Perception of vowels and prosody by cochlear implant recipients in noise

The Role of Early Intact Auditory Experience on the Perception of Spoken Emotions, Comparing Prelingual to Postlingual Cochlear Implant Users

OBJECTIVES

Cochlear implants (CI) are remarkably effective, but have limitations regarding the transformation of the spectro-temporal fine structures of speech. This may impair processing of spoken emotions, which involves the identification and integration of semantic and prosodic cues. Our previous study found spoken-emotions-processing differences between CI users with postlingual deafness (postlingual CI) and normal hearing (NH) matched controls (age range, 19 to 65 years). Postlingual CI users over-relied on semantic information in incongruent trials (prosody and semantics present different emotions), but rated congruent trials (same emotion) similarly to controls. Postlingual CI's intact early auditory experience may explain this pattern of results. The present study examined whether CI users without intact early auditory experience (prelingual CI) would generally perform worse on spoken emotion processing than NH and postlingual CI users, and whether CI use would affect prosodic processing in both CI groups. First, we compared prelingual CI users with their NH controls. Second, we compared the results of the present study to our previous study (Taitlebaum-Swead et al. 2022; postlingual CI).

DESIGN

Fifteen prelingual CI users and 15 NH controls (age range, 18 to 31 years) listened to spoken sentences composed of different combinations (congruent and incongruent) of three discrete emotions (anger, happiness, sadness) and neutrality (performance baseline), presented in prosodic and semantic channels (Test for Rating of Emotions in Speech paradigm). Listeners were asked to rate (six-point scale) the extent to which each of the predefined emotions was conveyed by the sentence as a whole (integration of prosody and semantics), or to focus only on one channel (rating the target emotion [RTE]) and ignore the other (selective attention). In addition, all participants performed standard tests of speech perception. Performance on the Test for Rating of Emotions in Speech was compared with the previous study (postlingual CI).

RESULTS

When asked to focus on one channel, semantics or prosody, both CI groups showed a decrease in prosodic RTE (compared with controls), but only the prelingual CI group showed a decrease in semantic RTE. When the task called for channel integration, both groups of CI users used semantic emotional information to a greater extent than their NH controls. Both groups of CI users rated sentences that did not present the target emotion higher than their NH controls, indicating some degree of confusion. However, only the prelingual CI group rated congruent sentences lower than their NH controls, suggesting reduced accumulation of information across channels. For prelingual CI users, individual differences in identification of monosyllabic words were significantly related to semantic identification and semantic-prosodic integration.

CONCLUSIONS

Taken together with our previous study, we found that the degradation of acoustic information by the CI impairs the processing of prosodic emotions, in both CI user groups. This distortion appears to lead CI users to over-rely on the semantic information when asked to integrate across channels. Early intact auditory exposure among CI users was found to be necessary for the effective identification of semantic emotions, as well as the accumulation of emotional information across the two channels. Results suggest that interventions for spoken-emotion processing should not ignore the onset of hearing loss.

Lexical Stress Identification in Cochlear Implant-Simulated Speech by Non-Native Listeners

This study investigates whether a presumed difference in the perceptibility of cues to lexical stress in spectro-temporally degraded simulated cochlear implant (CI) speech affects how listeners weight these cues during a lexical stress identification task, specifically in their non-native language. Previous research suggests that in English, listeners predominantly rely on a reduction in vowel quality as a cue to lexical stress. In Dutch, changes in the fundamental frequency (F0) contour seem to have a greater functional weight than the vowel quality contrast. Generally, non-native listeners use the cue-weighting strategies from their native language in the non-native language. Moreover, few studies have suggested that these cues to lexical stress are differently perceptible in spectro-temporally degraded electric hearing, as CI users appear to make more effective use of changes in vowel quality than of changes in the F0 contour as cues to linguistic phenomena. In this study, native Dutch learners of English identified stressed syllables in CI-simulated and non-CI-simulated Dutch and English words that contained changes in the F0 contour and vowel quality as cues to lexical stress. The results indicate that neither the cue-weighting strategies in the native language nor in the non-native language are influenced by the perceptibility of cues in the spectro-temporally degraded speech signal. These results are in contrast to our expectations based on previous research and support the idea that cue weighting is a flexible and transferable process.

