Effect of training rate on recognition of spectrally shifted speech

OBJECTIVE: Previous studies have shown that the protocol used for auditory training may significantly affect the outcome of training. However, it is unclear how often training should be performed to maximize its benefit. The present study investigated how the frequency of training contributed to normal-hearing listeners' adaptation to spectrally shifted speech. METHODS: Eighteen normal-hearing listeners were trained with spectrally shifted and compressed speech via an 8-channel acoustic simulation of cochlear implant speech processing. Five short training sessions (1 hr per session) were completed by each subject; subjects were trained at one of three training rates: five sessions per week, three sessions per week, or one session per week. Subjects were trained to identify medial vowels presented in a cVc format; depending on the level of difficulty, the number of response choices was increased and/or the acoustic differences between vowels were reduced. Vowel and consonant recognition was measured before and after training as well as at regular intervals during the training period. Sentence recognition was measured before and after training only. RESULTS: Results showed that pretraining vowel recognition scores were poor (14.0% correct, on average) for all subjects, due to the severe spectral shift. After five sessions of targeted vowel contrast training, there was a significant improvement of shifted vowel recognition for most subjects. The mean improvement was comparable (approximately 15 percentage points) across the three training rate conditions, despite significant intersubject variability in pre- and pretraining baseline performance. There was no significant difference in training outcomes among the three training rates. Spectrally shifted consonant and sentence recognition also improved by approximately 20 percentage points after training, even though consonants and sentences were not explicitly trained. Similar to vowel recognition, there was no significant difference in training outcomes among the three training rates for shifted consonant and sentence recognition. CONCLUSIONS: The results demonstrated that the training rate had little effect on normal-hearing listeners' adaptation to spectrally shifted speech, at least for the training periods (ranging from 1 to 5 wk) used in the present study. The outcome of auditory training may depend more strongly on the amount of training (i.e., total number of training sessions) rather than the frequency of training (i.e., daily or once per week). Although more frequent training may accelerate listeners' adaptation to spectrally shifted speech, there may be significant benefits from training as little as one session per week. The results of the present study suggest that appropriate training schedules can be developed to optimize the effectiveness, efficiency, and effort associated with hearing-impaired patients' auditory rehabilitation.     

微信联合PBL在口腔内科住院医师规范化培训中的应用效果

目的探讨微信联合PBL在口腔内科住院医师规范化培训中的应用。方法选择口腔内科规范化培训的住院医师30例,采用微信联合PBL教学方式,统一评价教学质量,规培前、规培1年、规培2年考核专业成绩和操作成绩。结果30例规培学生优良率为83.33%;与规培前比,规培1年、规培2年时专业成绩和操作成绩均升高,有差异(P<0.05)。结论微信联合PBL可提高口腔内科住院医师规范化培训效果.     

Comparison of word-, sentence-, and phoneme-based training strategies in improving the perception of spectrally distorted speech.

PURPOSE: To compare the effectiveness of 3 self-administered strategies for auditory training that might improve speech perception by adult users of cochlear implants. The strategies are based, respectively, on discriminating isolated words, words in sentences, and phonemes in nonsense syllables. METHOD: Participants were 18 normal-hearing adults who listened to speech processed by a noise-excited vocoder to simulate the information provided by a cochlear implant. They were assigned randomly to word-, sentence-, or phoneme-based training and underwent 9 training sessions (20 min each) on separate days over a 2- to 3-week period. The effectiveness of training was assessed as the improvement in accuracy of discriminating vowels and consonants, as well as identifying words in sentences, relative to participants' best performance in repeated tests prior to training. RESULTS: Word- and sentence-based training led to significant improvements in the ability to identify words in sentences that were significantly larger than the improvements produced by phoneme-based training. There were no significant differences between the effectiveness of word- and sentence-based training. No significant improvements in consonant or vowel discrimination were found for the sentence- or phoneme-based training groups, but some improvements were found for the word-based training group. CONCLUSION: The word- and sentence-based training strategies were more effective than the phoneme-based strategy at improving the perception of spectrally distorted speech.     

Evaluation of Speech-Perception Training for Hearing Aid Users: A Multisite Study in Progress

Following an overview of theoretical issues in speech-perception training and of previous efforts to enhance hearing aid use through training, a multisite study, designed to evaluate the efficacy of two types of computerized speech-perception training for adults who use hearing aids, is described. One training method focuses on the identification of 109 syllable constituents (45 onsets, 28 nuclei, and 36 codas) in quiet and in noise, and on the perception of words in sentences presented in various levels of noise. In a second type of training, participants listen to 6- to 7-minute narratives in noise and are asked several questions about each narrative. Two groups of listeners are trained, each using one of these types of training, performed in a laboratory setting. The training for both groups is preceded and followed by a series of speech-perception tests. Subjects listen in a sound field while wearing their hearing aids at their usual settings. The training continues over 15 to 20 visits, with subjects completing at least 30 hours of focused training with one of the two methods. The two types of training are described in detail, together with a summary of other perceptual and cognitive measures obtained from all participants.     

