Enhancing Audibility for Low-Level Speech in Pediatric Hearing Aid Users

Purpose: The purpose of the study was to evaluate whether an adaptive gain enhancer significantly improved soft speech recognition at 40 and 50 dBA. Method: Twenty children, ages 9–12 years, and 13 children, ages 5–8 years, with sensorineural hearing loss were included in this single, cross-sectional group intervention study. They were fitted with study hearing aids with three programs: Calm Situation with Speech Enhancer (SE) set at “moderate,” “strong,” and “off.” Consonant–nucleus–consonant (CNC) word recognition testing was completed with each program in quiet at 40 and 50 dBA. Results: An analysis of variance (ANOVA) for the three SE conditions off, moderate, and strong at 50 dBA was significant and had a small effect size: F (2) = 9.40 ( p ≤ .001; η 2 = .16). Post hoc comparisons using Bonferroni's correction found that mean CNC scores were significantly different between SE off and SE moderate ( p = .005, 95% confidence interval [CI, 1.79, 12.99]) as well as SE off and SE strong ( p < .001, 95% CI [3.91, 15.11]), and for both conditions, there was significant improvement with SE enabled versus off. A separate ANOVA for the three SE conditions at 40 dBA was also significant and had a medium effect: F (2) = 14.93, ( p < .001, η 2 = .24 . Post hoc comparisons using Bonferroni's correction found that mean CNC scores were significantly different between SE off and SE moderate ( p < .001, 95% CI [5.10, 20.12]) as well as SE off and SE strong ( p < .001, 95% CI [8.50, 23.51]), with participants scoring higher on CNC when SE was enabled versus off. For both 40 and 50 dBA, there were no significant differences found between SE strong and SE moderate. Conclusions: This study provides evidence that an adaptive, low-level gain enhancer significantly improves speech perception performance in children for soft speech. The use of an adaptive, low-level gain enhancer may be considered for use in pediatric patients to improve audibility for soft speech.