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Hawthorne K. A meta-analysis of expressive prosody in cochlear implant users. JOURNAL OF COMMUNICATION DISORDERS 2024; 110:106431. [PMID: 38781923 DOI: 10.1016/j.jcomdis.2024.106431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/29/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Prosody is used to express indexical (identifying the talker), linguistic (e.g., question intonation, lexical stress), pragmatic (e.g., contrastive stress, sarcasm), and emotional/affective functions. It is manifested through changes in fundamental frequency (f0), intensity, and duration. F0 and intensity are degraded when perceived through a cochlear implant (CI). The purpose of this meta-analysis is to compare expressive prosody in speech produced by CI users versus normal hearing peers. METHODS A systematic search of the literature found 25 articles that met all inclusion criteria. These articles were assessed for quality, and data pertaining to the expression of f0, intensity, and duration, as well as classification accuracy and appropriateness ratings from normal hearing listeners, were extracted and meta-analyzed using random effects models. RESULTS The articles included in the meta-analysis were generally of acceptable or high quality. Meta-analyses revealed significant differences between individuals with CIs vs. normal hearing on all measures except mean f0, mean intensity, and rhythm. Effect sizes were generally medium to large. There was significant heterogeneity across studies, but little evidence of publication bias. CONCLUSIONS CI users speak with less variable f0, smaller f0 contours, more variable intensity, a slower speech rate, and reduced final lengthening at syntactic boundaries. These acoustic differences are reflected in significantly poorer ratings of speech produced by CI users compared to their normal hearing peers, as assessed by groups of normal hearing listeners. Because atypical expressive prosody is associated with negative outcomes, clinicians should consider targeting prosody when working with individuals who use CIs.
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Affiliation(s)
- Kara Hawthorne
- Gallaudet University, Department of Hearing, Speech, and Language Sciences, Sorenson Language and Communication Center, Washington, D.C. 20002, United States.
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Leyns C, Papeleu T, Feryn T, De Baer S, Bettens K, Corthals P, D'haeseleer E. Age and Gender Differences in Belgian Dutch Intonation. J Voice 2024; 38:801.e1-801.e26. [PMID: 35078698 DOI: 10.1016/j.jvoice.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE This study investigated whether intonation is influenced by age and gender and obtained normative data for the intonation of Flemish (Belgian Dutch) speaking cis women and cis men in Flanders, Belgium, per age group. METHOD A total of 105 cis women and 102 cis men were included and equally spread in five age groups by gender. Semi-structured speech samples were elicited using a prosody protocol. An objective acoustic analysis was performed to determine four intonation parameters (general intonation shift, general fundamental frequency range, final intonation shift, and fundamental frequency variation index). RESULTS Cis women used a higher percentage of general upward and downward intonation shifts than cis men. Cis men generally used more flat intonation shifts than cis women. A larger mean value was observed in cis women as compared to cis men for each of the continuous intonation parameters per sentence type. In terms of age, differences in continuous intonation parameters were found between younger and older age groups, mostly with the 46-55-year-old age group, in which the younger age groups showed smaller mean values for all parameters. CONCLUSIONS Cis women use a more expressive intonation than cis men. In terms of age, older persons showed a more expressive intonation in a number of sentences compared to younger persons. The prosody protocol and the normative data from this study can be used to determine speech therapy goals.
