Assessing speech perception in children with hearing loss: What conventional clinical tools may miss

Objectives: This study tested the hypothesis that word recognition in a complex, two-talker masker is more closely related to real-world speech perception for children with hearing loss than testing performed in quiet or steady-state noise. Design: Sixteen school-age hearing aid users were tested on aided word recognition in noise or two-talker speech. Unaided estimates of speech perception in quiet were retrospectively obtained from the clinical record. Ten parents completed a questionnaire regarding their children's ease of communication and understanding in background noise. Results: Unaided performance in quiet was correlated with aided performance in competing noise, but not in two-talker speech. Only results in the two-talker masker were correlated with parental reports of their children's functional hearing abilities. Conclusions: Speech perception testing in a complex background such as two-talker speech may provide a more accurate predictor of the communication challenges of children with hearing loss than testing in steady noise or quiet.