Tese
Teste de palavras no ruído: proposta de um instrumento para avaliação do reconhecimento de fala na rotina clínica
Fecha
2023-02-08Autor
Dalla Costa, Lidiéli
Institución
Resumen
This research aimed to propose an instrument to assess speech recognition in the
presence of competitive noise, define its application strategy to be applied in the clinical
routine, obtain evidence of criterion validity, present the reference values, and
investigate the reliability of the instrument. Initially, the organization of the material that
constituted the Word-with-Noise Test was performed. Subsequently, the application
strategy of the instrument was defined, through the application of a pilot study. The
criterion validity investigation and definition of reference values for the test was then
carried out by evaluating 50 normal-hearing adult subjects and 12 subjects with
hearing loss. Lastly, the reliability of the test was investigated using a test-retest
strategy in a group of 45 normal-hearing adults. The proposed instrument consisted of
lists of monosyllabic and disyllabic words and speech spectrum noise. The test
application strategy was defined as the Speech Recognition Threshold with noise fixed
at 55 dBHL. Regarding criterion validity, the instrument showed excellent ability to
distinguish between normal-hearing subjects, without reports of difficulty in recognizing
speech-in-noise and subjects with hearing loss, with complaints of difficulty in
recognizing speech-in-noise, evidenced by extremely high Area Under the Curve
values of 0.987 for the monosyllabic stimulus and 1,000 for the disyllabic stimulus. The
cut-off points expressed as signal/noise ratio of 1.47 dB for the monosyllabic stimulus
and -2.02 dB for the disyllabic stimulus were defined as reference values for the
proposed instrument. There was a statistically significant difference between the test
and retest performances. The intraclass correlation coefficients obtained were
indicative of good reliability (r=0.759; p<0.001) for the monosyllabic stimulus and
moderate reliability (r=0.631; p<0.001) for the disyllabic stimulus. It was concluded that
it was possible to propose an instrument to assess speech-in-noise recognition, called
the Word-with-Noise Test. This test presented satisfactory evidence of criterion
validity, with established reference values, presenting satisfactory reliability and
demonstrating itself to be fast and easy to apply and interpret the results, making it a
useful tool to be employed in the audiological clinical routine.