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Mahshie J, Core C, Larsen MD. Factors affecting consonant production accuracy in children with cochlear implants: Expressive vocabulary and maternal education. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 38934649 DOI: 10.1111/1460-6984.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Despite the ability of cochlear implants (CIs) to provide children with access to speech, there is considerable variability in spoken language outcomes. Research aimed at identifying factors influencing speech production accuracy is needed. AIMS To characterize the consonant production accuracy of children with cochlear implants (CWCI) and an age-matched group of children with typical hearing (CWTH) and to explore several factors that potentially affect the ability of both groups to accurately produce consonants. METHODS & PROCEDURES We administered the Bankson-Bernthal Test of Phonology (BBTOP) to a group of 25 CWCI (mean age = 4;9, SD = 1;6, range = 3;2-8;5) implanted prior to 30 months of age with a mean duration of implant usage of 3;6 and an age-matched group of 25 CWTH (mean age = 5;0, SD = 1;6, range = 3;1-8;6). The recorded results were transcribed, and the accuracy of the target consonants was determined. Expressive vocabulary size estimates were obtained from a language sample using the number of different words (NDW). A parent questionnaire provided information about maternal education, duration of CIs experience and other demographic characteristics of each child. OUTCOMES & RESULTS The CWCI group demonstrated some similarities to, and some differences from, their hearing peers. The CWCI demonstrated poorer consonant production accuracy overall and in various phonetic categories and word positions. However, both groups produced initial consonants more accurately than final consonants. Whilst CWCI had poorer production accuracy than CWTH for all phonetic categories (stops, nasals, fricatives, affricates, liquids and glides and consonant clusters), both groups exhibited similar error patterns across categories. For CWCI, the factors most related to consonant production accuracy when considered individually were expressive vocabulary size, followed by duration of CI experience, chronological age, maternal education and gender. The combination of maternal education and vocabulary size resulted in the best model of consonant production accuracy for this group. For the CWTH, chronological age followed by vocabulary size were most related to consonant production accuracy. No combination of factors yielded an improved model for the CWTH. CONCLUSIONS & IMPLICATIONS Whilst group differences in production accuracy between the CWCI and CWTH were found, the pattern of errors was similar for the two groups of children, suggesting that the children are at earlier stages of overall consonant production development. Although duration of CI experience was a significant covariate in a single-variable model of consonant production accuracy for CWCI, the best multivariate model of consonant production accuracy for these children was based on the combination of expressive vocabulary size and maternal education. WHAT THIS PAPER ADDS What is already known on the subject Research has shown that a range of factors is associated with consonant production accuracy by CWCIs, including factors such as the age at implant, duration of implant use, gender, other language skills and maternal education. Despite numerous studies that have examined speech sound production in these children, most have explored a limited number of factors that might explain the variability in scores obtained. Research that examines the potential role of a range of child-related and environmental factors in the same children is needed to determine the predictive role of these factors in speech production outcomes. What this paper adds to the existing knowledge Whilst the consonant production accuracy was lower for the CWCIs than for their typically hearing peers, there were some similarities suggesting that these children are experiencing similar, but delayed, acquisition of consonant production skills to that of their hearing peers. Whilst several factors are predictive of consonant production accuracy in children with implants, vocabulary diversity and maternal education, an indirect measure of socio-economic status, were the best combined predictors of consonant production accuracy. What are the potential or actual clinical implications of this work? Understanding the factors that shape individual differences in CWCI speech production is important for effective clinical decision-making and intervention planning. The present findings point to two potentially important factors related to speech sound production beyond the duration of robust hearing in CWCI, namely, a lexical diversity and maternal education. This suggests that intervention is likely most efficient that addresses both vocabulary development and speech sound development together. The current findings further suggest the importance of parental involvement and commitment to spoken language development and the importance of receiving early and consistent intervention aimed both at skill development and parental efficacy.