Prosodic Focus Interpretation in Spectrotemporally Degraded Speech by Non-Native Listeners

PURPOSE

This study assesses how spectrotemporal degradations that can occur in the sound transmission of a cochlear implant (CI) may influence the ability of non-native listeners to recognize the intended meaning of utterances based on the position of the prosodically focused word. Previous research suggests that perceptual accuracy and listening effort are negatively affected by CI processing (or CI simulations) or when the speech is presented in a non-native language, in a number of tasks and circumstances. How these two factors interact to affect prosodic focus interpretation, however, remains unclear.

METHOD

In an online experiment, normal-hearing (NH) adolescent and adult native Dutch learners of English and a small control group of NH native English adolescents listened to CI-simulated (eight-channel noise-band vocoded) and non-CI-simulated English sentences differing in prosodically marked focus. For assessing perceptual accuracy, listeners had to indicate which of four possible context questions the speaker answered. For assessing listening effort, a dual-task paradigm was used with a secondary free recall task.

RESULTS

The results indicated that prosodic focus interpretation was significantly less accurate in the CI-simulated condition compared with the non-CI-simulated condition but that listening effort was not increased. Moreover, there was no interaction between the influence of the degraded CI-simulated speech signal and listening groups in either their perceptual accuracy or listening effort.

CONCLUSION

Non-native listeners are not more strongly affected by spectrotemporal degradations than native listeners, and less proficient non-native listeners are not more strongly affected by these degradations than more proficient non-native listeners.

Perception of Prosody in Hearing-Impaired Individuals and Users of Hearing Assistive Devices: An Overview of Recent Advances

PURPOSE

Prosody perception is an essential component of speech communication and social interaction through which both linguistic and emotional information are conveyed. Considering the importance of the auditory system in processing prosody-related acoustic features, the aim of this review article is to review the effects of hearing impairment on prosody perception in children and adults. It also assesses the performance of hearing assistive devices in restoring prosodic perception.

METHOD

Following a comprehensive online database search, two lines of inquiry were targeted. The first summarizes recent attempts toward determining the effects of hearing loss and interacting factors such as age and cognitive resources on prosody perception. The second analyzes studies reporting beneficial or detrimental impacts of hearing aids, cochlear implants, and bimodal stimulation on prosodic abilities in people with hearing loss.

RESULTS

The reviewed studies indicate that hearing-impaired individuals vary widely in perceiving affective and linguistic prosody, depending on factors such as hearing loss severity, chronological age, and cognitive status. In addition, most of the emerging information points to limitations of hearing assistive devices in processing and transmitting the acoustic features of prosody.

CONCLUSIONS

The existing literature is incomplete in several respects, including the lack of a consensus on how and to what extent hearing prostheses affect prosody perception, especially the linguistic function of prosody, and a gap in assessing prosody under challenging listening situations such as noise. This review article proposes directions that future research could follow to provide a better understanding of prosody processing in those with hearing impairment, which may help health care professionals and designers of assistive technology to develop innovative diagnostic and rehabilitation tools.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809772.

Strategic perceptual weighting of acoustic cues for word stress in listeners with cochlear implants, acoustic hearing, or simulated bimodal hearing

Perception of word stress is an important aspect of recognizing speech, guiding the listener toward candidate words based on the perceived stress pattern. Cochlear implant (CI) signal processing is likely to disrupt some of the available cues for word stress, particularly vowel quality and pitch contour changes. In this study, we used a cue weighting paradigm to investigate differences in stress cue weighting patterns between participants listening with CIs and those with normal hearing (NH). We found that participants with CIs gave less weight to frequency-based pitch and vowel quality cues than NH listeners but compensated by upweighting vowel duration and intensity cues. Nonetheless, CI listeners' stress judgments were also significantly influenced by vowel quality and pitch, and they modulated their usage of these cues depending on the specific word pair in a manner similar to NH participants. In a series of separate online experiments with NH listeners, we simulated aspects of bimodal hearing by combining low-pass filtered speech with a vocoded signal. In these conditions, participants upweighted pitch and vowel quality cues relative to a fully vocoded control condition, suggesting that bimodal listening holds promise for restoring the stress cue weighting patterns exhibited by listeners with NH.

