# Investigating the contribution of extended high-frequency hearing loss to poor speech-in-noise perception in clinically normal hearing children and young adults.

> **NIH NIH R21** · UNIVERSITY OF CINCINNATI · 2024 · $150,607

## Abstract

People with clinically defined normal hearing frequently report difficulty hearing in challenging environments.
They often leave audiology clinics with no diagnosis to explain the difficulty they experience listening in noise.
Studies in adults demonstrate that extended high frequency (EHF; > 8 kHz) hearing, beyond the currently tested
range of clinical audiometry, contributes to speech perception in noise. Young children are the most sensitive to
EHFs, and this sensitivity is progressively lost throughout the remainder of life. Previous studies found a
significant relationship between EHF hearing loss (EHFHL) and difficulty understanding speech-in-noise (SiN)
in adults with clinically normal hearing. However, to our knowledge, no studies have investigated this relationship
in typically-developing, normal-hearing children and youth. The present study aims to address this gap by
investigating the association between EHFHL and impaired SiN perception in children and young adults (8 to 30
y/o) with clinically normal hearing (≤ 20 dB HL, 0.25 - 0.8 kHz). There are three specific aims. In Aim 1 we will
establish the relationship between EHFHL and subjective reports of listening difficulties using standard (0.25-8
kHz) and EHF (9 - 16 kHz) audiometry. The adult and child versions of the Speech, Spatial and Qualities (SSQ)
questionnaire will measure self- and parent-reported difficulty listening in noise. In Aim 2 we will determine the
impact of EHFHL on the perception of spatial speech using the sound-field digits-in-noise (sfDIN) test. In Aim 3,
we will evaluate low-frequency correlates of EHFHL and their possible effect on SiN. Objective (chirp transient-
evoked otoacoustic emissions) and behavioral (spectro-temporal modulation task) measures of supra-threshold
hearing will be used to determine whether supra-threshold deficits at standard frequencies (≤ 8 kHz) account for
associations between EHFHL and SiN that have been observed for adults and are predicted for children.
Outcomes of these experiments will enhance our understanding of the impact of EHFHL on communication
abilities of children. If EHFHL contributes to the difficulty children experience in challenging environments, as we
hypothesize, then including EHF hearing assessment in an audiologic test battery could identify susceptible
individuals and in turn lead to prevention and early intervention for hearing loss.

## Key facts

- **NIH application ID:** 10808983
- **Project number:** 5R21DC020242-04
- **Recipient organization:** UNIVERSITY OF CINCINNATI
- **Principal Investigator:** Lina Motlagh Zadeh
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $150,607
- **Award type:** 5
- **Project period:** 2022-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10808983

## Citation

> US National Institutes of Health, RePORTER application 10808983, Investigating the contribution of extended high-frequency hearing loss to poor speech-in-noise perception in clinically normal hearing children and young adults. (5R21DC020242-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10808983. Licensed CC0.

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