Audiometric profiles in children with speech sound disorder: Subclinical hearing loss as a potential factor

Abstract

In the present study, hearing sensitivity in children with speech sound disorder (SSD) is scrutinized. Middle ear function (wideband tympanometry and acoustic stapedial reflexes, ASR) and inner ear function (audiometric thresholds in the conventional 1-8 kHz and extended 10-16 kHz high frequency (EHF) range, and distortion product otoacoustic emissions (DPOAEs 2-10 kHz) were investigated. Hearing results were analyzed in relation to speech discrimination of phonemic contrasts (quiet and in noise conditions) and reproduction. Thirty-two children with SSD and 41 children with typical development (TD) ages 4-5 years participated. Children with SSD exhibited significantly less sensitive hearing compared to children with TD. This was demonstrated as more absent contralateral ASR (right ear SSD 43.7%; TD 22.0%), a higher prevalence of minimal hearing loss (MHL, > 15 dB HL at one or more frequencies or ears 1-8 kHz and PTA ≤ 20 dB HL, SSD 53.1%; TD 24.3%) and EHF hearing impairment (EHF HI, > 20 dB HL at one or more frequencies or ears 10-16 kHz , SSD 31.3%; TD 24.3%). At 2 kHz bilaterally, children with SSD showed significantly higher hearing thresholds than children with TD (mean difference, left ear 3.4 dB: right ear 4.3 dB), together with a significantly lower SNR in DPOAEs at 2.2 kHz (left ear 5.1 dB mean difference between groups). In all children, audiometric thresholds at the key-frequencies for speech, 2 and 4 kHz and DPOAEs within similar spectral regions, predicted 7-12% of the variance in phonemic discrimination and reproduction. Overall, these results suggest that hearing should be more fully investigated in children with SSD.

Listening and Processing Skills in Young School Children with a History of Developmental Phonological Disorder

“…When investigating the proportions of participants with poor results, the findings show that DPD participants were more often reported having sub-threshold scores for the total score, and the subscale SAP, EAS, and PSS scores. The finding that the subscale environmental and auditory sensitivity differed between the groups, to the disadvantage of the children with DPD, corroborates the findings of hearing-related problems in DPD children that were found by [3]. In that study, subclinical hearing loss was found in 4-5-year-old children with DPD.…”

“…DPD and Speech Sound Disorders (SSD) in childhood are often used interchangeably [2][3][4]. However, SSD includes both functional and organic difficulties with the spoken sound system [5].…”