Assessing Language Skills as a Predictor of Children's Listening Difficulties: Validation and Reference Data on a New Auditory Language Task.

Objectives: Some children experience greater listening difficulties in noisy and reverberant environments than their peers, despite having normal peripheral hearing. In these cases, other potential causes have to be explored. One is a language disorder. Testing this possibility in audiology requires a language screening test that can be used by audiologists. This study aims to establish reference data for a screening test, the auditory cloze test (AudiCloze), to examine sex differences and to validate the results by comparing them with the standardized Clinical Evaluation of Language Fundamentals Fifth Edition (CELF-5) sentences recall test. Finally, the study examines the relationship between children's language skills-a composite of the new auditory cloze test and sentences recall-and their abilities to listen in noise and reverberation within a representative sample.

Design: The study included 125 primary school children aged 6 to 11 (76 females and 49 males) with normal hearing, all of whom completed the AudiCloze test. In addition, 55 of these children completed the CELF-5 sentence recall test, and 85 children completed a listening test designed to assess sentence intelligibility in a noisy and reverberant condition, the Test of Listening Difficulties-Universal.

Results: No sex differences were observed in the AudiCloze performance. A significant positive correlation was identified between age-adjusted AudiCloze and standardized CELF-5 sentence recall scores (r = 0.63, p < 0.001). In addition, children's performance on sentence intelligibility in noise and reverberation using the Test of Listening Difficulties-Universal was significantly predicted by their language skills composite variable (β = 0.76, p < 0.001).

Conclusions: AudiCloze is the first validated language assessment tool specifically developed for audiologists to assess children as young as six years old to use their knowledge of language when listening in acoustically challenging situations. Language skills are crucial for children's sentence intelligibility in noise and reverberation. Being able to detect language deficits in children referred for an auditory processing assessment should facilitate referral of children who need specialist language assessment and intervention and hence improve outcomes for these children.