Authors: Jacqueline Scholl¹
¹Soundwrx
Background: School-based hearing screening relies on pure-tone detection, which does not assess functional listening. Many children with normal thresholds have difficulty understanding speech in noise, suggesting auditory processing or neural encoding deficits. This study evaluates speech-in-noise screening efficiency and explores electrophysiologic correlates in a subset completing follow-up, while examining rhythmic processing as a marker of auditory timing.
Method: Children aged 5–9 years underwent screening including pure-tone audiometry, tympanometry, otoacoustic emissions, speech-in-noise assessment, and a tablet-based rhythmic synchronization task. Those who failed were referred for diagnostics. A subset completing follow-up underwent Auditory Brainstem Response and Frequency-Following Response testing and auditory processing measures. Analyses evaluated wave morphology, latency, interpeak intervals, and neural phase-locking.
Results: Speech-in-noise screening showed greater sensitivity for identifying functional deficits than pure-tone measures. Many children who passed traditional screening had difficulty in noise and were later diagnosed with auditory pathway disorders. In the electrophysiologic subset, findings included reduced Wave I amplitude, prolonged interpeak latencies, and degraded neural encoding of speech. Rhythmicity showed increased auditory timing variability but no robust group differences.
Conclusion: Speech-in-noise screening is an efficient front-line tool for identifying functional auditory deficits. Electrophysiologic findings support a neural basis for these difficulties, while rhythmic processing shows promise but requires further validation. Low follow-up rates reflect real-world barriers, underscoring the need for efficient screening tools to identify at-risk children early. Access to sound does not ensure access to information, particularly in complex listening environments.
