RP206 - Language Effects on Word Recognition and Access to Hearing Health Care: Investigating Spanish and English Speakers with Hearing Loss

Thursday, April 18, 2024

4:00 PM – 4:30 PM EST

Location: A406-407

Earn 0.05 CEUs

Instructional Level: Intermediate

Lead Presenter(s)

Sandra L. Velandia, AuD

Assistant Professor
University of Miami
University of Miami
Miami, Florida

Disclosure(s): Advanced Bionic, LLC: Speaker/Honoraria (Ongoing)

Abstract: According to 2020 Census data, there are 62.1 million Spanish-speaking Hispanics/Latinos living in the US. English and Spanish languages possess great structural and phonological differences that may influence speech perception outcomes. However, we do not understand the effects of test language on speech perception outcomes in hearing-impaired listeners, or how such differences may affect access to hearing healthcare in the Spanish-speaking population. The aim of this study is to explore the effects of language on word recognition ability and how these effects may cause delays in access to hearing healthcare for Spanish speakers with hearing loss.

Summary: The purpose of this study was to compare the effects of English and Spanish language on word recognition ability in patients with hearing loss and how this may cause delays in access to hearing healthcare for Spanish speakers with hearing loss.
Methods. 1554 records of individuals 18 to 99 years of age were reviewed. These patients were seen between March 30, 2019 and March 30, 2020. Demographic information was collected. The following data was included: audiometric data, pure tone thresholds from 250 – 8000 Hz, word recognition scores, speech reception threshold, and language of test materials used. Test materials used for speech perception testing included the recorded NU-6 words in English and recorded Spanish Bisyllable words.
Descriptive analyses were based on non-missing responses and conducted for demographic variables and audiometric outcomes. Dependent variables included speech reception thresholds and word recognition scores. Results were analyzed using analysis of variance (ANOVA) with two within-subject factors: language and PTA severity. Statistical significance was defined by p-values < 0.05. Pairwise comparisons with Bonferroni corrections for multiple comparisons were used to follow up significant main effects. All analyses were performed using SPSS® software (version 28.0; New York: IBM Corp®).

Results:

In total, 1451 individuals were included in the study. The sample consisted of 48% male and 52% female, 38% Spanish-speakers, 60% English-speakers, with the remaining identifying as “other”. Others were removed from the analysis, leaving 1385 individuals. Each ear was analyzed separately totaling 2770 ears for review. A standard PTA of 0.5, 1 and 2 kHz was calculated as well as a high-frequency PTA (HF-PTA) of 2, 4, and 8 kHz to explore the relationship between high-frequency HL and speech perception outcomes by language. PTA and HF-PTA were categorized as 1) normal as indicated by a PTA < 25 dB, 2) mild as indicated by a PTA of 26 – 45 dB, 3) moderate as indicated by a PTA of 46- 65 dB, and 4) severe-profound as indicated by a PTA of 66 dB or more of HL.
The results indicated a significant main effect for PTA severity. Pairwise comparisons revealed a mean difference of 6% between Spanish-language (81%) and English-language (75%) word recognition scores (p < .001). The differences are significant in the mild, moderate, and severe PTA categories with the greatest difference occurring in the severe category (mean difference = 15%).
The results also indicated a significant main effect for HF PTA severity, a significant main effect for language, and a significant interaction between PTA severity and language. Pairwise comparisons revealed a mean difference of 3% between Spanish-language (91%) and English-language (88%) word recognition scores (p < .001). The differences are only at the severe PTA (mean difference = 5%).

Conclusions:
There are structural and phonological differences between English and Spanish languages that affect speech discrimination outcomes in individuals with hearing loss, especially in high frequencies. This causes the Spanish-speaking individuals to not feel as impaired, delaying and reducing access to hearing healthcare and increasing health disparities experienced by the Hispanic/Latino population.

Learning Objectives:

Describe structural and phonological differences between English and Spanish languages and identify how that affects speech discrimination for individuals with hearing loss
Discuss when to refer patients for hearing rehabilitation services such as hearing aids and cochlear implants while analyzing clinical cases.
Describe why Spanish-speaking individuals may not feel as hearing impaired, and how this may delay access to hearing healthcare and increase health disparities for the Hispanic/Latino population.