Speech-in-Noise and Quality-of-Life Measures in School-Aged Children With Normal Hearing and With Unilateral Hearing Loss.

objectives(1) Measure sentence recognition in co-located and spatially separated target and masker configurations in school-aged children with unilateral hearing loss (UHL) and with normal hearing (NH). (2) Compare self-reported hearing-related quality-of-life (QoL) scores in school-aged children with UHL and NH.

designListeners were school-aged children (6 to 12 yrs) with permanent UHL (n = 41) or NH (n = 35) and adults with NH (n = 23). Sentence reception thresholds (SRTs) were measured using Hearing In Noise Test-Children sentences in quiet and in the presence of 2-talker child babble or a speech-shaped noise masker in target/masker spatial configurations: 0/0, 0/-60, 0/+60, or 0/±60 degrees azimuth. Maskers were presented at a fixed level of 55 dBA, while the level of the target sentences varied adaptively to estimate the SRT. Hearing-related QoL was measured using the Hearing Environments and Reflection on Quality of Life (HEAR-QL-26) questionnaire for child subjects.

resultsAs a group, subjects with unaided UHL had higher (poorer) SRTs than age-matched peers with NH in all listening conditions. Effects of age, masker type, and spatial configuration of target and masker signals were found. Spatial release from masking was significantly reduced in conditions where the masker was directed toward UHL subjects' normal-hearing ear. Hearing-related QoL scores were significantly poorer in subjects with UHL compared to those with NH. Degree of UHL, as measured by four-frequency pure-tone average, was significantly correlated with SRTs only in the two conditions where the masker was directed towards subjects' normal-hearing ear, although the unaided Speech Intelligibility Index at 65 dB SPL was significantly correlated with SRTs in four conditions, some of which directed the masker to the impaired ear or both ears. Neither pure-tone average nor unaided Speech Intelligibility Index was correlated with QoL scores.

conclusionsAs a group, school-aged children with UHL showed substantial reductions in masked speech perception and hearing-related QoL, irrespective of sex, laterality of hearing loss, and degree of hearing loss. While some children demonstrated normal or near-normal performance in certain listening conditions, a disproportionate number of thresholds fell in the poorest decile of the NH data. These findings add to the growing literature challenging the past assumption that one ear is "good enough."