A phonological system at 2 years after cochlear implantation

Consonant and vowel production in the spontaneous speech productions of children with auditory brainstem implants

Auditory brainstem implantation provides hearing sensations in children and adults with anomalies of the auditory nerves. In children, perceptual benefits have been established, and research already demonstrated (limited) effects on children's speech production. The current study extends the literature by scrutinizing the phonological development of three children with ABI. Spontaneous speech samples were used to establish their phonemic inventories of vowels, word-initial consonants and word-final consonants, both independently of the target phoneme and relative to the target phoneme. The three children produced all vowels with longer device use and larger vocabulary size. Word-initial and word-final consonants appeared in the three children's spontaneous productions. However, the segmental accuracy was only moderate in the children's productions.

Long-term effects of cochlear implantation on the intelligibility of speech in French-speaking children

Our study compares the intelligibility of French-speaking children with a cochlear implant (N = 13) and age-matched children with typical hearing (N = 13) in a narrative task. This contrasts with previous studies in which speech intelligibility of children with cochlear implants is most often tested using repetition or reading tasks. Languages other than English are seldom considered. Their productions were graded by naive and expert listeners. The results show that (1) children with CIs have lower intelligibility, (2) early implantation is a predictor of good intelligibility, and (3) late implantation after two years of age does not prevent the children from eventually reaching good intelligibility.

Speech Production Accuracy and Variability in Monolingual and Bilingual Children With Cochlear Implants: A Comparison to Their Peers With Normal Hearing

Purpose This study investigates consonant and vowel accuracy and whole-word variability (also called token-to-token variability or token-to-token inconsistency) in bilingual Spanish-English and monolingual English-speaking children with cochlear implants (CIs) compared to their bilingual and monolingual peers with normal hearing (NH). Method Participants were 40 children between 4;6 and 7;11 (years;months; M _age = 6;2), n = 10 each in 4 participant groups: bilingual Spanish-English with CIs, monolingual English with CIs, bilingual Spanish-English with NH, and monolingual English with NH. Spanish and English word lists consisting of 20 words of varying length were generated, and 3 productions of each word were analyzed for percent consonants correct, percent vowels correct, and the presence of any consonant and/or vowel variability. Results Children with CIs demonstrated lower accuracy and more whole-word variability than their peers with NH. There were no differences in rates of accuracy or whole-word variability between bilingual and monolingual children matched on hearing status, and bilingual children had lower accuracy and greater whole-word variability in English than in Spanish. Conclusions High rates of whole-word variability are prevalent in the speech of children with CIs even after many years of CI experience, and bilingual language exposure does not appear to negatively impact phonological development in children with CIs. Contributions to our understanding of underlying sources of speech production variability and clinical implications are discussed.

Cluster production in speech of Persian-speaking cochlear implanted children

OBJECTIVE

This study is to examine the final cluster processing in Cochlear implanted child and compare the hearing age factor with the chronological age one.

INTRODUCTION

Scholars argue that, in a Cochlear Implanted (CI) child, the hearing age is the crucial factor in the speech rather than the chronological age. To determine which factor affects the production more, we examined the mastery of Persian final consonant clusters realization in CI children at one-to-two years of hearing experience and compared the result to Normal Hearing (NH) peers.

METHODS AND MATERIALS

The study included 21 children in two categories of girls and boys. Using picture-naming task, we collected the data from participants.

RESULT

Data analysis showed that all the children used the same set of phonological rules at their developmental stages of word final consonant cluster but the distribution of preferences differed between the groups. In one hand, Cluster reduction was the most produced phonological rule in both groups and on the other hand, CI children preferred breathing, coalescence and cluster simplification more than NH children did. Considering Gender, unlike NH girls and boys who had the same trend in their phonological system, CI girls were closer to complete production rather than boys.

CONCLUSION

According to this survey, what seems to be important in speech production of CI children is years of hearing experience rather than chronological age. Girls tried different rules compared to boys for cluster production, but when the mastery over cluster production was achieved, there was no difference between girls and boys.

Phonological processes in the speech of school-age children with hearing loss: Comparisons with children with normal hearing

PURPOSE

In this descriptive study, phonological processes were examined in the speech of children aged 5;0-7;6 (years; months) with mild to profound hearing loss using hearing aids (HAs) and cochlear implants (CIs), in comparison to their peers. A second aim was to compare phonological processes of HA and CI users.

METHOD

Children with hearing loss (CWHL, N = 25) were compared to children with normal hearing (CWNH, N = 30) with similar age, gender, linguistic, and socioeconomic backgrounds. Speech samples obtained from a list of 88 words, derived from three standardized speech tests, were analyzed using the CASALA (Computer Aided Speech and Language Analysis) program to evaluate participants' phonological systems, based on lax (a process appeared at least twice in the speech of at least two children) and strict (a process appeared at least five times in the speech of at least two children) counting criteria.