人工耳蜗术后康复机构“参与式家长培训”初探

本文阐述了在人工耳蜗术后康复中开展“参与式家长培训”活动的原因、方法;“参与式家长培训”强调教师与家长、家长与家长之间的多向交流,旨在促进家长主动参与机构的培训活动以及儿童术后康复的全过程。通过“参与式培训“使家长进行亲历式的学习,提高了机构开展家长培训活动的成效,可以保证术后儿童在康复过程中获得良好的家庭支持,提高术后康复的效果。     

Simulated patients versus seminars to train case history and feedback skills in audiology students: A randomized controlled trial

Objective: To compare simulated patients (SP) versus seminars for training audiology students to take a case history and give feedback with adult patients. Design: A randomized controlled trial with cross-over. Study sample: Twenty-four audiology students, five SPs, two clinical educators (CE) and three evaluators. Students were randomly allocated to Group 1 who completed SP then seminar training or Group 2 who completed seminar then SP training. The SP training saw each student work with an SP in a clinic room and receive individualized feedback. The seminar training saw the student group work with a single CE in a lecture room and receive group feedback. All students were assessed taking a case history and giving feedback to an SP before, between, and after the training blocks. Results: Mixed model analyses of derived factors for case history and feedback showed significant (p?Conclusion: SP training provided no benefit over seminar training in audiology students learning case history and feedback skills with adult patients.     

听障儿童注意力训练的个案研究

目的本研究以听障儿童视觉和听觉通道的注意力训练为内容,以提高听障儿童的注意能力为目的,编制一套渐进式视-听觉通道注意力训练方案。方法通过对1名配戴助听器的听障儿童进行12次的训练。采用单一被试A-B-A实验设计来检验训练的效果。结果训练后该儿童的注意稳定性,注意广度和注意分配指标都得到了明显提高并具延续效应。其中,注意广度的进步最为显著,保持效果最佳。结论渐进式视-听觉通道注意力训练是一种可行的训练方案,值得听障儿童教育和康复工作者参考。     

嗓音训练治疗声门闭合不全所致功能性嗓音障碍的疗效分析

目的探讨嗓音训练对声门闭合不全的功能性嗓音障碍患者的疗效。方法对24例声门闭合不全的功能性嗓音障碍患者进行8周的嗓音训练,训练内容包括健康宣教、肌肉放松、喉部按摩、暖嗓、呼吸训练、嗓音训练和共鸣训练,训练前后对患者进行电子喉镜检查、GRBAS评估、嗓音障碍指数量表（VHI）评估、计算机嗓音声学分析,比较训练前后评估结果。结果24例患者训练后电子喉镜检查16例患者声门闭合良好（66.67%,16/24）,6例声门裂隙变小（25.00%,6/24）,2例声门裂隙无明显变化（8.33%,2/24）;GRBAS评分中总嘶哑度G(0.61±0.66)明显低于训练前(1.91±0.87)（P<0.05）,粗糙声Ｒ(0.51±0.58)明显低于训练前(1.41±0.52)（P<0.05）;VHI评分总分(29.21±21.02)分明显低于训练前的(52.35±23.45)分（P<0.05）;计算机嗓音声学分析最长发声时间（15.24±3.64）s比训练前（9.02±3.45）s明显延长（P<0.05）,基频微扰、最高基频、最低音强、嗓音障碍严重指数训练后分别为（0.21±0.08）%、（420.11±44.21）Hz、（54.21±3.20）dB、（1.62±0.82）比训练前的（0.92±0.12）%、（375.21±49.21）Hz、（56.81±3.42）dB、（0.21±1.02）有改善（P<0.05）。结论嗓音训练能改善声门闭合不全的功能性嗓音障碍患者的声门闭合及嗓音质量。     

听障儿童的听觉察知能力训练

听觉察知能力是最基本的听觉能力,要求患者对声音做出准确而及时的反应。听力障碍者要能够逐步形成利用残余听力、助听听力或重建听力的意识和能力。听觉察知能力训练分为无意察知能力诱导和有意察知训练两部分。训练内容和方法各有侧重。本文介绍了听觉察知能力训练的内容与方法,分享了一例听觉察知能力训练的个别化教育康复方案。     

Training Japanese listeners to perceive American English vowels: influence of training sets.

