الفهرس 
Milestones in early speech developmentOnly 14 pages are availabe for public view
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Abstract
Selecting the ideal hearing aid for a patient is a blend of art and science. While a basic pure-tone configuration may have once steered our decision making, real-world speech tests have now taken center stage as an objective measuring tool with which to select amplification. Speech in noise (SIN) testing for some may be a very routine practice, and for others may seem a bit daunting because it is an unknown (Taylor, 2011). The BKB-SIN is a speech-in-noise test that uses BKB (Bamford-Kowal- Bench) sentences, recorded by male talker in four-talker babble. The BKB-SIN can be used to estimate SNR loss in decibels (dB SNR loss) in children and adults for whom the QuickSIN test is too difficult. SNR loss is described as the dB increase in signal-to-noise ratio required by an individual with hearing impairment to understand speech in presence of noise as compared with normal hearing individual. It is quick and easy to administer and score, provide age-related norms for children, suitable for cochlear implant users, appropriate for adults with auditory memory difficulties, can quantify the benefits of directional microphones and help the audiologist in choosing appropriate amplification options for individuals with hearing loss. The BKB SIN, English version, is comprised of 18 lists, recorded by a male talker. Each List Pair consists of two lists of eight to ten sentences each. The first sentence in each list has four key words, and the remaining sentences each have three. The key words in each sentence are scored as correct or incorrect. The sentences are presented at prerecorded signal-tonoise ratios that decrease in 3-dB steps. List Pairs 1-8 have ten sentences in each list, with one sentence at each SNR of: +21, +18, +15, +12, +9, +6, +3, 0, -3 and -6 dB. List Pairs 9-18 have eight sentences in each list, with one sentence at each SNR of: +21, +18, +15, +12, +9, +6, +3 and 0 dB. Each list in the pair is individually scored, and the results of the two lists are averaged to obtain the List Pair score. Results are compared to normative data to obtain the SNR Loss. The BKB SIN uses 4-talker babble in place of noise in order to simulate real world listening condition (Sharma et al., 2017). This study included 69 children who were divided into two groups: normal hearing subjects and hearing-impaired subjects. These subjects were 25 males and 29 females for normal hearing group. Their age ranged from 5- 18 years with the mean of 11.02±3.8 years. All subjects were submitted to full basic audiological assessment. They all had pure tone air-conduction thresholds less than or equal to 15 dB HL at audiometric test frequencies from 250Hz to 8000Hz (American National Standards Institute, 1996). Phase I included 15 normal hearing subjects with the mean of 16.4±1.1. Phase III included 9 normal hearing subjects with the mean of 11.8±1.9 and phase IV included 30 normal hearing subjects divided into three age groups of ten participants each. The first group age ranged from 5 to 7 years wih a mean of 5.67±0.54 years. The second group age ranged from above 7 to 10 years wih a mean of 8.95±1.01 years. The third group age ranged from above 10 to 14 years with a mean of 12.6±1.17 years. Finally, application on 15 hearingimpaired subjects divided into three groups. The first group age ranged from 5.5 to 7 years old with a mean of 6.40±0.65 years. The second group age ranged from 7.5 to 10 with a mean of 8.8 ±0.9 years. The third group age ranged from 11 to 14 with a mean of 12.4 ±1.41 years. Phase I provided the basis for phase II; by calculation of SNR 50 of each recorded sentence-babble combination to test sentence equivalence. Phase II results gave 151 selected sentences and exclusion of 159 sentences according to selection criteria. The selected sentences were constructed in 18 equivalent lists. Phase III provided the SNR starting level of lists. Phase provided age related norms for children. Finally, application of Arabic BKB SIN test on 15 children with sensorineural hearing loss. After measuring the statistical power of Arabic BKB SIN test, the new Arabic BKB SIN can be applicated as a reliable and standardized test for measuring SNR loss. It can be used as a unique testing technique, as a predictive of real-world and functional hearing ability.