Meta-Analysis on the Identification of Linguistic and Emotional Prosody in Cochlear Implant Users and Vocoder Simulations

OBJECTIVES

This study quantitatively assesses how cochlear implants (CIs) and vocoder simulations of CIs influence the identification of linguistic and emotional prosody in nontonal languages. By means of meta-analysis, it was explored how accurately CI users and normal-hearing (NH) listeners of vocoder simulations (henceforth: simulation listeners) identify prosody compared with NH listeners of unprocessed speech (henceforth: NH listeners), whether this effect of electric hearing differs between CI users and simulation listeners, and whether the effect of electric hearing is influenced by the type of prosody that listeners identify or by the availability of specific cues in the speech signal.

DESIGN

Records were found by searching the PubMed Central, Web of Science, Scopus, Science Direct, and PsycINFO databases (January 2018) using the search terms "cochlear implant prosody" and "vocoder prosody." Records (published in English) were included that reported results of experimental studies comparing CI users' and/or simulation listeners' identification of linguistic and/or emotional prosody in nontonal languages to that of NH listeners (all ages included). Studies that met the inclusion criteria were subjected to a multilevel random-effects meta-analysis.

RESULTS

Sixty-four studies reported in 28 records were included in the meta-analysis. The analysis indicated that CI users and simulation listeners were less accurate in correctly identifying linguistic and emotional prosody compared with NH listeners, that the identification of emotional prosody was more strongly compromised by the electric hearing speech signal than linguistic prosody was, and that the low quality of transmission of fundamental frequency (f0) through the electric hearing speech signal was the main cause of compromised prosody identification in CI users and simulation listeners. Moreover, results indicated that the accuracy with which CI users and simulation listeners identified linguistic and emotional prosody was comparable, suggesting that vocoder simulations with carefully selected parameters can provide a good estimate of how prosody may be identified by CI users.

CONCLUSIONS

The meta-analysis revealed a robust negative effect of electric hearing, where CIs and vocoder simulations had a similar negative influence on the identification of linguistic and emotional prosody, which seemed mainly due to inadequate transmission of f0 cues through the degraded electric hearing speech signal of CIs and vocoder simulations.

Comparing Emotion Recognition and Word Recognition in Background Noise

Purpose Word recognition in quiet and in background noise has been thoroughly investigated in previous research to establish segmental speech recognition performance as a function of stimulus characteristics (e.g., audibility). Similar methods to investigate recognition performance for suprasegmental information (e.g., acoustic cues used to make judgments of talker age, sex, or emotional state) have not been performed. In this work, we directly compared emotion and word recognition performance in different levels of background noise to identify psychoacoustic properties of emotion recognition (globally and for specific emotion categories) relative to word recognition. Method Twenty young adult listeners with normal hearing listened to sentences and either reported a target word in each sentence or selected the emotion of the talker from a list of options (angry, calm, happy, and sad) at four signal-to-noise ratios in a background of white noise. Psychometric functions were fit to the recognition data and used to estimate thresholds (midway points on the function) and slopes for word and emotion recognition. Results Thresholds for emotion recognition were approximately 10 dB better than word recognition thresholds, and slopes for emotion recognition were half of those measured for word recognition. Low-arousal emotions had poorer thresholds and shallower slopes than high-arousal emotions, suggesting greater confusion when distinguishing low-arousal emotional speech content. Conclusions Communication of a talker's emotional state continues to be perceptible to listeners in competitive listening environments, even after words are rendered inaudible. The arousal of emotional speech affects listeners' ability to discriminate between emotion categories.

Mandarin-Speaking, Kindergarten-Aged Children With Cochlear Implants Benefit From Natural F 0 Patterns in the Use of Semantic Context During Speech Recognition

PURPOSE

The purpose of this study was to investigate the extent to which semantic context and F0 contours affect speech recognition by Mandarin-speaking, kindergarten-aged children with cochlear implants (CIs).

METHOD

The experimental design manipulated two factors, that is, semantic context, by comparing the intelligibility of normal sentence versus word list, and F0 contours, by comparing the intelligibility of utterances with natural versus flat F0 patterns. Twenty-two children with CIs completed a speech recognition test.

RESULTS

Children with CIs could use both semantic context and F0 contours to assist speech recognition. Furthermore, natural F0 patterns provided extra benefit when semantic context was present than when it was absent.