PURPOSE: Studies on speech perception training have shown that adult 2nd language learners can learn to perceive non-native consonant contrasts through laboratory training. However, research on perception training for non-native vowels is still scarce, and none of the previous vowel studies trained more than 5 vowels. In the present study, the influence of training set sizes was investigated by training native Japanese listeners to identify American English (AE) vowels. METHOD: Twelve Japanese learners of English were trained 9 days either on 9 AE monophthongs (fullset training group) or on the 3 more difficult vowels (subset training group). Five listeners served as controls and received no training. Performance of listeners was assessed before and after training as well as 3 months after training was completed. RESULTS: Results indicated that (a) fullset training using 9 vowels in the stimulus set improved average identification by 25%; (b) listeners in both training groups generalized improvement to untrained words and tokens spoken by novel speakers; and (c) both groups maintained improvement after 3 months. However, the subset group never improved on untrained vowels. CONCLUSIONS: Training protocols for learning non-native vowels should present a full set of vowels and should not focus only on the more difficult vowels.     

功能性发声障碍职业用嗓者嗓音训练前后嗓音音域图及声学分析研究

目的评估发声训练的临床疗效及音域图(voice range profile,VRP)在嗓音评估中的作用。方法对100例功能性发声障碍职业用嗓者进行为期8周的发声训练,包括:放松训练、呼吸训练、共鸣及构音训练、振动训练及发声综合训练;训练前后采用德国XION DIVAS系统对受试者进行音域图测试及声学分析,比较训练前后最大声强、最小声强、最高基频、最低基频、基频微扰(jitter)、最长发声时间(maximum phonation time,MPT)及嗓音障碍严重指数(dysphonia severity index,DSI)的变化。结果 100例受试者发声训练后音域图各指标均有不同程度改善,最大声强均值由90.33 dB SPL增加至95.00 dB SPL;最小声强均值由47.26 dB SPL降低至43.71 dB SPL;最高频率均值由506.29 Hz增加至682.05 Hz;jitter均值由训练前的2.50%改善至0.73%;MPT均值由训练前的12.92±2.91 s改善至23.64±1.05 s,DSI从训练前的-2.89±1.86改善为5.43±0.79,差异均有统计学意义(均为P<0.05)。结论发声训练对改善职业用嗓者的功能性发声障碍切实有效,可改善其嗓音质量,音域图可作为职业用嗓者发声训练效果的评估手段。     

Structured telephone training improves telephone competence in prelingually deafened children with a cochlear implant

Abstract

Objective

The aim of the study is to assess the efficacy of a 6-month telephone use training programme in prelingually deafened children with a cochlear implant (CI).

Methods

Eleven children with a CI aged between 3.5 and 8 years participated in a step-by-step telephone training programme. After completion of 3 months of formal training provided by a special education professional, parents continued telephone training at home for 3 months and kept records. The outcomes of the entire 6-month telephone training were measured at three intervals using the Telephone Profile, the Iowa closed-set sentence test (Level A), and a parent questionnaire.

Results

The scores on the Telephone Profile and Iowa closed-set sentence test significantly increased between the pre-training assessment and the assessments at 3 and 6 months. The results on the Iowa closed-set sentence test significantly decreased between the 3- and the 6-month-post training assessments. The majority of parents reported ‘slight improvement’ in telephone skills after telephone training. No improvement was reported by the majority of parents in the use of repair strategies during telephone conversations.

Discussion

Telephone training provided by a special education professional appears effective in prelingually deafened children with a CI. Home training provided by parents is less effective, but helps maintain the skills acquired in the professional telephone training.

Conclusion

Structured telephone training provided by a professional improves telephone skills in children with a CI. Repair strategies for telephone use should be incorporated into rehabilitation programmes for CI users.     

听障儿童声母最小音位对比式识别能力的个案研究

目的通过对一名听障儿童声母最小音位对比式识别能力进行评估与干预训练,验证分层训练方法对提高其声母最小音位对比式识别能力的有效性。方法以一名3岁、双耳配戴助听器的听障儿童为被试,采用分层训练的方法进行为期6周的干预训练。训练前、后分别使用声母最小音位对比式识别能力评估词表进行评估,训练过程中采用单一被试法（B1-B2设计）、声母最小音位对比式识别能力评估A监控词表进行监控。结果训练后,该儿童声母识别的正确率较训练前有了大幅度提高（由62.1％上升为93．3％）,并且通过了同龄儿童的参考标准;处理前期和处理后期两组数据存在极显著差异（P〈0.01）。同时,个案在日常生活中的识别能力也有了一定程度的提高。结论本研究设计的训练方案对提高听障儿童声母最小音位对比式识别能力是有效的。     

Training and simulation in otolaryngology

This article focuses on key issues surrounding the needs and application of simulation technologies for technical skills training in otolaryngology. The discussion includes an overview of key topics in training and learning, the application of these issues in simulation environments, and the subsequent applications of these simulation environments to otolaryngology. Examples of past applications are presented, with discussion of how the interplay of cultural changes in surgical training in general along with the rapid advancements in technology have shaped and influenced their adoption and adaptation. The authors conclude with emerging trends and potential influences advanced simulation and training will have on technical skills training in otolaryngology.     

