The study aimed to develop Mandarin speech perception tests for Malaysian Chinese children. Two tests were developed which were the Syllabic Pattern Perception Test (SPPT) and the Tone Perception Test (TPT). Both tests were designed for children aged between three to six years-old. A total of 80 normal hearing children aged 3 years to 6 years and 11 months from several kindergartens around Kuala Lumpur and Ipoh participated in this study. Results showed that the mean scores for the SPPT did not differ significantly across age (p > 0.05), possibly due to a ceiling effect. Although the SPPT showed relatively low test-retest and inter-rater Spearman correlation coefficients (r = 0.68 for correct syllable pattern response and r = 0.38 for correct item response), the scores were highly repeatable in both test-retest and interrater conditions. For the TPT, the mean scores of five and six year old children were significantly higher than three year old subjects while the mean score of four year old subjects was significantly poorer than the six years old. The test-retest and inter-rater reliability were high and the coefficients approximated 0.80 (p < 0.05). For both tests, gender and dialects or languages used as the second language did not have significant effect on the test scores. Content validity evidence was also collected from a group of panelists. In conclusion, SPPT and TPT are reliable and valid Mandarin speech tests to be used on Malaysian Chinese children who speak Mandarin.

Cochlear implant (CI) is the main intervention option for people with severe and profound sensorineural hearing loss. The purpose of this study was to investigate the auditory performance of a group of prelingually deafened paediatric cochlear implant users using direct speech perception measures (objective) and a parental questionnaire (subjective) and to identify significant demographic factors that might contribute to their performance. A total of 48 children from the Cochlear Implant Program under the Malaysian Ministry of Health with hearing age of 12 to 89 months (mean = 42.60 ± 19.46 months) participated in this study. The speech perception test was conducted using selected tests from the Malay version of the Evaluation of Auditory Response to Speech (EARS) while parental views of the children’s performance were collected using the Malay version of the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) questionnaire. The recorded speech stimuli were presented to the children in a free field at approximately 65 dB SPL in a sound treated room. The speech perception test results were then categorized using the Malay version of the Categories of Auditory Performance Index (My-CAPI) with 10 categories ranging from ‘0’ to ‘9’. Results showed that most of the children (N = 20, 41.7%) were performing at category 2 of My-CAPI (limited closed set speech perception) with three children achieved the maximum category 9 (advanced open-set sentences in noise). Communication mode was the only demographic factor that significantly correlated with the My-CAPI and PEACH scores (p < 0.01). Pearson correlation coefficient showed a strong relationship between the PEACH scores and My-CAPI levels (p < 0.01; r = 0.71) suggesting that the PEACH questionnaire can be used as an indicator of the auditory performance if the speech perception tests cannot be performed. The findings suggest that the majority of the CI children tested in this study had not achieved satisfactory auditory performance and that the use of oral communication mode was the main factor associated with better auditory outcomes. Keywords: Speech perception; children; cochlear implant; Parents’ Evaluation of Aural/Oral Performance of Children (PEACH); Categories of Auditory Performance Index (CAPI)

The spoken language development strongly depends on the normally functioning auditory system. For children with severe or profound hearing loss, cochlear implant has become the best solution in improving and promoting spoken language, quality of life, self-esteem and social well-being. Standardized self-report questionnaires are considered as the most widely used and low-cost approach to measure spoken language development among children. We aimed to provide an overview of the questionnaires available for assessing the spoken language development among children with cochlear implant. In addition, factors that may influence the development of good spoken language were also reviewed. A literature search from January 2010 to December 2020 making use of the Science Direct and PubMed databases was conducted. Medical Subject Headings (MeSH) and other key words for the search were (communication OR language) AND cochlear implant AND (children OR pediatric) AND (questionnaire OR survey). Research articles that were identified in the database using the keywords were refined by year. Only original articles were selected. Articles that quoted all the selected key words in the title and abstract; and written in English with full text were included in the review. Twelve instruments were utilized in the methodology of the 10 articles. Only one instrument was specific for spoken language assessment of children with cochlear implant. The age at which a child received an implant, good rehabilitation program and active involvement of parents was found to influence development of good spoken language skills among the cochlear implanted children. Cochlear implants provide deaf children with the opportunity to develop spoken language skills. Longer use of a cochlear implant dramatically affects the amount of spoken language. Rather, it was cochlear implantation at a younger age that served to assists spoken language competence.

Background and Objectives: The cortical auditory evoked potential (CAEP) is a useful objective test for diagnosing hearing loss and auditory disorders. Prior to its clinical applications in the pediatric population, the possible influences of fundamental variables on the CAEP should be studied. The aim of the present study was to determine the effects of age and type of stimulus on the CAEP waveforms. Subjects and Methods: Thirty-five healthy Malaysian children aged 4 to 12 years participated in this repeated-measures study. The CAEP waveforms were recorded from each child using a 1 kHz tone burst and the speech syllable /ba/. Latencies and amplitudes of P1, N1, and P2 peaks were analyzed accordingly. Results: Significant negative correlations were found between age and speech-evoked CAEP latency for each peak (p< 0.05). However, no significant correlations were found between age and tone-evoked CAEP amplitudes and latencies (p>0.05). The speech syllable /ba/ produced a higher mean P1 amplitude than the 1 kHz tone burst (p=0.001). Conclusions The CAEP latencies recorded with the speech syllable became shorter with age. While both tone-burst and speech stimuli were appropriate for recording the CAEP, significantly bigger amplitudes were found in speech-evoked CAEP. The preliminary normative CAEP data provided in the present study may be beneficial for clinical and research applications in Malaysian children.