Assistive technology evaluations: Remote-microphone technology for children with Autism Spectrum Disorder

doi:10.1016/j.jcomdis.2016.08.003

Journal of Communication Disorders

Volume 64, November–December 2016, Pages 1-17

https://doi.org/10.1016/j.jcomdis.2016.08.003 Get rights and content

Highlights

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RM system improved speech recognition for most children with ASD relative to no RM system.
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Teacher, participant, and parent questionnaires revealed significant improvements in auditory behaviors with the RM system.
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Individual functional evaluations will be necessary to determine the benefit of an RM system for a particular student.

Abstract

The goal of this study was to conduct assistive technology evaluations on 12 children diagnosed with Autism Spectrum Disorder (ASD) to evaluate the potential benefits of remote-microphone (RM) technology. A single group, within-subjects design was utilized to explore individual and group data from functional questionnaires and behavioral test measures administered, designed to assess school- and home-based listening abilities, once with and once without RM technology. Because some of the children were unable to complete the behavioral test measures, particular focus was given to the functional questionnaires completed by primary teachers, participants, and parents. Behavioral test measures with and without the RM technology included speech recognition in noise, auditory comprehension, and acceptable noise levels. The individual and group teacher (n = 8–9), parent (n = 8–9), and participant (n = 9) questionnaire ratings revealed substantially less listening difficulty when RM technology was used compared to the no-device ratings. On the behavioral measures, individual data revealed varied findings, which will be discussed in detail in the results section. However, on average, the use of the RM technology resulted in improvements in speech recognition in noise (4.6 dB improvement) in eight children, higher auditory working memory and comprehension scores (12–13 point improvement) in seven children, and acceptance of poorer signal-to-noise ratios (8.6 dB improvement) in five children. The individual and group data from this study suggest that RM technology may improve auditory function in children with ASD in the classroom, at home, and in social situations. However, variability in the data and the inability of some children to complete the behavioral measures indicates that individualized assistive technology evaluations including functional questionnaires will be necessary to determine if the RM technology will be of benefit to a particular child who has ASD.

Section snippets

Learner outcomes

1.
The reader will be able to describe the potential benefit of remote-microphone systems for children with ASD.
2.
The reader will be able to identify applicable questionnaires that will help professionals to better understand listening difficulties of children with ASD.
3.
The reader will be able to explain the behavioral test measures that may be used in assessing the potential benefit of remote-microphone systems in children with ASD.

Participants

The methods and procedures for this study were approved by the Institutional Review Board at the University of North Texas. Parental consent, and when possible participant assent, was obtained from 17 children, but only 12 children were able to participate in the study. Five participants did not complete the study due to one or more of the following reasons: the inability to tolerate wearing the RM technology (n = 3); parent and teacher questionnaires were not returned following the trial period,

Results

This study utilized a within-subjects, repeated-measures design for all functional questionnaires and test measures. Average ratings from each questionnaire were analyzed statistically, and effect sizes were also calculated. Individual data from the functional questionnaires is provided in Table 3. Given the smaller sample sizes for the behavioral data, the group data were not analyzed statistically. Instead, the individual data provided in Table 4 were examined to determine significant

Discussion

The goals of assessing the group and individual benefits of RM technology in children diagnosed with ASD were achieved by addressing the two hypotheses in the study. First, the primary hypothesis of this study was that the 12 children diagnosed with ASD, with higher and lower levels of functioning, would benefit from RM technology on functional questionnaires and behavioral test measures. Although sample sizes varied across the measures, statistical analyses revealed significant average benefit

Conclusions

The results of this study on the potential benefits of RM technology for 12 children with ASD suggested that most children with ASD receive significant functional benefit and some children receive behavioral benefits of the technology over a no-device condition. When using the RM technology, teacher, participant, and parent questionnaires revealed significantly improved auditory filtering, auditory attention, auditory memory, and listening abilities across a wide variety of listening situations

Acknowledgements

We would like to acknowledge Phonak for providing a research grant to complete this study. The grant funds were used to purchase test material, to reimburse participants for their time and effort, and to pay a part-time graduate research assistant. We would also like to thank the participants, parents, and teachers involved in the study.

