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Does hearing speech in noise predict story understanding in DLD?

Magimairaj BM, Nagaraj NK, Champlin CA, et al. · Frontiers in psychology · 2021

Open access · cc by · source: Europe PMC

Among children with language disorder, how well they understood sentences in background noise predicted how well they understood spoken stories, but basic tone-hearing tasks did not.

Study at a glance

Design
Cross-sectional — Single-time-point hierarchical regression within a DLD sample: age, non-verbal IQ and speech-in-quiet, then phonological STM, vocabulary, tone-perception thresholds and finally speech-in-noise predicting narrative comprehension
N
N=216 · 216 children with DLD recruited from nine school districts in Kansas and Texas; no typically developing comparison group
Population
School-age children (mean age about 90 months) meeting criteria for developmental language disorder with normal-range non-verbal IQ and hearing
Outcome
Comprehension of spoken stories (Test of Narrative Language comprehension questions)

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Key findings

Age, non-verbal IQ and speech-in-quiet together explained 36% of the variance in comprehension; phonological memory added 8% and vocabulary another 6%. The tone-perception tasks added nothing, but speech-in-noise ability explained a further 6% even after all other predictors, and this held when the order of the auditory measures was reversed. Tone-perception tasks were linked to non-verbal IQ, whereas speech-in-noise was not, suggesting tone tasks tap general attention while listening in noise draws on language-specific skills.

Methodology

The researchers tested 216 school children with developmental language disorder on spoken story comprehension, nonword repetition (phonological short-term memory), two vocabulary tests, three tone-perception tasks (simultaneous masking, backward masking and frequency-sweep discrimination) and a sentence-in-noise test. They then used stepwise regression to see which abilities explained story comprehension after accounting for age, non-verbal IQ and sentence repetition in quiet.

Limitations

The design is correlational and at one time point, so it cannot show that poor listening in noise causes comprehension problems; both could reflect weaker language representations. There was no typically developing comparison group, so we cannot tell whether the relationship is special to DLD. The unique contribution of speech-in-noise was modest and its clinical significance was not quantified, stepwise regression results depend on entry order, and one author receives royalties from the comprehension test used.

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