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ReSound Auracast - February 2024

Speech Perception for Unilateral v. Bilateral Hearing Loss in Children

Anne Marie Tharpe, PhD

December 26, 2005

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Question

I was reading an article regarding Unilateral Hearing Loss and came upon a study conducted by (Bess, Tharpe, & Gibler, 1986). This study went on to describe effects of unilateral hearing loss on speech perception and that those kids with severe-profound unilateral hearing loss exhibited poorer speech recognition when compared to those of mild-moderate unilateral hearing loss. My question is, has there been any study to compare the speech perception of a unilateral hearing loss to a bilateral hearing loss of the same degree and configuration? If so what were their findings? Was the bilateral worse than unilateral when comparing speech and localization? Thanks for your time.

Answer

To my knowledge, there has been no research directly comparing listeners with unilateral and bilateral hearing loss on tasks of speech perception and localization. However, based on what we know about the auditory cues required for localization (e.g., interaural time and intensity differences), it is reasonable to assume that those with unilateral hearing loss are more likely to experience localization difficulties than those with bilateral hearing loss in most situations. Furthermore, we know that, in general, the greater the degree of unilateral hearing loss, the poorer the localization and speech perception ability. But, there is great individual variability and we cannot easily predict the speech perception and localization abilities of an individual based on an audiogram.

In a recent study that addresses part of your question, Rothpletz, Tharpe, and Grantham (2004) examined the effects of asymmetrical signal degradation on binaural speech perception ability in normal hearing children and adults. Specifically, there were 3 listening conditions:

  1. monaural, with mild degradation in 1 ear;
  2. binaural, with mild degradation in both ears (symmetric degradation);
  3. binaural, with mild degradation in one ear and severe degradation in the other ear (asymmetric degradation).
Sentences and babble were degraded digitally to simulate mild and severe cochlear hearing loss. All participants demonstrated significant binaural advantage (average of 7 dB) when listening to symmetrically degraded signals as compared to when listening monaurally. In contrast, adults and children achieved little or no binaural benefit, on average, when listening to asymmetrically degraded signals. Of course, this study used normal hearing listeners and individuals with hearing loss may perform quite differently both as a result of the loss itself and long term listening experience.

References

Rothpletz AM, Tharpe AM, & Grantham W (2004). "The Effect of Asymmetrical Signal Degradation on Binaural Speech Recognition". Journal of Speech, Hearing, Language Research.

Anne Marie Tharpe, Ph.D., has been an audiologist for over 20 years. She is on the faculty in the Department of Hearing and Speech Sciences at the Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences in Nashville Tennessee. She can be contacted at anne.m.tharpe@vanderbilt.edu


anne marie tharpe

Anne Marie Tharpe, PhD

Professor and Chair, Dept. Hearing and Speech Sciences - Vanderbilt University& Associate Director

Anne Marie Tharpe, Professor and Chair of the DHSS and Associate Director of the Vanderbilt Bill Wilkerson Center, is the author of over 75 journal articles, books, and book chapters dealing with pediatric audiology. In addition, she has spoken to over 175 audiences around the world about various aspects of childhood hearing loss.  Dr. Tharpe maintains a small clinical practice in addition to running a research laboratory and teaching audiology, speech-language pathology, and deaf education graduate students. Most of her research has focused on the early identification and intervention of hearing loss in the pre-school and school-age child. Specifically, she is interested in the impact of hearing loss on overall child development.


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