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Affiliation(s)
- James Mahshie
- Department of Speech, Language and Hearing Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Cynthia Core
- Department of Speech, Language and Hearing Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Michael D Larsen
- Department of Mathematics and Statistics, Saint Michael's College, Colchester, Vermont, USA
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Sfakianaki A, Nicolaidis K, Kafentzis GP. Temporal, spectral and amplitude characteristics of the Greek fricative /s/ in hearing-impaired and normal-hearing speech. CLINICAL LINGUISTICS & PHONETICS 2024:1-27. [PMID: 38271713 DOI: 10.1080/02699206.2023.2301308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024]
Abstract
Fricatives, and especially sibilants, are very frequently misarticulated by speakers with hearing loss. Misarticulations can result in phonemic contrast weakening or loss, compromising intelligibility. The present study focuses on the examination of acoustic characteristics of the Greek alveolar fricative /s/, an articulatorily demanding sound, produced by young adult speakers with profound hearing impairment and with normal hearing. An array of variables was examined using mixed-effects and random forest models aiming to assess the effectiveness of various measures in differentiating hearing-impaired and normal-hearing /s/ production. Significant differences were found in spectral and amplitude measures, but not in temporal measures. In hearing-impaired speech, spectral slope and RMS amplitude had significantly lower values, indicating a more distributed spectrum, suggestive of decreased flow velocity through the fricative constriction. Also, a trend for concentration of energy at lower frequencies was observed suggesting more posterior fricative articulation than normal. Moreover, measures capturing the variation of frequency and amplitude over time revealed different patterns of sibilance development across time than normal, denoting the production of a less well-formed or less sibilant /s/ by speakers with hearing impairment. The investigation of contextual effects on /s/ in hearing-impaired speech showed increased spectral variance, negative skewness and lower kurtosis in the labial (rounded) context /u/ in relation to the nonlabial contexts /i/ and /a/, indicating a more diffuse, less compact spectrum with concentration at high frequencies. Findings are discussed in relation to previous literature on fricative production by speakers with hearing impairment and normal hearing in Greek and other languages.
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Affiliation(s)
- Anna Sfakianaki
- Department of Philology, University of Ioannina, Ioannina, Greece
- Computer Science Department, University of Crete, Heraklion, Greece
| | - Katerina Nicolaidis
- Department of Theoretical and Applied Linguistics, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Yang J, Xu L. Acoustic characteristics of sibilant fricatives and affricates in Mandarin-speaking children with cochlear implants. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:3501-3512. [PMID: 37378672 DOI: 10.1121/10.0019803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
The purpose of the study was to examine the acoustic features of sibilant fricatives and affricates produced by prelingually deafened Mandarin-speaking children with cochlear implants (CIs) in comparison to their age-matched normal-hearing (NH) peers. The speakers included 21 children with NH aged between 3.25 and 10 years old and 35 children with CIs aged between 3.77 and 15 years old who were assigned into chronological-age-matched and hearing-age-matched subgroups. All speakers were recorded producing Mandarin words containing nine sibilant fricatives and affricates (/s, ɕ, ʂ, ts, tsʰ, tɕ, tɕʰ, tʂ, tʂʰ/) located at the word-initial position. Acoustic analysis was conducted to examine consonant duration, normalized amplitude, rise time, and spectral peak. The results revealed that the CI children, regardless of whether chronological-age-matched or hearing-age-matched, approximated the NH peers in the features of duration, amplitude, and rise time. However, the spectral peaks of the alveolar and alveolopalatal sounds in the CI children were significantly lower than in the NH children. The lower spectral peaks of the alveolar and alveolopalatal sounds resulted in less distinctive place contrast with the retroflex sounds in the CI children than in the NH peers, which might partially account for the lower intelligibility of high-frequency consonants in children with CIs.
