Assessment of Speech Intelligibility and Its Influencing Factors in Hearing-Impaired Children

Abstract

Background: Background: Speech intelligibility is a key determinant of communication ability in children with hearing impairment. Limitations in auditory input, delayed amplification, and inadequate speech therapy often lead to reduced intelligibility, affecting language, learning, and social interaction. Objective: To assess speech intelligibility in hearing-impaired children and identify the primary factors influencing intelligibility outcomes, including degree of hearing loss, age at intervention, type of amplification device, and duration of speech therapy. Methodology: A cross-sectional study was conducted among children aged 5-12 years with bilateral sensorineural hearing loss using hearing aids or cochlear implants for at least one year. They were attending speech or auditory-verbal therapy and were able to speak in short phrases. Children who had additional intellectual or motor problems, inconsistent device use, or mixed hearing loss were not included. Speech intelligibility was evaluated using standardized speech samples rated by trained listeners on a five-point scale. Demographic and clinical data were obtained from audiological records and caregiver interviews. The mean and standard deviation were calculated for number-based data, and percentages were used for categories. Statistical analyses, including Pearson correlation and multiple regression, were applied to determine the predictors of intelligibility. Results: Findings revealed that children with mild to moderate hearing loss demonstrated significantly higher intelligibility scores than those with severe to profound loss (p<0.05). Earlier fitting of amplification devices and greater duration of speech therapy were strongly associated with improved intelligibility. Children using cochlear implants generally outperformed those using hearing aids, though individual variability was observed. Conclusion: Speech intelligibility in hearing-impaired children is influenced by multiple interrelated factors. Early identification, timely amplification, and consistent speech-language therapy significantly enhance speech outcomes. These results highlight the importance of comprehensive auditory rehabilitation programs focused on early intervention and targeted speech training to optimize communication abilities in hearing-impaired children.