Vocal Biomarkers of Mild-to-Moderate Hearing Loss in Children and Adults: Voiceless Sibilants.

Purpose: The purpose of this study was to determine if an objective measure of speech production could serve as a vocal biomarker for the effects of high-frequency hearing loss on speech perception. It was hypothesized that production of voiceless sibilants is governed sufficiently by auditory feedback that high-frequency hearing loss results in subtle but significant shifts in the spectral characteristics of these sibilants.

Method: Sibilant production was examined in individuals with mild to moderately severe congenital (22 children; 8-17 years old) and acquired (23 adults; 55-80 years old) hearing losses. Measures of hearing level (pure-tone average thresholds at 4 and 8 kHz), speech perception (detection of nonsense words within sentences), and speech production (spectral center of gravity [COG] for /s/ and /ʃ/) were obtained in unaided and aided conditions.

Results: For both children and adults, detection of nonsense words increased significantly as hearing thresholds improved. Spectral COG for /ʃ/ was unaffected by hearing loss in both listening conditions, whereas the spectral COG for /s/ significantly decreased as high-frequency hearing loss increased. The distance in spectral COG between /s/ and /ʃ/ decreased significantly with increasing hearing level. COG distance significantly predicted nonsense-word detection in children but not in adults.

Conclusions: At least one aspect of speech production (voiceless sibilants) is measurably affected by high-frequency hearing loss and is related to speech perception in children. Speech production did not predict speech perception in adults, suggesting a more complex relationship between auditory feedback and feedforward mechanisms with age. Even so, these results suggest that this vocal biomarker may be useful for identifying the presence of high-frequency hearing loss in adults and children and for predicting the impact of hearing loss in children.