The Speech Intelligibility Index: Tutorial and Applications for Children Who Are Deaf and Hard of Hearing

Purpose: Speech audibility refers to how much access a listener has to the acoustic cues that comprise spoken communication. The Speech Intelligibility Index (SII) is a measure of speech audibility that has had increasing use in pediatric audiology to quantify auditory access with and without hearing aids. This tutorial focuses on clinical applications of the SII in children who are deaf and hard of hearing (DHH). Method: We discuss the calculation of the SII and the current clinical tools that calculate aided and unaided SII. We describe practical uses of the SII throughout the steps of audiologic care, including at diagnosis of hearing loss, hearing technology candidacy, hearing aid verification, and long-term management of children who are DHH. Common questions about clinical applications of the SII are addressed throughout the tutorial. Finally, we present three case studies that illustrate the application of SII to clinical decision making and counseling with children and their families. Conclusions: The SII has multiple applications in pediatric audiology. Speech audibility can support device candidacy and management decisions for children who are DHH.