Development and validation of a new Mandarin tone identification test

High variability phonetic training facilitates perception-to-production transfer in Mandarin-speaking children with cochlear implants: An acoustic investigation

This study primarily aimed to evaluate the effectiveness of high variability phonetic training (HVPT) for children with cochlear implants (CIs) via the cross-modal transfer of perceptual learning to lexical tone production, a scope that has been largely neglected by previous training research. Sixteen CI participants received a five-session HVPT within a period of three weeks, whereas another 16 CI children were recruited without receiving any formal training. Lexical tone production was assessed with a picture naming task before the provision (pretest) and immediately after (posttest) and ten weeks after (follow-up test) the completion of the training protocol. The production samples were coded and analyzed acoustically. Despite considerable distinctions from the typical baselines of normal-hearing peers, the trained CI children exhibited significant improvements in Mandarin tone production from pretest to posttest in pitch height of T1, pitch slope of T2, and pitch curvature of T3. Moreover, the training-induced acoustic changes in the concave characteristic of the T3 contour was retained ten weeks after training termination. This study represents an initial acoustic investigation on HVPT-induced benefits in lexical tone production for the pediatric CI population, which provides valuable insights into applying this perceptual training technique as a viable tool in clinical practices.

Investigating Perception to Production Transfer in Children With Cochlear Implants: A High Variability Phonetic Training Study

PURPOSE

This study builds upon an established effective training method to investigate the advantages of high variability phonetic identification training for enhancing lexical tone perception and production in Mandarin-speaking pediatric cochlear implant (CI) recipients, who typically face ongoing challenges in these areas.

METHOD

Thirty-two Mandarin-speaking children with CIs were quasirandomly assigned into the training group (TG) and the control group (CG). The 16 TG participants received five sessions of high variability phonetic training (HVPT) within a period of 3 weeks. The CG participants did not receive the training. Perception and production of Mandarin tones were administered before (pretest) and immediately after (posttest) the completion of HVPT via lexical tone recognition task and picture naming task. Both groups participated in the identical pretest and posttest with the same time frame between the two test sessions.

RESULTS

TG showed significant improvement from pretest to posttest in identifying Mandarin tones for both trained and untrained speech stimuli. Moreover, perceptual learning of HVPT significantly facilitated trainees' production of T1 and T2 as rated by a cohort of 10 Mandarin-speaking adults with normal hearing, which was corroborated by acoustic analyses revealing improved fundamental frequency (F0) median for T1 and T2 production and enlarged F0 movement for T2 production. In contrast, TG children's production of T3 and T4 showed nonsignificant changes across two test sessions. Meanwhile, CG did not exhibit significant changes in either perception or production.

CONCLUSIONS

The results suggest a limited and inconsistent transfer of perceptual learning to lexical tone production in children with CIs, which challenges the notion of a robust transfer and highlights the complexity of the interaction between perceptual training and production outcomes. Further research on individual differences with a longitudinal design is needed to optimize the training protocol or tailor interventions to better meet the diverse needs of learners.

A Review of Speech Perception of Mandarin-Speaking Children With Cochlear Implantation

Objective: This paper reviewed the literature on the development of and factors affecting speech perception of Mandarin-speaking children with cochlear implantation (CI). We also summarized speech outcome measures in standard Mandarin for evaluating auditory and speech perception of children with CI.

Method: A comprehensive search of Google Scholar and PubMed was conducted from March to June 2021. Search terms used were speech perception/lexical tone recognition/auditory perception AND cochlear implant AND Mandarin/Chinese.

Conclusion: Unilateral CI recipients demonstrated continuous improvements in auditory and speech perception for several years post-activation. Younger age at implantation and longer duration of CI use contribute to better speech perception. Having undergone a hearing aid trial before implantation and having caregivers whose educational level is higher may lead to better performance. While the findings that support the use of CI to improve speech perception continue to grow, much research is needed to validate the use of unilateral and bilateral implantation. Evidence to date, however, revealed bimodal benefits over CI-only conditions in lexical tone recognition and sentence perception in noise. Due to scarcity of research, conclusions on the benefits of bilateral CIs compared to unilateral CI or bimodal CI use cannot be drawn. Therefore, future research on bimodal and bilateral CIs is needed to guide evidence-based clinical practice.