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Affiliation(s)
- Jing Yang
- Program of Communication Sciences and Disorders, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53201, USA
| | - Li Xu
- Hearing, Speech & Language Sciences, Ohio University, Athens, Ohio 45701, USA
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Yang J, Wang X, Yu J, Xu L. Intelligibility of Word-Initial Obstruent Consonants in Mandarin-Speaking Prelingually Deafened Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-22. [PMID: 37208163 DOI: 10.1044/2023_jslhr-22-00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE This study assessed the intelligibility of obstruent consonants in prelingually deafened Mandarin-speaking children with cochlear implants (CIs). METHOD Twenty-two Mandarin-speaking children with normal hearing (NH) aged 3.25-10.0 years and 35 Mandarin-speaking children with CIs aged 3.77-15.0 years were recruited to produce a list of Mandarin words composed of 17 word-initial obstruent consonants in different vowel contexts. The children with CIs were assigned to chronological age-matched (CA) and hearing age-matched (HA) subgroups with reference to the NH controls. One hundred naïve NH adult listeners were recruited for a consonant identification task that consisted of a total of 2,663 stimulus tokens through an online research platform. For each child speaker, the consonant productions were judged by seven to 12 different adult listeners. An average percentage of consonants correct was calculated across all listeners for each consonant. RESULTS The CI children in both the CA and HA subgroups showed lower intelligibility in their consonant productions than the NH controls. Among the 17 obstruents, both CI subgroups showed higher intelligibility for stops, but they demonstrated major problems with the sibilant fricatives and affricates and showed a different confusion pattern from the NH controls on these sibilants. Of the three places (alveolar, alveolopalatal, and retroflex) in Mandarin sibilants, both CI subgroups showed the lowest intelligibility and the greatest difficulties with alveolar sounds. For the NH children, there was a significant positive relationship between overall consonant intelligibility and chronological age. For the children with CIs, the best fit regression model revealed significant effects of chronological age and age at implantation, with their quadratic terms included. CONCLUSIONS Mandarin-speaking children with CIs experience major challenges in the three-way place contrasts of sibilant sounds in consonant production. Chronological age and the combined effect of CI-related time variables play important roles in the development of obstruent consonants in the CI children.
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Affiliation(s)
- Jing Yang
- Program of Communication Sciences and Disorders, University of Wisconsin-Milwaukee
| | - Xianhui Wang
- Hearing, Speech and Language Sciences , Ohio University, Athens
| | - Jue Yu
- Center for Speech and Language Processing, School of Foreign Languages, Tongji University, Shanghai, China
| | - Li Xu
- Hearing, Speech and Language Sciences , Ohio University, Athens
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Prelinguistic Consonant Production and the Influence of Mouthing Before and After Cochlear Implantation. Ear Hear 2021; 43:1347-1354. [PMID: 34966159 DOI: 10.1097/aud.0000000000001193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The goal of the study was to investigate prelinguistic consonant production and the influence of vocalizations that co-occurred with object mouthing on consonant production in infants with profound sensorineural hearing loss before and after cochlear implantation to advance knowledge of early speech development in infants with profound hearing loss. DESIGN Participants were 43 infants, 16 infants with profound sensorineural hearing loss and 27 hearing infants. In the mixed longitudinal and cross-sectional design, infants with profound hearing loss and age-matched hearing infants participated before cochlear implantation, at an average age of 9.9 mo, and/or after cochlear implantation, at an average age of 17.8 mo. Mean age at cochlear implantation for infants with profound hearing loss was 12.4 mo; mean duration of cochlear implant use at time of testing was 4.2 mo. RESULTS Before and after cochlear implantation, infants with profound hearing loss produced significantly fewer supraglottal consonants per consonant-vowel vocalization than hearing peers and had smaller overall consonant inventories. Before, but not after cochlear implantation, infants with profound hearing loss produced proportionally more vocalizations, supraglottal consonant-vowel vocalizations, and different supraglottal consonants in vocalizations during mouthing than did hearing infants. CONCLUSIONS The results document consonant production before cochlear implantation in a larger group of infants with profound hearing loss than previously examined. The results also extend evidence of early delays in consonant production to infants who received cochlear implants at 12 mo of age, and show that they likely miss the potential benefits of auditory-motor feedback in vocalization-mouthing combinations that occur before they have access to sound through cochlear implants.
