Background: There is a need for objective pediatric hearing aid outcome measurement and thus
a need for the evaluation of outcome measures. We explored a commercially available
pediatric sentence-in-noise measure adapted for use as an aided outcome measure.
Purpose: The purposes of the current study were (1) to administer an adapted BKB-SIN (Bamford-Kowal-Bench
Speech-in-Noise test) to adults and children who have normal hearing and children
who use hearing aids and (2) to evaluate the utility of this adapted BKB-SIN as an
aided, within-subjects outcome measure for amplification strategies.
Research Design: We used a mixed within and between groups design to evaluate speech recognition in
noise for the three groups of participants. The children who use hearing aids were
tested under the omnidirectional, directional, and digital noise reduction (DNR) conditions.
Results from each group were compared to each other, and we compared results of each
aided condition for the children who use hearing aids to evaluate the test utility
as an aided outcome measure.
Study Sample: The study sample consisted of 14 adults with normal hearing (aged 22–28 yr) and 15
children with normal hearing (aged 6–18 yr), recruited through word of mouth, and
14 children who use hearing aids (aged 9–16 yr) recruited from local audiology clinics.
Data Collection and Analysis: List pairs of the BKB-SIN test were presented at 50 dB HL as follows: four list pairs
to each participant with normal hearing, four list pairs in the omnidirectional condition,
and two list pairs in the directional and DNR conditions. Children who use hearing
aids were fitted bilaterally with laboratory devices and completed the BKB-SIN test
aided. Data were plotted as mean percent of key words correct at each signal-to-noise
ratio (SNR). Further, we conducted an analysis of variance for group differences and
within-groups for the three aided conditions.
Results: Adult participants outperformed children with normal hearing, who outperformed the
children who use hearing aids. SNR-50 (signal-to-noise ratio at which listener can
obtain a speech recognition score of 50% correct) scores demonstrated reliability
of the adapted test implementation. The BKB-SIN test measured significant differences
in performance for omnidirectional versus directional microphone conditions but not
between omnidirectional and DNR conditions.
Conclusions: We conclude that the adapted implementation of the BKB-SIN test can be administered
reliably and feasibly. Further study is warranted to develop norms for the adapted
implementation as well as to determine if an adapted implementation can be sensitive
to age effects. Until such norms are developed, clinicians should refrain from comparing
results from the adapted test to the test manual norms and should instead use the
adapted implementation as a within-subject measure.
Key Words
Amplification - BKB-SIN - outcome measure - pediatric - speech in noise