Bimodal Benefits for Lexical Tone Recognition: An Investigation on Mandarin-speaking Preschoolers with a Cochlear Implant and a Contralateral Hearing Aid

Pitch perception is known to be difficult for individuals with cochlear implant (CI), and adding a hearing aid (HA) in the non-implanted ear is potentially beneficial. The current study aimed to investigate the bimodal benefit for lexical tone recognition in Mandarin-speaking preschoolers using a CI and an HA in opposite ears. The child participants were required to complete tone identification in quiet and in noise with CI + HA in comparison with CI alone. While the bimodal listeners showed confusion between Tone 2 and Tone 3 in recognition, the additional acoustic information from the contralateral HA alleviated confusion between these two tones in quiet. Moreover, significant improvement was demonstrated in the CI + HA condition over the CI alone condition in noise. The bimodal benefit for individual subjects could be predicted by the low-frequency hearing threshold of the non-implanted ear and the duration of bimodal use. The findings support the clinical practice to fit a contralateral HA in the non-implanted ear for the potential benefit in Mandarin tone recognition in CI children. The limitations call for further studies on auditory plasticity on an individual basis to gain insights on the contributing factors to the bimodal benefit or its absence.

Speech fine structure contains critical temporal cues to support speech segmentation

Segmenting the continuous speech stream into units for further perceptual and linguistic analyses is fundamental to speech recognition. The speech amplitude envelope (SE) has long been considered a fundamental temporal cue for segmenting speech. Does the temporal fine structure (TFS), a significant part of speech signals often considered to contain primarily spectral information, contribute to speech segmentation? Using magnetoencephalography, we show that the TFS entrains cortical responses between 3 and 6 Hz and demonstrate, using mutual information analysis, that (i) the temporal information in the TFS can be reconstructed from a measure of frame-to-frame spectral change and correlates with the SE and (ii) that spectral resolution is key to the extraction of such temporal information. Furthermore, we show behavioural evidence that, when the SE is temporally distorted, the TFS provides cues for speech segmentation and aids speech recognition significantly. Our findings show that it is insufficient to investigate solely the SE to understand temporal speech segmentation, as the SE and the TFS derived from a band-filtering method convey comparable, if not inseparable, temporal information. We argue for a more synthetic view of speech segmentation - the auditory system groups speech signals coherently in both temporal and spectral domains.

Tone perception in Mandarin-speaking school age children with otitis media with effusion

OBJECTIVES

The present study explored tone perception ability in school age Mandarin-speaking children with otitis media with effusion (OME) in noisy listening environments. The study investigated the interaction effects of noise, tone type, age, and hearing status on monaural tone perception, and assessed the application of a hierarchical clustering algorithm for profiling hearing impairment in children with OME.

METHODS

Forty-one children with normal hearing and normal middle ear status and 84 children with OME with or without hearing loss participated in this study. The children with OME were further divided into two subgroups based on their severity and pattern of hearing loss using a hierarchical clustering algorithm. Monaural tone recognition was measured using a picture-identification test format incorporating six sets of monosyllabic words conveying four lexical tones under speech spectrum noise, with the signal-to-noise ratio (SNR) conditions ranging from -9 to -21 dB.

RESULTS

Linear correlation indicated tone recognition thresholds of children with OME were significantly correlated with age and pure tone hearing thresholds at every frequency tested. Children with hearing thresholds less affected by OME performed similarly to their peers with normal hearing. Tone recognition thresholds of children with auditory status more affected by OME were significantly inferior to those of children with normal hearing or with minor hearing loss. Younger children demonstrated poorer tone recognition performance than older children with OME. A mixed design repeated-measure ANCOVA showed significant main effects of listening condition, hearing status, and tone type on tone recognition. Contrast comparisons revealed that tone recognition scores were significantly better under -12 dB SNR than under -15 dB SNR conditions and tone recognition scores were significantly worse under -18 dB SNR than those obtained under -15 dB SNR conditions. Tone 1 was the easiest tone to identify and Tone 3 was the most difficult tone to identify for all participants, when considering -12, -15, and -18 dB SNR as within-subject variables. The interaction effect between hearing status and tone type indicated that children with greater levels of OME-related hearing loss had more impaired tone perception of Tone 1 and Tone 2 compared to their peers with lesser levels of OME-related hearing loss. However, tone perception of Tone 3 and Tone 4 remained similar among all three groups. Tone 2 and Tone 3 were the most perceptually difficult tones for children with or without OME-related hearing loss in all listening conditions.

