الفهرس 
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Abstract
Children require more signal-to-noise ratio (SNR) than adults to recognize speech in the presence of competing background sounds (Corbin et al., 2016). Children with hearing loss have greater difficulty recognizing speech in these situations when compared with age-matched peers with normal hearing (Rance et al., 2007). selecting the ideal hearing aid for a patient is a blend of art and science. While a basic pure-tone configuration may have once steered our decision making, real-world speech tests have now taken center stage as an objective measuring tool with which to select amplification. Speech in noise (SIN) testing for some may be a very routine practice, and for others may seem a bit daunting because it is an unknown (Taylor, 2011). Cochlear implantation has become an effective treatment of severe to profound hearing loss. Numerous studies had shown that after cochlear implantation many patients showed high levels of speech understanding, even allowing them to use the telephone in everyday life. As mentioned by Killion (1997), the SNR loss is used to mean the dB increase in SNR required for 50 % correct word recognition, over the SNR required by those with normal hearing, to achieve a 50% correct score. This is analogous to the use of ”hearing loss” to mean the number of dB increase in SPL required by those with normal hearing sensitivity. Thus, loss of clarity is measured as an SNR loss; loss of sensitivity (audibility) is measured as a (threshold) hearing loss. The Arabic Bamford-Kowal-Bench Speech-in-Noise test (BKBSIN) was developed by Amer et al., (2021) to measure the signal-to noise ratio loss in decibels (dB SNR loss). Measuring speech in noise can be done using the Bamford-Kowal-Bench Speech-in-Noise test (BKB-SIN) test for children. The current study aimed to compare Speech-in-Noise test in children with sensorineural hearing loss using hearing aids and cochlear implants by Arabic BKB-SIN (Bamford-Kowal-Bench Speech-in-Noise test). This study included 60 children. Their age ranged from 5-18 years with average IQ (Stanford Binet Test). They were divided into two groups, the control group (I) It consisted of 20 healthy children (9 males and 11 females). Their age ranged from 5-15 years. All subjects had bilateral normal peripheral hearing in the frequency range of 250- 8000Hz. The study group (II) included 40 children. This group was further subdivided into two subgroups; HA subgroup (IIa) which consists of 20 children with bilateral moderate sensorineural hearing loss using bilateral hearing aids (13 males and 7 females). Their age ranged from 6 – 17 years. All HAs were with basic technology. CI subgroup (IIb) which included 20 children with unilateral CI (8 males and 12 females). Their age ranged from 6 – 17 years. All subjects in this subgroup had unilateral CI (12 in right ear and 8 in left ear). All subjects in this study group had satisfactory aided response as tested in free field. According to results of the current study, comparing the results of BKB Speech in Noise test among control group (I) and study subgroups (IIa and IIb), revealed that there was a significant difference between the control and the studied subgroups. Also, there was a significant difference between the two studied subgroups (HA and CI subgroups). According to results of the current study, the performance of Arabic BKB Speech in Noise test in the control group showed that 100% of subjects of this group were normal/near normal. The performance of Arabic BKB Speech in Noise test in the HA subgroup was higher than the CI subgroup. Results revealed a statistically significant positive correlation between BKB-SNR loss and onset of amplification among CI subgroup. However, there was no statistically significant correlation between BKB-SNR loss and onset of amplification among HA subgroup Results revealed no statistically significant correlations between BKB- SNR loss and the age, onset of speech therapy, duration of using amplification and onset of hearing loss among study subgroups. Similar to the results of the current study Ching et al., (2017) reported a significant positive effect of early age at activation of CI on speech perception in noise. These findings provided a strong evidence on the effectiveness of early implantation for improving speech perception outcomes. Meanwhile, there was no significant effect of early age at activation of HA on speech perception in noise. Age at amplification was the factor that explains the largest percentage of variance for both measures of speech perception and is also a significant predictor of language and speech production. Children with the earliest access to the speech signal through amplification, overall, will have the best outcomes on auditory-based communication measures (Sininger et al., 2010).