عنوان

تاثیر توانبخشی مبتنی بر تمایز زیر و بمی بر درک گفتار در حضور نویز درکودکان کم شنوای 6 تا 10 سال

Objective: Speech perception in noise is a highly challenging situation experienced by hearing-impaired children (HIC). Despite advances in hearing aid technologies, speech perception in noise still poses challenges. Pitch-based training improves pitch discrimination and speech perception and may facilitate concurrent sound segregation. Considering the role of harmonics in the analysis of concurrent sounds, we perF0rmed a harmonic assessment, examined the role of harmonic training in the rehabilitation of moderate-to-severe HIC, and investigated its effect on their speech perception in noise also using long latency auditory evoked potentials (LLAEPs) and object-related negativity (ORN), a neural metric of concurrent sound segregation, this study investigated the sensitivity of HIC in processing harmonic relationMethods: The participants were 57 normally hearing children (NHC) with a mean age of 7.73 ± 1.57 years and 18 HIC with a mean age of 7.94 ± 1.47 years. The two groups were compared in terms of harmonic assessment, the Pitch Pattern Sequence Test (PPST), the Consonant-Vowel in Noise (CV in noise) test, and the BamF0rd-Kowal Bench (BKB) test. They were presented with a sequence of 200 Hz harmonic complex tones that had either all harmonic in tune or the third harmonic mistuned by 2%, 4%, 8%, and 16% of its original value and LLAEPs and ORN in 2%, 4%, 8%, and 16% conditions was recorded Subsequently, the HIC underwent harmonic training, and the results of the pre- and post-harmonic training assessments were compared.Results: HIC displayed poorer harmonic discrimination than NHC at all harmonics (P < 0/05). They also showed lower scores in PPST, CV in noise, and BKB tests compared to NHC (P < 0/05). The analysis of scalp-recorded LLAEPs indicated that tuned stimuli elicited lower N2 amplitudes in HIC than control. The difference in LLAEP between tuned and mistuned stimuli yielded higher latency ORN2% and less presence of ORN waves in all conditions in HIC than NHC. Harmonic training led to HIC's better perF0rmance in harmonic assessment, PPST, and CV in noise test (P<0.05). However, the BKB test and ORN amplitude and latency results pre- and post-training did not significantly differ (P > 0/05).Conclusion: Harmonic training plays a significant role in improving the HIC's temporal processing of the PPST and CV in noise test; thereF0re, it can serve as a rehabilitation method to enhance temporal processing and auditory scene analysis.Keywords: Pitch, Harmonic training, Hearing impaired children, Speech in noise, Object Related Negativity