Abstract
OBJECTIVE: To assess perception of specific speech pattern contrasts in infants with normal hearing (NH) and infants with sensorineural hearing loss (HL). STUDY DESIGN: Prospective longitudinal and cross-sectional study. SETTING: Tertiary referral center. PATIENTS: Nine infants with NH and 11 infants with HL ranging from mild to profound. METHODS: Speech pattern contrast perception was evaluated in infants with NH and HL using a new behavioral test called Visual Reinforcement Assessment of the Perception of Speech Pattern Contrasts (VRASPAC). VRASPAC assesses the infant's ability to distinguish the speech features of vowel height and place and consonant voicing, continuance, and place. Detection of a phonetic change is indicated by a conditioned head-turn response. Performance is reported as the percent confidence that responses are not random. RESULTS: The infants with NH attained high confidence scores for the vowel height and place contrasts used in this study. The infants with HL achieved high scores for the vowel height contrast regardless of degree of hearing loss. High scores were attained for the vowel place contrast by infants with losses less than 60 dB HL. Performance for the consonant contrasts was variable for all of the infants. Results from 1 infant assessed precochlear and postcochlear implantation indicated substantial improvement in speech pattern contrast perception with the implant. CONCLUSION: Perception of speech pattern contrasts in infants, particularly for the vowel contrasts, can be evaluated with a high level of confidence using VRASPAC. Consonant contrast perception is much more variable than vowel contrast perception and requires further investigation.