CONCLUSION

Dynamic F0 contours play an important role in speech recognition by Mandarin-speaking children with CIs despite the well-known limitation of CI devices in extracting F0 information.

Recognition of Spanish consonants in 8-talker babble by children with cochlear implants, and by children and adults with normal hearing

This paper presents the results of closed-set recognition task for 80 Spanish consonant-vowel sounds in 8-talker babble. Three groups of subjects participated in the study: a group of children using cochlear implants (CIs; age range: 7-13), an age-matched group of children with normal hearing (NH), and a group of adults with NH. The speech-to-noise ratios at which the participants recognized 33% of the target consonants were +7.8 dB, -3 dB, and -6 dB, respectively. In order to clarify the qualitative differences between the groups, groups were matched for the percentage of recognized syllables. As compared with the two groups with NH, the children with CIs: (1) produced few "I do not know" responses; (2) frequently selected the voiced stops (i.e., /b, d, ɡ/) and the most energetic consonants (i.e., /l, r, ʝ, s, ʧ/); (3) showed no vowel context effects; and (4) had a robust voicing bias. As compared with the adults with NH, both groups of children showed a fronting bias in place of articulation errors. The factors underlying these error patterns are discussed.

Using prosody to infer discourse prominence in cochlear-implant users and normal-hearing listeners

Cochlear implants (CIs) provide speech perception to adults with severe-to-profound hearing loss, but the acoustic signal remains severely degraded. Limited access to pitch cues is thought to decrease sensitivity to prosody in CI users, but co-occurring changes in intensity and duration may provide redundant cues. The current study investigates how listeners use these cues to infer discourse prominence. CI users and normal-hearing (NH) listeners were presented with sentences varying in prosody (accented vs. unaccented words) while their eye-movements were measured to referents varying in discourse status (given vs. new categories). In Experiment 1, all listeners inferred prominence when prosody on nouns distinguished categories ("SANDWICH"→not sandals). In Experiment 2, CI users and NH listeners presented with natural speech inferred prominence when prosody on adjectives implied contrast across both categories and properties ("PINK horse"→not the orange horse). In contrast, NH listeners presented with simulated CI (vocoded) speech were sensitive to acoustic differences in prosody, but did not use these cues to infer discourse status. Together, this suggests that exploiting redundant cues for comprehension varies with the demands of language processing and prior experience with the degraded signal.

Word segmentation in phonemically identical and prosodically different sequences using cochlear implants: A case study

Cochlear implant (CI) users frequently achieve good speech understanding based on phoneme and word recognition. However, there is a significant variability between CI users in processing prosody. The aim of this study was to examine the abilities of an excellent CI user to segment continuous speech using intonational cues. A post-lingually deafened adult CI user and 22 normal hearing (NH) subjects segmented phonemically identical and prosodically different sequences in French such as 'l'affiche' (the poster) versus 'la fiche' (the sheet), both [lafiʃ]. All participants also completed a minimal pair discrimination task. Stimuli were presented in auditory-only and audiovisual presentation modalities. The performance of the CI user in the minimal pair discrimination task was 97% in the auditory-only and 100% in the audiovisual condition. In the segmentation task, contrary to the NH participants, the performance of the CI user did not differ from the chance level. Visual speech did not improve word segmentation. This result suggests that word segmentation based on intonational cues is challenging when using CIs even when phoneme/word recognition is very well rehabilitated. This finding points to the importance of the assessment of CI users' skills in prosody processing and the need for specific interventions focusing on this aspect of speech communication.

Voice emotion perception and production in cochlear implant users

Voice emotion is a fundamental component of human social interaction and social development. Unfortunately, cochlear implant users are often forced to interface with highly degraded prosodic cues as a result of device constraints in extraction, processing, and transmission. As such, individuals with cochlear implants frequently demonstrate significant difficulty in recognizing voice emotions in comparison to their normal hearing counterparts. Cochlear implant-mediated perception and production of voice emotion is an important but relatively understudied area of research. However, a rich understanding of the voice emotion auditory processing offers opportunities to improve upon CI biomedical design and to develop training programs benefiting CI performance. In this review, we will address the issues, current literature, and future directions for improved voice emotion processing in cochlear implant users.