Download Title: The Computerized Revised Token Test: Assessing the Impact

Title: The Computerized Revised Token Test: Assessing the Impact of Age and Sound
Intensity
Authors:
Sheila Pratt, Ph.D.
Cynthia Eberwein, MS
Malcolm McNeil, Ph.D.
Amanda Ortmann, M.A.
Jillyn Roxberg, M.A.
Tepanta Fossett, M.A.
Neil Szuminsky, M.S.
John Durrant, Ph.D.
Patrick Doyle, Ph.D.
Affiliations:
Veteran’s Administration Pittsburgh Healthcare System
7180 Highland Drive
Building 2, 132A-H
Pittsburgh, PA 15206
USA
University of Pittsburgh
Department of Communication Science & Disorders
4033 Forbes Tower
Pittsburgh, PA 15260
USA
Voice: 412-383-6537
Fax: 412-383-6555
Email: [email protected]
Title: The Computerized Revised Token Test: Assessing the Impact of Age and Sound
Intensity
Abstract:
Background
The Revised Token Test (McNeil & Prescott, 1978, RTT) is a well-established test of
auditory language processing disorders in persons with aphasia. A computerized version
of the test, the Computerized Revised Token Test (C-RTT), was developed recently in
our laboratory to better control stimuli presentation, and eliminate variability associated
with the complex scoring requirements of the RTT.
In the current study the impact of participant age and acoustic signal intensity on
performance of non-brain injured adults on the C-RTT was assessed. Although age
effects have not observed with the RTT, we believed that strict adherence to timing and
stimuli characteristics allowed by computer administration and scoring could separate
young from older adults.
Methods
The participants consisted of Young and Elder adults without history or evidence of
speech-language impairment or brain injury. The Young adults were undergraduate
students (20-29 years) and the Elder group (70-85 years) consisted of community
dwelling adults. The Young participants had normal hearing and speech perception skills,
while the hearing of the Elder participants ranged from moderate to severely impaired.
The speech perception skills of the Elder participants were consistent with their age and
hearing loss severity. In order to eliminate auditory deprivation as a factor they all were
previous hearing aid users.
A fifty-item version of the C-RTT was administered to all of the participants in
soundfield at a range of intensity levels, such that performance-intensity functions could
be plotted. The overall and subtest responses were scored automatically and online. The
Elders were administered the C-RTT with and without their hearing aids. The level at
which maximum performance occurred for each performance-intensity function was
determined.
Results
The intensity levels at which the Elder participants performed maximally were
significantly greater than the Young adults regardless of whether the Elders were wearing
their hearing aids. The differences between the mean presentation levels were 37 dB SPL
without hearing aids and 23 dB SPL with hearing aids. The maximum overall scores of
the Elder participants were not different from the Young participants regardless of
hearing aid use. However, at the subtest level the older participants demonstrated
consistently worse performance than the Young participants on Subtest 8. When
presentation level was adjusted as a covariate, the groups were significantly different and
a greater number of subtests differences between the groups became evident. The Elders
differed from the Young participants on Subtests 6 and 8 regardless of hearing aid use.
Although performance was somewhat more depressed when they wore their hearing aids
than when they did not there were no significant differences per hearing aid use.
Discussion
The results are consistent with previous work in hearing and aging, indicating that
audibility plays a substantive role in auditory processing of language in older adults
(Humes & Floyd, 2005; Humes & Roberts, 1990). Once speech signals are sufficiently
intense older adults tend to process speech and language similarly to younger adults,
although increasing linguistic, memorial and acoustic demands will differentiate the
groups as was observed with Subtest 8.
Conclusion
The results have implications for administration and interpretation of the C-RTT and
other tests of language processing.
References
McNeil, M.R. & Prescott, T.E. (1978). Revised Token Test. Austin, TX: Pro-ed.
Humes, L.E. & Floyd, S.S. (2005). Measures of working memory, sequence learning,
and speech recognition in the elderly. Journal of Speech, Language, and Hearing
Research, 48, 224-235.
Humes, L.E. & Roberts, L. (1990). Speech-recognition difficulties of the hearingimpaired elderly: The contributions of audibility. Journal of Speech and Hearing
Research, 33, 726-735.