CONCLUSIONS

The hierarchical clustering algorithm demonstrated usefulness in risk stratification for tone perception deficiency in children with OME-related hearing loss. There was marked impairment in tone perception in noise for children with greater levels of OME-related hearing loss. Monaural lexical tone perception in younger children was more vulnerable to noise and OME-related hearing loss than that in older children.

Processing of Acoustic Cues in Lexical-Tone Identification by Pediatric Cochlear-Implant Recipients

PURPOSE

The objective was to investigate acoustic cue processing in lexical-tone recognition by pediatric cochlear-implant (CI) recipients who are native Mandarin speakers.

METHOD

Lexical-tone recognition was assessed in pediatric CI recipients and listeners with normal hearing (NH) in 2 tasks. In Task 1, participants identified naturally uttered words that were contrastive in lexical tones. For Task 2, a disyllabic word (yanjing) was manipulated orthogonally, varying in fundamental-frequency (F0) contours and duration patterns. Participants identified each token with the second syllable jing pronounced with Tone 1 (a high level tone) as eyes or with Tone 4 (a high falling tone) as eyeglasses.

RESULTS

CI participants' recognition accuracy was significantly lower than NH listeners' in Task 1. In Task 2, CI participants' reliance on F0 contours was significantly less than that of NH listeners; their reliance on duration patterns, however, was significantly higher than that of NH listeners. Both CI and NH listeners' performance in Task 1 was significantly correlated with their reliance on F0 contours in Task 2.

CONCLUSION

For pediatric CI recipients, lexical-tone recognition using naturally uttered words is primarily related to their reliance on F0 contours, although duration patterns may be used as an additional cue.

Lexical tone recognition in noise in normal-hearing children and prelingually deafened children with cochlear implants

OBJECTIVE

The purpose of the present study was to investigate Mandarin tone recognition in background noise in children with cochlear implants (CIs), and to examine the potential factors contributing to their performance.

DESIGN

Tone recognition was tested using a two-alternative forced-choice paradigm in various signal-to-noise ratio (SNR) conditions (i.e. quiet, +12, +6, 0, and -6 dB). Linear correlation analysis was performed to examine possible relationships between the tone-recognition performance of the CI children and the demographic factors.

STUDY SAMPLE

Sixty-six prelingually deafened children with CIs and 52 normal-hearing (NH) children as controls participated in the study.

RESULTS

Children with CIs showed an overall poorer tone-recognition performance and were more susceptible to noise than their NH peers. Tone confusions between Mandarin tone 2 and tone 3 were most prominent in both CI and NH children except for in the poorest SNR conditions. Age at implantation was significantly correlated with tone-recognition performance of the CI children in noise.

CONCLUSIONS

There is a marked deficit in tone recognition in prelingually deafened children with CIs, particularly in noise listening conditions. While factors that contribute to the large individual differences are still elusive, early implantation could be beneficial to tone development in pediatric CI users.

Known-Groups and Concurrent Validity of the Mandarin Tone Identification Test (MTIT)

Objective

The Mandarin Tone Identification Test (MTIT) is a new test designed to assess the tone identification abilities of children with hearing impairment (HI). Evidence for reliability and sensitivity has been reported. The present study aimed to evaluate the known-groups and concurrent validity of the MTIT.

Design

The MTIT and Mandarin Pediatric Speech Intelligibility test (MPSI) were administered in quiet and in noise conditions. The known-groups validity was evaluated by comparing the performance of the MTIT on children with two different levels of HI. The MPSI was included to evaluate the concurrent validity of the MTIT.