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Faes J, Gillis S. Consonant and vowel production in the spontaneous speech productions of children with auditory brainstem implants. CLINICAL LINGUISTICS & PHONETICS 2021; 35:1132-1160. [PMID: 33427516 DOI: 10.1080/02699206.2020.1869833] [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: 09/09/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Jolien Faes
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
| | - Steven Gillis
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
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Li J, Mayr R, Zhao F. Speech production in Mandarin-speaking children with cochlear implants: a systematic review. Int J Audiol 2021; 61:711-719. [PMID: 34620034 DOI: 10.1080/14992027.2021.1978567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to systematically review and critically appraise the literature describing the phonetic characteristics and accuracy of the consonants, vowels and tones produced by Mandarin-speaking children with cochlear implants (CIs). DESIGN The protocol in this review was designed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. EBSCOhost, PubMed, Scopus, PsycINFO, ProQuest Central databases were searched for relevant articles which met the inclusion criteria. STUDY SAMPLE A total of 18 journal papers were included in this review. RESULTS The results revealed that Mandarin-speaking children with CIs perform consistently more poorly in their production of consonants, in particular on fricatives, have a smaller and less well-defined vowel space, and exhibit greater difficulties in tone realisation, notably T2 and T3, when compared to their normal-hearing (NH) peers. The results from acoustic and accuracy analyses are negatively correlated with CI implantation age, but largely positively correlated with hearing age. CONCLUSIONS Findings of this review highlight the factors that influence consonant, vowel and tone production in Mandarin-speaking children with CIs, thereby providing critical information for clinicians and researchers working with this population.
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Affiliation(s)
- Jiaying Li
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Robert Mayr
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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Abstract
OBJECTIVES This systematic review is designed to (a) describe measures used to quantify vocal development in pediatric cochlear implant (CI) users, (b) synthesize the evidence on prelinguistic vocal development in young children before and after cochlear implantation, and (c) analyze the application of the current evidence for evaluating change in vocal development before and after cochlear implantation for young children. Investigations of prelinguistic vocal development after cochlear implantation are only beginning to uncover the expected course of prelinguistic vocal development in children with CIs and what factors influence that course, which varies substantially across pediatric CI users. A deeper understanding of prelinguistic vocal development will improve professionals' abilities to determine whether a child with a CI is exhibiting sufficient progress soon after implantation and to adjust intervention as needed. DESIGN We systematically searched PubMed, ProQuest, and CINAHL databases for primary reports of children who received a CI before 5 years 0 months of age that included at least one measure of nonword, nonvegetative vocalizations. We also completed supplementary searches. RESULTS Of the 1916 identified records, 59 met inclusion criteria. The included records included 1125 total participants, which came from 36 unique samples. Records included a median of 8 participants and rarely included children with disabilities other than hearing loss. Nearly all of the records met criteria for level 3 for quality of evidence on a scale of 1 (highest) to 4 (lowest). Records utilized a wide variety of vocalization measures but often incorporated features related to canonical babbling. The limited evidence from pediatric CI candidates before implantation suggests that they are likely to exhibit deficits in canonical syllables, a critical vocal development skill, and phonetic inventory size. Following cochlear implantation, multiple studies report similar patterns of growth, but faster rates producing canonical syllables in children with CIs than peers with comparable durations of robust hearing. However, caution is warranted because these demonstrated vocal development skills still occur at older chronological ages for children with CIs than chronological age peers with typical hearing. CONCLUSIONS Despite including a relatively large number of records, the evidence in this review regarding changes in vocal development before and after cochlear implantation in young children remains limited. A deeper understanding of when prelinguistic skills are expected to develop, factors that explain deviation from that course, and the long-term impacts of variations in vocal prelinguistic development is needed. The diverse and dynamic nature of the relatively small population of pediatric CI users as well as relatively new vocal development measures present challenges for documenting and predicting vocal development in pediatric CI users before and after cochlear implantation. Synthesizing results across multiple institutions and completing rigorous studies with theoretically motivated, falsifiable research questions will address a number of challenges for understanding prelinguistic vocal development in children with CIs and its relations with other current and future skills. Clinical implications include the need to measure prelinguistic vocalizations regularly and systematically to inform intervention planning.