音位对比式听觉识别训练的研究

目的探讨与听觉音位对比相关的训练材料在聋儿集体康复主题教育中的有效性,以及听觉音位对比识别训练与主题教育衔接的可行性。方法抽取12名聋儿为被试,年龄3．5～4．5岁,智力正常,经测定听力补偿后听觉音位对比识别能力均处于同一水平。将被试随机分为实验组和对照组,其中实验组在主题教育中使用与听觉音位对比相关的训l练材料,对照组仍沿用原教材,对两组被试实验前后的听觉音位对比能力分别进行评估,采集有关数据进行统计分析。结果①实验组聋儿在使用实验材料前后的听觉音位对比识别能力评估结果有显著性差异;②对照组聋儿前后评估结果没有显著性差异,实验组聋儿的听觉音位对比识别评估结果与对照组实验后结果有显著性差异。结论①本研究所编制的听觉音位对比相关训练材料是有效的;②在主题教育中,应当增加听觉音位对比识别能力的训练,二者的结合是可行的。     

Efficacy of Music Training in Hearing Aid and Cochlear Implant Users: A Systematic Review and Meta-Analysis

This study aimed to evaluate the efficacy of music training on the improvement of musical perception among hearing-impaired listeners using a systematic review and meta-analysis. Article search was conducted from five databases, Scopus, ScienceDirect, Web of Knowledge, CINAHL, and PubMed. A total of 186 participants from 10 studies investigating the music training effects on individuals fitted with hearing assistive devices and outcome measurements were included. The meta-analysis showed standardized mean difference as a measure of the effect size, in musical improvement between the preand post-training. Although the funnel plot yielded an asymmetrical graph, the Egger’s regression showed no significant publication bias. Interestingly, subgroup analysis showed that the training effect was greater in children than in adults. With a necessity of longer training period to significantly improve their musical perception, cochlear implant only users had better effect compared to bi-modal users with both cochlear implant and hearing aids. However, the difference in the training effect between the users with and without previous musical experience was nonsignificant. The present study concludes that auditory music training brings hearing-impaired listeners into better musical perception while informing that training effects differ depending on age, duration of the training, and the type of hearing device used.     

快速用力呼气法对发育迟缓儿童言语呼吸支持不足矫治的个案研究

目的探索快速用力呼气法对治疗发育迟缓儿童言语呼吸支持不足问题的有效性。方法采用单一被试单基线A-B实验设计，运用快速用力呼气法对1名存在言语呼吸支持不足问题的发育迟缓儿童进行康复训练，测量、分析训练前后的最长声时和平均言语强度。结果训练后，该儿童最长声时和平均言语强度显著提高。结论快速用力呼气法对解决发育迟缓儿童呼吸支持不足的问题是有效的。     

Rehabilitation of cochlear implant patients

Pre- and post-surgical treatment of cochlear implant patients is discussed. Before surgery training of lipreading ability, auditory training with conventional hearing aids and counselling should be offered. After surgery the main focus lies on auditory training with the cochlear implant; communication training in a group and counselling should be offered too.     

Human Vestibulo-Ocular Reflex Adaptation: Consolidation Time Between Repeated Training Blocks Improves Retention

We sought to determine if separating vestibulo-ocular reflex (VOR) adaptation training into training blocks with a consolidation (rest) period in between repetitions would result in improved VOR adaptation and retention. Consolidation of motor learning refers to the brain benefitting from a rest period after prior exposure to motor training. The role of consolidation on VOR adaptation is unknown, though clinicians often recommend rest periods as a part of vestibular rehabilitation. The VOR is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. The unilateral incremental adaptation technique typically consists of one 15-min training block leading to an increase in VOR gain of ~?10 % towards the training side. We tested nine normal subjects, each over six separate sessions/days. Three training protocols/sessions were 5 min each (1?×?5-min training) and three training protocols/sessions were 55 min each. Each 55-min protocol comprised 5-min training, 20-min rest, 5-min training, 20-min rest, 5-min training (3?×?5-min training). Active and passive VOR gains were measured before and after training. For training with consolidation breaks, VOR gain retention was measured over 1 h. The VOR gain increase after 1?×?5-min training was 3.1?±?2.1 % (P?<?0.01). One might expect that repeating this training three times would result in ×?3 total increase of 9.3 %; however, the gain increase after 3?×?5-min training was only 7.1?±?2.8 % (P?<?0.001), suggesting that consolidation did not improve VOR adaptation for our protocols. However, retention was improved by the addition of consolidation breaks, i.e. gains did not decrease over 1 h (P?=?0.43). These data suggest that for optimal retention VOR adaptation exercises should be performed over shorter repeated blocks.