Study sample

81 children with HI were recruited in the present study. They were Mandarin-speaking children with profound HI (mean age = 9; 0, n = 41) and with moderate to severe HI (mean age = 8; 9, n = 40).

Results

Scores on the MTIT differed between the two groups with different hearing levels suggesting good known-groups validity. A strong relationship between tone and sentence perception both in quiet and in noise provided preliminary evidence for concurrent validity.

Conclusions

The present study confirmed that the MTIT has good known-groups validity and provided preliminary evidence for concurrent validity. The MTIT could be used to evaluate tone identification ability in children with HI with confidence.

A busca de evidências de validade no desenvolvimento de instrumentos em Fonoaudiologia: revisão sistemática

RESUMO Objetivo: Identificar, na literatura, o uso da Psicometria na área da Fonoaudiologia e os processos utilizados para a busca de evidências de validade dos instrumentos da área. Estratégia de pesquisa: As bases pesquisadas foram MEDLINE (acessado via PubMed), LILACS, Scopus e SciELO. Os descritores foram “Validation studies”, “Validity of tests”, “Speech, Language and Hearing Sciences” e “Valid” (seguido de elemento de truncagem), em português, inglês e espanhol. Critérios de seleção: Foram incluídos os estudos que realizavam algum tipo de validação de testes referentes a áreas da Fonoaudiologia. Resultados: Foram encontrados 296 artigos e destes, apenas 48 foram incluídos. A maioria dos estudos foi publicada por periódicos internacionais, da área da Fonoaudiologia e com amostra de ampla faixa etária. A principal área avaliada pelos instrumentos foi linguagem (20 estudos), seguida por audiologia (13 estudos). O ano de maior publicação foi 2014 e o principal tipo de busca de evidências de validade foi com base na estrutura interna. Conclusão: O uso dos princípios de busca de evidências de validade de instrumentos da área fonoaudiológica ainda é escasso. Porém, observa-se que a maior parte dos estudos foi desenvolvida nos últimos anos, demonstrando tendência atual para atenção à necessidade de aprimoramento dos instrumentos.

Tone identification in Mandarin-speaking children with profound hearing impairment

OBJECTIVES

Little is known about the tone identification ability of Mandarin-speaking children with profound hearing impairment (HI) and fitted with hearing aids (HAs). The present study aimed to evaluate the Mandarin tone identification ability in children with profound HI and fitted with HAs, and explore the effects of hearing thresholds, the age of first HA fitting and the duration of HA use on Mandarin tone identification ability.

METHODS

Subjects were Mandarin-speaking children aged 5;4-12;6 years with profound HI (n=41). The Mandarin Tone Identification Test was administered in five test conditions: in -10, -5, 0 and 5dB signal-to-noise ratios (S/Ns) and quiet. Hearing aids were in the usual user's settings, optimized for the best speech reception, and the volume was set to comfortable listening level.

RESULTS

Two-way repeated measures ANOVA showed significant effects of test conditions and tone contrasts in Mandarin tone identification. Post-hoc pairwise comparisons showed significant difference in performance among the five test conditions. Results also indicated that, among the six tone contrasts, the Tone 1/Tone 2 and Tone 2/Tone 3 contrasts were the most difficult tone contrasts in quiet. No significant difference in performance was found among the six tone contrasts in noise. Pearson product-moment correlation showed that the age of first HA fitting, the duration of HA use, aided and unaided average thresholds as well as the aided hearing thresholds in the low frequency region were not significantly correlated with tone identification ability in the five test conditions.

CONCLUSIONS

Consistent with previous findings, the Tone 1/Tone 2 and Tone 2/Tone 3 contrasts were the most difficult to identify in quiet; but the presence of noise resulted in these tone contrasts being equally difficult. Findings also suggest that the tone identification ability of children with profound HI needs to be improved. Although the age of first HA fitting and the duration of HA use were not significantly correlated with tone identification performance in children with profound HI, this finding does not preclude the importance of early HA fitting.