References (43)

B. Haesen et al.
A review of behavioural and electrophysical studies on auditory processing and speech perception in autism spectrum disorders
Research in Autism Spectrum Disorders
(2011)
ANL
Acceptable noise level
(2009)
J.I. Alcántara et al.
Speech-in-noise perception in high-functioning individuals with autism or Asperger’s syndrome
Journal of Child Psychology and Psychiatry
(2004)
American National Standards Institute
Acoustical performance criteria, design requirements, and guidelines for schools, Part 1: permanent schools (No. ANSI S12.60-2010)
(2010)
American Psychiatric Association
Diagnostic and statistical manual of mental disorders
(2013)
American Speech-Language-Hearing Association (2005). Acoustics in educational settings: position statement [position...
K.L. Anderson et al.
Children’s home inventory for listening difficulties
(2011)
K. Anderson et al.
Listening inventory for education – revised (L.I.F.E. – R.) – teacher appraisal of listening difficulty
(2012)
J. Ashburner et al.
Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder
American Journal of Occupational Therapy
(2008)
BKB-SIN
Bamford-Kowal-Bench speech in noise test
(2005)

J. Cohen

Statistical power analysis for the behavioral sciences

(1988)

J. Cruckley et al.

An exploration of non-quiet listening at school

Journal of Educational Audiology

(2011)

W.P. Dunlap et al.

Meta-analysis of experiments with matched groups or repeated measures designs

Psychological Methods

(1996)

Dunn, W. (2002). Infant/toddler sensory profile user’s manual. San...

K. Egelhoff et al.

Brief report: Preliminary reliability, construct validity and standardization of the auditory behavior questionnaire (ABQ) for children with autism spectrum disorders

Journal of Autism and Developmental Disorders

(2013)

N.P. Erber

Auditory and audiovisual reception of words in low-frequency noise by children with normal hearing and by children with impaired hearing

Journal of Speech and Hearing Research

(1971)

M.J. Gardner et al.

Confidence intervals rather than P values: Estimation rather than hypothesis testing

British Journal of Medicine

(1986)

L.V. Hedges et al.

Statistical methods for meta-analysis

(1985)

Hintze, J. (2007). NCSS 2007. NCSS, LLC. Kaysville, Utah, USA....

J. Hornickel et al.

Assistive listening devices drive neuroplasticity in children with dyslexia

Proceedings of the National Academy Of Sciences U S A

(2012)

Individuals With Disabilities Education Act, 20 U.S.C. § 1400...

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In these studies, remote microphone technology use has been shown to not only improve speech understanding in noise and over distance, but also to be associated with broader improvements in functioning such as reduced listening effort and improved parent- and teacher-reported behavior. As a result, management options should be considered for autistic children who have listening difficulties given their potential to improve behavior in home, school and other real-world environments (Rance et al., 2017; Schafer et al., 2016). Future research to develop or identify an existing auditory-specific questionnaire assessing the listening difficulties of autistic children may be useful, particularly for patients who are lower functioning in whom behavioral auditory assessments cannot be completed.
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Over 40% of patients exhibited significantly reduced speech recognition in noise and abnormal dichotic integration that were not attributed to deficits in attention. The majority of patients (86%) performed abnormally on at least one auditory measure, suggesting that functional auditory issues can exist in autistic patients despite normal pure-tone sensitivity.
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View full text

Assistive technology evaluations: Remote-microphone technology for children with Autism Spectrum Disorder

Highlights

Abstract

Section snippets

Learner outcomes

Participants

Results

Discussion

Conclusions

Acknowledgements

Research in Autism Spectrum Disorders

Acceptable noise level

Speech-in-noise perception in high-functioning individuals with autism or Asperger’s syndrome

Journal of Child Psychology and Psychiatry

Acoustical performance criteria, design requirements, and guidelines for schools, Part 1: permanent schools (No. ANSI S12.60-2010)

Diagnostic and statistical manual of mental disorders

Children’s home inventory for listening difficulties

Listening inventory for education – revised (L.I.F.E. – R.) – teacher appraisal of listening difficulty

Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder

American Journal of Occupational Therapy

Bamford-Kowal-Bench speech in noise test