![]() 22 The tool, which has been validated in other foreign languages, 14 23 24 25 including Malay, 26 uses syntactically correct and semantically meaningful list of sentences. HINT is a validated subjective assessment tool developed to assess an individual's binaural hearing on their speech intelligibility in competing background noise. As all the selected subjects are familiar with Malay language, therefore, the current study has elected the test as the assessment tool for binaural hearing assessment. The reason for using HINT test is because it has been validated into Malay version. The current study, despite the presence of other hearing in noise test such as Listening in spatialized noise (LISN) 20 and speech in noise (SIN) 21 test, utilized the Malay version of hearing in noise test (HINT) to evaluate the binaural auditory processing in patients with schizophrenia. 19 Hence, these reflect that the use of words or sentences in noise should be encouraged when assessing the auditory processing of schizophrenia patients. Another study using Speech-in-Babble Perception test, 18 however, revealed that patients with first-episode psychosis do have difficulties when listening to targeted signals embedded in noise. ![]() 17 also suggested that schizophrenia patients demonstrated no deficits in recognizing monosyllabic words in background noise. An investigation of speech perception ability using narrative texts embedded in phonetic noise has also been documented. 15 The study was conducted using nonsense sentences, i.e., a syntactically correct but semantically not meaningful, to patients with schizophrenia in quiet and background noise. 14 In support, a study suggested that patients with schizophrenia were able to utilize content or voice prime to assist their attention to targeted signals such as speech, even in background noise. This would minimize the floor and ceiling effects. Thus, it is more rationale to assess their auditory performance in a simulated conversational environment, i.e listening to sentences in noise. ![]() 11 12 13 In spite of minimizing the limitations, it does not reflect our daily verbal conversation activities. In order to avoid the limitations, previous studies have applied basic component of speech such as non-meaningful vowel-consonants as stimuli. 9 10 Therefore, auditory processing investigations using sentences are debatable. 8 In fact, previous studies have found that the presence of competing noise would affect the patients' attention towards important signals. Schizophrenia, with regards to the deficits in cortical GABAergic system, is also associated with deficits in cognitive functions such as in attention and working memory.
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