Dissertations, Theses, and Capstone Projects

Date of Degree

1980

Document Type

Dissertation

Degree Name

Ph.D.

Program

Speech-Language-Hearing Sciences

Advisor

Irving Hochberg

Committee Members

Harry Levitt

Gerald Studebaker

Subject Categories

Speech and Hearing Science

Abstract

The major purpose of this study was to explore the effect of cochlear dysfunction on central auditory speech test performance. There has been limited research reported concerning the effects of peripheral hearing loss occurring in the absence of central auditory pathology on tests specifically designed to diagnose central auditory impairment. Similarly, there has been limited research reported concerning the effects of peripheral hearing loss in the presence of central auditory pathology on tests designed specifically for the evaluation and diagnosis of central auditory pathology. Despite the lack of such data, these tests are frequently performed on individuals with cochlear pathology, suspected of having co-existent central pathology. Both definition of candidacy for central auditory testing in the presence of cochlear pathology and the interpretation of such test results appear arbitrary in that they are left to the discretion of the individual examiner. This study was a systematic investigation of the use of a battery of central auditory speech tests with cochlear impaired subjects.

Thirty-three subjects, 15 males and 18 females, ranging in age from 18-58 years, all with sensorineural hearing loss medically diagnosed to have cochlear site of lesion, were evaluated using a central auditory speech test battery consisting of the following tests: the Competing Sentence Test, the Synthetic Sentence Identification Test-Contralateral Competing Message, the Synthetic Sentence Identification Test-Ipsilateral Competing Message, the Staggered Spondaic Word Test, the Binaural Fusion Test, the Rapid Alternating Speech Test, and the Monaural Low-Pass Filtered Speech Test.

The findings suggest that cochlear dysfunction has an effect on central auditory speech test performance. The degree of the effect varies with (a) the choice of the test, (b) the presentation level of the test, (c) the undistorted speech discrimination scores of the cochlear impaired subject, (d) the audiogram configuration, and (e) the presentation mode of the test.

The level of performance on the central auditory speech test battery is related to the level of the auditory site for which the tests are intended. The level of performance was highest for those tests designed primarily for the evaluation of cortical functioning; that is the Synthetic Sentence Identification Test-Contralateral Competing Message, the Competing Sentence Test, and the Staggered Spondaic Word Test. The lower the level of the auditory lesion for which the tests are intended, the poorer the level of performance; these tests include the Binaural Fusion Test, the Rapid Alternating Speech Test, the Synthetic Sentence Identification Test-Ipsilateral Competing Message, and the Monaural Low-Pass Filtered Speech Test.

Based on those investigated in this study, the following central auditory speech test battery is recommended: (a) Competing Sentence Test at 35dBSL, (b) the Synthetic Sentence Identification Test-Contralateral Competing Message at MCR -40dBHL at 30dBSL, (c) the Staggered Spondaic Word Test at 50dBSL using Katz' scoring procedure, and (d) the Binaural Fusion Test at 40dBSL. Suggestions are made for administering the Rapid Alternating Speech Test and the Synthetic Sentence Identification Test-Ipsilateral Competing Message using specific modifications. The use of the Monaural Low-Pass Filtered Speech Test is not recommended for cochlear impaired individuals.

Recommendations for candidacy for central auditory speech testing in cochlear impaired subjects are made.

A table of difference scores is proposed to compare the performance of cochlear impaired subjects with normal hearing subjects and cochlear impaired subjects with central auditory impaired individuals to aid in the interpretation of central auditory speech test scores.

Comments

Digital reproduction from the UMI microform.

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