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Affiliation(s)
- Clara Leyns
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Tine Papeleu
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Tilde Feryn
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Sarah De Baer
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Kim Bettens
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Paul Corthals
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
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Frosolini A, Fantin F, Tundo I, Pessot N, Badin G, Bartolotta P, Vedovelli L, Marioni G, de Filippis C. Voice Parameters in Children With Cochlear Implants: A Systematic Review and Meta-Analysis. J Voice 2023:S0892-1997(23)00021-8. [PMID: 36868956 DOI: 10.1016/j.jvoice.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION An intact auditory system is essential for the development and maintenance of voice quality and speech prosody. On the contrary hearing loss affects the adjustments and appropriate use of organs involved in speech and voice production. Spectro-acoustic voice parameters have been evaluated in Cochlear Implant (CI) users, and the authors of previous systematic reviews on the topic concluded that fundamental frequency (F0) seemed preliminarily the most reliable parameter to evaluate voice alterations in adult CI users. The main aim of this systematic review and meta-analysis was to clarify the vocal parameters and prosodic alterations of speech in pediatric CI users. MATERIALS AND METHODS The protocol of the systematic review was registered on the PROSPERO database, International prospective register of systematic reviews. We conducted a search of the English literature published in the period between January 1, 2005 and April 1, 2022 on the Pubmed and Scopus databases. A meta-analysis was conducted to compare the values of voice acoustic parameters in CI users and non-hearing-impaired controls. The analysis was conducted using the standardized mean difference as the outcome measure. A random-effects model was fitted to the data. RESULTS A total of 1334 articles were initially evaluated using title and abstract screening. After applying inclusion/exclusion criteria, 20 articles were considered suitable for this review. The age of the cases ranged between 25 and 132 months at examination. The most studied parameters were F0, Jitter, Shimmer and Harmonics-to-Noise Ratio (HNR); other parameters were seldom reported. A total of 11 studies were included in the meta-analysis of F0, with the majority of estimates being positive (75%); the estimated average standardized mean difference based on the random-effects model was 0.3033 (95% CI: 0.0605 to 0.5462; P = 0.0144). For Jitter (0.2229; 95% CI: -0.1862 to 0.7986; P = 0.2229) and shimmer (0.2540; 95% CI: -0.1404 to 0.6485; P = 0.2068) there was a trend toward positive values without reaching statistical significance. DISCUSSION AND CONCLUSIONS This meta-analysis confirmed that higher F0 values have been observed in the pediatric population of CI users compared to age-matched normal hearing volunteers, whereas the parameters of voice noise were not significantly different between cases and controls. Prosodic aspects of language need further investigations. In longitudinal contexts, prolonged auditory experience with CI has brought voice parameters closer to the norm. Following the available evidence, we stress the utility of inclusion of vocal acoustic analysis in the clinical evaluation and follow-up of CI patients to optimize the rehabilitation process of pediatric patients with hearing loss.
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Affiliation(s)
- Andrea Frosolini
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy; Department of Maxillo-Facial Surgery, Policlinico Le Scotte, University of Siena, Siena, Italy.
| | - Francesco Fantin
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
| | - Isabella Tundo
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy; Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Nicholas Pessot
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
| | - Giulio Badin
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy; Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Patrizia Bartolotta
- Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Biostatistics, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Biostatistics, University of Padova, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Cosimo de Filippis
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
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Yu J, Liao Y, Wu S, Li Y, Huang M. Discourse Prosody in Children's Rhyme Speech Produced by Prelingually Deaf Mandarin-Speaking Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1736-1751. [PMID: 32543941 DOI: 10.1044/2020_jslhr-19-00333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study aimed to obtain a comprehensive understanding about how Mandarin-speaking children with cochlear implants (CIs) performed speech prosody in a connected discourse and to what extent their prosodic scenario differed from those normal-hearing (NH) peers. Method Fifteen prelingually deaf Mandarin-speaking children with unilateral multichannel CIs were chosen and 15 age-matched NH controls were recruited. Speech samples were spontaneously elicited by children's rhyme speech genre and subject to phonetic annotation. Acoustic analysis was conducted on all speech samples, mainly focusing on the measurements of duration and fundamental frequency (F0). Tempo measures included temporal fluency, syllable-lengthening, and rhythm metrics, whereas melodic measures included both local and global F0 variations under different prosodic domains. Results The CI children generally achieved compatible temporal performance with the NH children in spontaneous discourse, except that they were somewhat arbitrary when operationalizing lengthening strategy and pausing strategy at different prosodic boundaries. With regard to melodic performance, CI children may not sufficiently modulate local phonetic nuances of F0 variation, and meanwhile, they performed atypically in the global F0 declination pattern and overall F0 resetting pattern, failing to signal the specific structure of children's rhyme discourse. Early age at implantation and longer CI experience did not play a significant role in the temporal performance of the CI children but did facilitate their articulation of dynamic pitch variation in the spontaneous discourse to some extent. Conclusion CI children did exhibit atypical prosodic patterns in discourse context, especially the overall mapping between the prosodic manifestation and the discourse structure.
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Affiliation(s)
- Jue Yu
- Center for Speech-Language Processing, School of Foreign Languages, Tongji University, Shanghai, China
| | - Yiyuan Liao
- Center for Speech-Language Processing, School of Foreign Languages, Tongji University, Shanghai, China
| | - Shengyi Wu
- Lab of Phonetics and Phonology, School of Humanities, Shaoxing University, Zhejiang, China
| | - Yun Li
- Department of Otolaryngology Head & Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, China
| | - Meiping Huang
- Department of Otolaryngology Head & Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, China
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