic signal are salient cues to syllable structure, which is accepted to be a crucial early step in phonological processing. As such, the ability to detect low-rate (envelope) modulations in signal amplitude is essential to parse an incoming speech signal into smaller phonological units., Purpose: The Parsing Syllable Envelopes (ParSE) test was developed to quantify the ability of children to recognize syllable boundaries using an amplitude modulation detection paradigm. The envelope of a 750-msec steady-state /a/ vowel is modulated into two or three pseudo-syllables using notches with modulation depths varying between 0% and 100% along an 11-step continuum. In an adaptive three-alternative forced-choice procedure, the participant identified whether one, two, or three pseudo-syllables were heard., Research Design: Development of the ParSE stimuli and test protocols, and collection of normative and test-retest reliability data., Study Sample: Eleven adults (aged 23 yr 10 mo to 50 yr 9 mo, mean 32 yr 10 mo) and 134 typically developing, primary-school children (aged 6 yr 0 mo to 12 yr 4 mo, mean 9 yr 3 mo). There were 73 males and 72 females., Data Collection and Analysis: Data were collected using a touchscreen computer. Psychometric functions (PFs) were automatically fit to individual data by the ParSE software. Performance was related to the modulation depth at which syllables can be detected with 88% accuracy (referred to as the upper boundary of the uncertainty region [UBUR]). A shallower PF slope reflected a greater level of uncertainty. Age effects were determined based on raw scores. z Scores were calculated to account for the effect of age on performance. Outliers, and individual data for which the confidence interval of the UBUR exceeded a maximum allowable value, were removed. Nonparametric tests were used as the data were skewed toward negative performance., Results: Across participants, the performance criterion (UBUR) was met with a median modulation depth of 42%. The effect of age on the UBUR was significant (p < 0.00001). The UBUR ranged from 50% modulation depth for 6-yr-olds to 25% for adults. Children aged 6-10 had significantly higher uncertainty region boundaries than adults. A skewed distribution toward negative performance occurred (p = 0.00007). There was no significant difference in performance on the ParSE between males and females (p = 0.60). Test-retest z scores were strongly correlated (r = 0.68, p < 0.0000001)., Conclusions: The ParSE normative data show that the ability to identify syllable boundaries based on changes in amplitude modulation improves with age, and that some children in the general population have performance much worse than their age peers. The test is suitable for use in planned studies in a clinical population., (American Academy of Audiology)

Background: Previous research suggests that a proportion of children experiencing reading and listening difficulties may have an underlying primary deficit in the way that the central auditory nervous system analyses the perceptually important, rapidly varying, formant frequency components of speech., Purpose: The Phoneme Identification Test (PIT) was developed to investigate the ability of children to use spectro-temporal cues to perceptually categorize speech sounds based on their rapidly changing formant frequencies. The PIT uses an adaptive two-alternative forced-choice procedure whereby the participant identifies a synthesized consonant-vowel (CV) (/ba/ or /da/) syllable. CV syllables differed only in the second formant (F2) frequency along an 11-step continuum (between 0% and 100%-representing an ideal /ba/ and /da/, respectively). The CV syllables were presented in either quiet (PIT Q) or noise at a 0 dB signal-to-noise ratio (PIT N)., Research Design: Development of the PIT stimuli and test protocols, and collection of normative and test-retest reliability data., Study Sample: Twelve adults (aged 23 yr 10 mo to 50 yr 9 mo, mean 32 yr 5 mo) and 137 typically developing, primary-school children (aged 6 yr 0 mo to 12 yr 4 mo, mean 9 yr 3 mo). There were 73 males and 76 females., Data Collection and Analysis: Data were collected using a touchscreen computer. Psychometric functions were automatically fit to individual data by the PIT software. Performance was determined by the width of the continuum for which responses were neither clearly /ba/ nor /da/ (referred to as the uncertainty region [UR]). A shallower psychometric function slope reflected greater uncertainty. Age effects were determined based on raw scores. Z scores were calculated to account for the effect of age on performance. Outliers, and individual data for which the confidence interval of the UR exceeded a maximum allowable value, were removed. Nonparametric tests were used as the data were skewed toward negative performance., Results: Across participants, the median value of the F2 range that resulted in uncertain responses was 33% in quiet and 40% in noise. There was a significant effect of age on the width of this UR (p < 0.00001) in both quiet and noise, with performance becoming adult like by age 9 on the PIT Q and age 10 on the PIT N. A skewed distribution toward negative performance occurred in both quiet (p = 0.01) and noise (p = 0.006). Median UR scores were significantly wider in noise than in quiet (T = 2041, p < 0.0000001). Performance (z scores) across the two tests was significantly correlated (r = 0.36, p = 0.000009). Test-retest z scores were significantly correlated in both quiet and noise (r = 0.4 and 0.37, respectively, p < 0.0001)., Conclusions: The PIT normative data show that the ability to identify phonemes based on changes in formant transitions improves with age, and that some children in the general population have performance much worse than their age peers. In children, uncertainty increases when the stimuli are presented in noise. The test is suitable for use in planned studies in a clinical population., (American Academy of Audiology)