Problèmes de perception de la parole dans le bruit chez les enfants qui présentent un trouble de traitement auditif

A hallmark listening problem of individuals presenting with Auditory Processing Disorder (APD) is their poor speech recognition in noise. The underlying cause of their difficulties in unfavorable listening conditions is unknown. The objective of this dissertation was to explore the underlying nature of the speech perception problems in noise in the case of APD.

The Test de Phrases dans le Bruit (TPB) was developed to explore the underlying origins of the speech perception difficulties in noise in the case of APD, in order to identify if they are related to an auditory dysfunction, a language-based dysfunction or both. The TPB consists of five lists of 40 recorded sentences, including 20 highly predictable (HP) sentences and 20 low predictable (LP) sentences, and a speech babble. The familiarity of each sentence final key word was tested with a group of children from five to seven years old. The intelligibility in noise of the sentences and the degree of predictability were also measured with adult participants in order to obtain equivalent lists. The actual sentence list sets of the TPB have been tested with a group of 15 adults and a group of 69 children without any hearing problem before its use with children presenting with APD.

To achieve the general goal of the study, ten participants identified with APD (APD group) were assessed with the TPB, as well as ten age and gender matched children with normal auditory processing functions (control group). The mean performances of the APD group were significantly lower than the ones of the control group on the TPB sentence keyword recognition in noise at the signal-to-noise ratios of 0, +3 and +4 dB. The group average of the HP and LP difference of scores was similar between the groups at each of the tested signal-to-noise ratio. These results suggest that, as a group, children with APD use linguistic contextual information when listening to speech in background noise to the same extent as the ones of the control group. According to these analyses, the underlying origin of the speech perception problems in noise in the case of APD would be related to an auditory dysfunction.

However, examination of the group data analyses differed from the individual analyses. The verification of the individual patterns revealed different profiles suggesting that further substantiation of these preliminary findings is warranted. A better understanding of the listening difficulties in noise exhibited by individuals with APD should lead to specific and efficacious intervention programs.