RESULTS

Developmental phonological processes were eliminated in the speech of younger and older CWNH while eleven developmental phonological processes persisted in the speech of both age groups of CWHL. CWHL showed a similar trend of age of elimination to CWNH, but at a slower rate. Children with HAs and CIs produced similar phonological processes. Final consonant deletion, weak syllable deletion, backing, and glottal replacement were present in the speech of HA users, affecting their overall speech intelligibility.

CONCLUSIONS

Developmental and non-developmental phonological processes persist in the speech of children with mild to profound hearing loss compared to their peers with typical hearing. The findings indicate that it is important for clinicians to consider phonological assessment in pre-school CWHL and the use of evidence-based speech therapy in order to reduce non-developmental and non-age-appropriate developmental processes, thereby enhancing their speech intelligibility.

Alveolar and Postalveolar Voiceless Fricative and Affricate Productions of Spanish-English Bilingual Children With Cochlear Implants

PURPOSE

This study investigates the production of voiceless alveolar and postalveolar fricatives and affricates by bilingual and monolingual children with hearing loss who use cochlear implants (CIs) and their peers with normal hearing (NH).

METHOD

Fifty-four children participated in our study, including 12 Spanish-English bilingual CI users (M = 6;0 [years;months]), 12 monolingual English-speaking children with CIs (M = 6;1), 20 bilingual children with NH (M = 6;5), and 10 monolingual English-speaking children with NH (M = 5;10). Picture elicitation targeting /s/, /tʃ/, and /ʃ/ was administered. Repeated-measures analyses of variance comparing group means for frication duration, rise time, and centroid frequency were conducted for the effects of CI use and bilingualism.

RESULTS

All groups distinguished the target sounds in the 3 acoustic parameters examined. Regarding frication duration and rise time, the Spanish productions of bilingual children with CIs differed from their bilingual peers with NH. English frication duration patterns for bilingual versus monolingual CI users also differed. Centroid frequency was a stronger place cue for children with NH than for children with CIs.

CONCLUSION

Patterns of fricative and affricate production display effects of bilingualism and diminished signal, yielding unique patterns for bilingual and monolingual CI users.

Consonant Acquisition in Young Cochlear Implant Recipients and Their Typically Developing Peers

PURPOSE

Consonant acquisition was examined in 13 young cochlear implant (CI) recipients and 11 typically developing (TD) children.

METHOD

A longitudinal research design was implemented to determine the rate and nature of consonant acquisition during the first 2 years of robust hearing experience. Twenty-minute adult-child (typically a parent) interactions were video and audio recorded at 3-month intervals following implantation until 24 months of robust hearing experience was achieved. TD children were similarly recorded between 6 and 24 months of age. Consonants that were produced twice within a 50-utterance sample were considered "established" within a child's consonant inventory.

RESULTS

Although the groups showed similar trajectories, the CI group produced larger consonant inventories than the TD group at each interval except for 21 and 24 months. A majority of children with CIs also showed more rapid acquisition of consonants and more diverse consonant inventories than TD children.

CONCLUSIONS

These results suggest that early auditory deprivation does not significantly affect consonant acquisition for most CI recipients. Tracking early consonant development appears to be a useful way to assess the effectiveness of cochlear implantation in young recipients.

Word initial fricative production in children with cochlear implants and their normally hearing peers matched on lexicon size

Fricative production is affected in children with cochlear implants (CI) as compared to age-matched normally hearing (NH) children. However, the phonological development of children with CI is rarely compared to that of NH peers matched on lexicon size. We compare the early word initial fricative development of 10 children with CI and 30 NH children matched on lexicon size and on chronological age. Children with CI are expected to differ from their NH peers when they are matched on chronological age. But, are lexical development and phonological development commensurate in children with CI as they have been shown to be in NH children? Results show that fricative production in children with CI deviates from that of age-matched NH peers. The differences between both groups disappear when they were matched on lexicon size. Thus, phonological development in children with CI is similar to that of their NH peers with comparable lexicon sizes.

Initial Stop Voicing in Bilingual Children With Cochlear Implants and Their Typically Developing Peers With Normal Hearing

PURPOSE

This study focuses on stop voicing differentiation in bilingual children with normal hearing (NH) and their bilingual peers with hearing loss who use cochlear implants (CIs).

METHOD

Twenty-two bilingual children participated in our study (11 with NH, M age = 5;1 [years;months], and 11 with CIs, M hearing age = 5;1). The groups were matched on hearing age and a range of demographic variables. Single-word picture elicitation was used with word-initial singleton stop consonants. Repeated measures analyses of variance with three within-subject factors (language, stop voicing, and stop place of articulation) and one between-subjects factor (NH vs. CI user) were conducted with voice onset time and percentage of prevoiced stops as dependent variables.

