Use of the digit triplet test in the home environment

Cullington, H.E. (2018) Use of the digit triplet test in the home environment. Science & Research Seminar on Connected Health, , Berlin, Germany. 24 - 25 Sep 2018.

Record type: Conference or Workshop Item (Paper)

Abstract

Background: people using cochlear implants are routinely evaluated with speech recognition testing. Although a sentence test in quiet has high face validity, many adults use top-down cognitive skills to fill in the gaps and identify what is being said despite limited auditory information1. In addition, those who have lower levels of language, or limited auditory-alone speech understanding may obtain floor scores. Finally, performance with cochlear implants has improved, resulting in between 49 and 71% of adults approaching or at ceiling on sentence testing in quiet2,3, thus reducing the sensitivity. Measuring speech understanding with digits is increasingly used, for example, using the Dutch digit triplet test4, and may offer distinct advantages. The closed set response format makes digit testing ideal for home use. Therefore we evaluated the validity and acceptability of the English Digit Triplet Test (DTT), in a simulated home environment, for measuring speech recognition in adults with cochlear implants, and compared the results to standard clinical speech perception tests.

Methods: subjects were sixteen adult cochlear implant users in our centre, aged from 43 to 83 years. We measured DTT speech reception thresholds (SRT) and speech recognition using clinical speech perception tests. Subjects answered a satisfaction questionnaire.

Results: eighty-eight percent of participants were able to be tested using the DTT, with no floor or ceiling effects. DTT SRTs were highly correlated with clinical sentence test scores in quiet, and adaptive SRTs in noise. Overall, participants felt positive about using the DTT for home testing.

Conclusion: the majority of adults using cochlear implants in this study were able and willing to use the DTT in a simulated home environment. The DTT SRT was highly correlated with traditional clinic sentence scores. Hearing testing in the clinic is still the gold standard of clinical care for people with cochlear implants, but a home test could provide a useful addition. We have now incorporated the Digit Triplet Test into our new home care pathway CHOICE.

References: 1 Vickers, D. A., Riley, A., Ricaud, R., Verschuur, C., Cooper, S., Nunn, T., . . . Kitterick, P. T. (2016). Preliminary assessment of the feasibility of using AB words to assess candidacy in adults. Cochlear Implants International, 17 Suppl 1, 17-21. doi: 10.1080/14670100.2016.1161143 2 Firszt, J. B., Holden, L. K., Skinner, M. W., Tobey, E. A., Peterson, A., Gaggl, W., . . . Wackym, P. A. (2004). Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear and Hearing, 25(4), 375-387. 3 Gifford, R. H., Shallop, J. K., & Peterson, A. M. (2008). Speech recognition materials and ceiling effects: considerations for cochlear implant programs. Audiology and Neuro-Otology, 13(3), 193-205. doi: 10.1159/000113510 4 Smits, C., Kapteyn, T. S., & Houtgast, T. (2004). Development and validation of an automatic speech-in-noise screening test by telephone. International Journal of Audiology, 43, 15-28.

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