Speech versus noise in pediatric sound localization.
BACKGROUND Accurate sound localization is essential for children's communication, safety, and learning. While noise stimuli are commonly used in directional hearing tests in clinical settings, speech stimuli may offer more child-friendly assessments. OBJECTIVES This study aimed to compare sound localization performance using noise and word stimuli across several groups of children with different types of hearing. METHODS A total of 108 children participated in the study: 31 normal-hearing children aged 6-10 (Ref6-10), 32 children aged 6-10 with hearing aids (HA6-10), and 45 children aged 11-17 with hearing aids (HA11-17). Participants completed a sound localization task using five speakers placed at horizontal angles (± 90°, ± 45°, 0°). They localized broadband noise bursts or one of four German words, presented randomly at different sound levels. Localization accuracy was measured using root mean square error (RMSE). Linear mixed-effects models analysis was conducted with Stimulus and Angle as within-subject factors and Group as a between-subject factor. RESULTS No significant differences have been found in the comparison between stimuli regarding the RMSE between the groups. A weakly significant difference between stimulus types was found only in the HA6-10 group at 0°, where noise stimuli were localized more accurately than words (p = 0.03). CONCLUSIONS: Both noise and word stimuli are suitable for assessing directional hearing in children. However, noise stimuli are more economical, as they require fewer presentations. In contrast, word stimuli are more time and resource-demanding due to the need for multiple presentations of each word to obtain statistically reliable results.