RESULTS

Main effects were statistically significant for language, stop voicing, and stop place of articulation on both voice onset time and prevoicing. There were no significant main effects for NH versus CI groups. Both children with NH and with CIs differentiated stop voicing in their languages and by stop place of articulation. Stop voicing differentiation was commensurate across the groups of children with NH versus CIs.

CONCLUSIONS

Stop voicing differentiation is accomplished in a similar fashion by bilingual children with NH and CIs, and both groups differentiate stop voicing in a language-specific fashion.

Picture naming and verbal fluency in children with cochlear implants

PURPOSE

In the present study, the authors examined lexical naming in children with cochlear implants (CIs). The goal was to determine whether children with CIs have deficits in lexical access and organization as revealed through reaction time in picture-naming and verbal fluency (VF) experiments.

METHOD

Children with CIs (n = 20, ages 7-10) were compared with 20 children with normal hearing (NH) matched for age and nonverbal IQ. Lexical abilities were examined using two naming tasks: a timed picture-naming task and a phonological and semantic VF naming task. Picture naming taps into lexical access capabilities and the VF task elucidates lexical organization.

RESULTS

No group differences were found between children with CIs and children with NH on the timed picture-naming task. Children with CIs generated significantly fewer words than the children with NH on the VF tasks. Larger group differences were found for the phonological VF task compared with the semantic VF task.

CONCLUSIONS

Limited early linguistic and auditory experiences may affect lexical representations and organization (lexical-semantic connections) in school-age children with hearing loss who use CIs. Further analyses and studies should continue to examine these underlying linguistic deficits. The present results suggest a need to emphasize not only increasing the size of children's vocabularies during therapy, but also expanding and increasing the semantic and phonological richness of their lexical representations.

Processing of phonological variation in children with hearing loss: compensation for English place assimilation in connected speech

PURPOSE

In this study, the authors explored phonological processing in connected speech in children with hearing loss. Specifically, the authors investigated these children's sensitivity to English place assimilation, by which alveolar consonants like t and n can adapt to following sounds (e.g., the word ten can be realized as tem in the phrase ten pounds).

METHOD

Twenty-seven 4- to 8-year-old children with moderate to profound hearing impairments, using hearing aids (n = 10) or cochlear implants (n = 17), and 19 children with normal hearing participated. They were asked to choose between pictures of familiar (e.g., pen) and unfamiliar objects (e.g., astrolabe) after hearing t- and n-final words in sentences. Standard pronunciations (Can you find the pen dear?) and assimilated forms in correct (… pem please?) and incorrect contexts (… pem dear?) were presented.

RESULTS

As expected, the children with normal hearing chose the familiar object more often for standard forms and correct assimilations than for incorrect assimilations. Thus, they are sensitive to word-final place changes and compensate for assimilation. However, the children with hearing impairment demonstrated reduced sensitivity to word-final place changes, and no compensation for assimilation. Restricted analyses revealed that children with hearing aids who showed good perceptual skills compensated for assimilation in plosives only.

The ear is connected to the brain: some new directions in the study of children with cochlear implants at Indiana University

Since the early 1980s, the DeVault Otologic Research Laboratory at the Indiana University School of Medicine has been on the forefront of research on speech and language outcomes in children with cochlear implants. This paper highlights work over the last decade that has moved beyond collecting speech and language outcome measures to focus more on investigating the underlying cognitive, social, and linguistic skills that predict speech and language outcomes. This recent work reflects our growing appreciation that early auditory deprivation can affect more than hearing and speech perception. The new directions include research on attention to speech, word learning, phonological development, social development, and neurocognitive processes. We have also expanded our subject populations to include infants and children with additional disabilities.

Tracking speech sound acquisition

This article describes a procedure to aid in the clinical appraisal of child speech. The approach, based on the work by Dinnsen, Chin, Elbert, and Powell (1990; Some constraints on functionally disordered phonologies: Phonetic inventories and phonotactics. Journal of Speech and Hearing Research, 33, 28-37), uses a railway idiom to track gains in the complexity of speech sound production. A clinical case study is reviewed to illustrate application of the procedure. The procedure is intended to facilitate application of an evidence-based procedure to the clinical management of developmental speech sound disorders.

Is age at implant the only factor that counts? The influence of working memory on lexical and grammatical development in children with cochlear implants

In this study, we explored the influence of time factors (age at implant, time with cochlear implant and age), complex working memory and phonological short-term memory on lexical and grammatical development in congenitally deaf children with cochlear implants. Fifteen children (aged 5 years 4 months to 11 years 5 months) were examined with the use of several linguistic and cognitive measures after a minimum of 18 months of implant use. Phonological short-term memory was assessed with non-word repetition, where the percentage of correctly repeated consonants and vowels was counted. For the assessment of lexical acquisition. a novel word learning task was administered. Receptive and expressive grammar was tested. Our results corroborate earlier findings on the influence of phonological short-term memory on novel word learning. The percentage of vowels correctly produced in non-word repetition was more important in this group than age at implant, not only for novel word learning. but also for receptive and expressive grammar.

Phonological patterns in the conversational speech of children with cochlear implants

In this descriptive, longitudinal study, phonological patterns (i.e., natural phonological processes) were examined in a set of conversational speech samples obtained from six young children fitted with cochlear implants. Both developmental and non-developmental patterns were observed. This is consistent with findings from previous studies of the speech of children with hearing loss who wear hearing aids. Several of the patterns found were also the same as those reported in previous studies of children with cochlear implants. One developmental pattern and two non-developmental patterns were significantly correlated with age demonstrating a decrease over time. Trends were evident in several other patterns suggesting possible directions for future investigations.

LEARNING OUTCOMES

The reader will be able to (1) differentiate developmental from non-developmental phonological patterns, (2) identify the patterns that can be seen in the speech of children fitted with cochlear implants, and (3) understand the direction of pattern occurrence over time in this population.

Speech perception of children with cochlear implants and children with traditional hearing aids

The aim of the study was to analyse speech perception of children with cochlear implants (N = 29) and children fitted with traditional hearing aids (N = 20). One- and two-syllable words were presented auditorily in a forced choice minimal-pair discrimination task. The children repeated the word and pointed to the appropriate picture presented on computer screen. The words were minimal pairs with respect to voicing or place of articulation in stops and fricatives; among affricates the minimal pairs included the most frequently substituted fricatives and stops in addition to voicing and place of articulation. Vowel discrimination was tested in minimal pairs and in nonsense words differing only in the vowel. Unaided, all children were profoundly hearing impaired and were included in auditory-oral therapy (Verbotonal method). The smallest differences between the groups were found for stops and vowels, and the largest for fricatives and affricates. The implanted children were significantly more successful.

Children's consonant inventories after extended cochlear implant use

Qualitative descriptions of the consonant inventories of 12 children who have used cochlear implants for at least 5 years are provided, together with description of sound correspondences between children's systems and the ambient language (English). Productions of English words were elicited in a picture-naming task, and a consonant inventory for each child was determined. Results showed that the consonant inventories of children who use cochlear implants are not simply subsets of the inventory of the ambient language, but rather unique sets of segments that may include consonants not in the ambient inventory. Comparison of the inventories of oral communication users and total communication users revealed qualitative differences between the 2 groups, based on the presence or absence of both English and non-English sound segments. Inventories of oral communication users tended to contain more English segments (e.g., alveolar fricatives, velar stops, velar nasals) than did the inventories of total communication users. Conversely, specific non-English segments, such as uvular stops, tended to occur in the inventories of total communication users more than in inventories of oral communication users. Therefore, a complete understanding of the phonological systems of children who use cochlear implants depends on full accounts of their segment inventories. Such understanding may affect decisions regarding habilitation procedures, insofar as successful acquisition of a linguistic system involves not only the inclusion of all ambient sound segments, but also the exclusion of all nonambient ones.

Aspects of Stop Consonant Production by Pediatric Users of Cochlear Implants

Purpose: Data and analyses are reported for stop consonant production by 12 children who have used cochlear implants for at least 5 years, focusing on variation within and between individual phonological systems.

Method: Participants were 6 oral communication users and 6 total communication users. Productions of single words were analyzed for stop inventories, phonotactic constraints, and morphophonemic alternations. Variation was further analyzed within optimality theory.

Results: Children’s inventories differed from English mainly in having additional, non-English stops. Total communication users had fewer ambient stops and more nonambient ones than did oral communication users. Control over English allophonic and neutralization rules varied among children. Phonological variation could be accounted for by positing unique underlying representations and different constraint rankings within optimality theory.

Clinical Implications: Atypical speech by children with cochlear implants involves both articulation and phonological organization. Although children vary considerably, characteristic patterns emerge. An understanding of these patterns is useful for identifying areas of difficulty and formulating intervention programs.

Cognitive factors and cochlear implants: some thoughts on perception, learning, and memory in speech perception

Over the past few years, there has been increased interest in studying some of the cognitive factors that affect speech perception performance of cochlear implant patients. In this paper, I provide a brief theoretical overview of the fundamental assumptions of the information-processing approach to cognition and discuss the role of perception, learning, and memory in speech perception and spoken language processing. The information-processing framework provides researchers and clinicians with a new way to understand the time-course of perceptual and cognitive development and the relations between perception and production of spoken language. Directions for future research using this approach are discussed including the study of individual differences, predicting success with a cochlear implant from a set of cognitive measures of performance and developing new intervention strategies.