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Turgeon C, Trudeau-Fisette P, Lepore F, Lippé S, Ménard L. Impact of visual and auditory deprivation on speech perception and production in adults. CLINICAL LINGUISTICS & PHONETICS 2020; 34:1061-1087. [PMID: 32013589 DOI: 10.1080/02699206.2020.1719207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 01/10/2020] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
Speech perception relies on auditory and visual cues and there are strong links between speech perception and production. We aimed to evaluate the role of auditory and visual modalities on speech perception and production in adults with impaired hearing or sight versus those with normal hearing and sight. We examined speech perception and production of three isolated vowels (/i/, /y/, /u/), which were selected based on their different auditory and visual perceptual saliencies, in 12 deaf adults who used one or two cochlear implants (CIs), 14 congenitally blind adults, and 16 adults with normal sight and hearing. The results showed that the deaf adults who used a CI had worse vowel identification and discrimination perception and they also produced vowels that were less typical or precise than other participants. They had different tongue positions in speech production, which possibly partly explains the poorer quality of their spoken vowels. Blind individuals had larger lip openings and smaller lip protrusions for the rounded vowel and unrounded vowels, compared to the other participants, but they still produced vowels that were similar to those produced by the adults with normal sight and hearing. In summary, the deaf adults, even though they used CIs, had greater difficulty in producing accurate vowel targets than the blind adults, whereas the blind adults were still able to produce accurate vowel targets, even though they used different articulatory strategies.
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Affiliation(s)
| | | | - Franco Lepore
- Department of Psychology, Université de Montréal , Montréal, Canada
| | - Sarah Lippé
- Department of Psychology, Université de Montréal , Montréal, Canada
| | - Lucie Ménard
- Department of Linguistic, UQAM , Montréal, Canada
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Grandon B, Vilain A. Development of fricative production in French-speaking school-aged children using cochlear implants and children with normal hearing. JOURNAL OF COMMUNICATION DISORDERS 2020; 86:105996. [PMID: 32485648 DOI: 10.1016/j.jcomdis.2020.105996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
In the course of productive phonological development, fricatives are among the last speech sounds to emerge and to be mastered by children, probably because of the high degree of articulatory precision they require or because of difficulties with their perception. Children with cochlear implants (CI) face additional difficulties with fricative perception, since high spectral frequency components are shown to be especially difficult to perceive with a cochlear implant. Studying fricative production in children with CIs allows to study how the partial transmission of speech sounds by cochlear implants influences children's speech production, and therefore to explore how perceptual abilities influence the late stages of phonological development. This acoustic study focuses on fricative production at three places of articulation (i.e., /f/, /s/ and /ʃ/), comparing productions by two groups of children (20 children with normal hearing (NH) vs. 13 children with CIs, all aged 5;7 to 10;7 years), and taking into account their consistency in coarticulation and the stability of their production across two different tasks (word-repetition and picture-naming). Statistical analyses were carried out by means of linear mixed-effect models. The results show that while both groups produce /ʃ/ with similar acoustic characteristics, between-group differences are found for /f/ and /s/. Furthermore, effects of consonant-vowel coarticulation are found for children with NH, and are absent for children with CIs. Effects of chronological age are only found for children with CIs (production in older children with CIs nearing that of children with NH). Our study shows that the development of fricative production of five- to 11-year-old children with CIs is affected by the children's hearing abilities and late access to auditory information. These limitations however do not prevent the children from eventually reaching a consistency similar to that of children with NH, as suggested by the fact that their production is still evolving during that age span. The results also show that the acquisition of coarticulation strategies can be impeded by degraded or delayed access to audio.
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Affiliation(s)
- Bénédicte Grandon
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France.
| | - Anne Vilain
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France; Institut Universitaire de France, France
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Grandon B, Martinez MJ, Samson A, Vilain A. Long-term effects of cochlear implantation on the intelligibility of speech in French-speaking children. JOURNAL OF CHILD LANGUAGE 2020; 47:881-892. [PMID: 31852552 DOI: 10.1017/s0305000919000837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
- Bénédicte Grandon
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Marie-José Martinez
- Université Grenoble Alpes, CNRS, Grenoble INP, Laboratoire Jean Kuntzmann, Grenoble, France
| | - Adeline Samson
- Université Grenoble Alpes, CNRS, Grenoble INP, Laboratoire Jean Kuntzmann, Grenoble, France
| | - Anne Vilain
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
- Institut Universitaire de France
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Boonen N, Kloots H, Verhoeven J, Gillis S. Can listeners hear the difference between children with normal hearing and children with a hearing impairment? CLINICAL LINGUISTICS & PHONETICS 2018; 33:316-333. [PMID: 30188741 DOI: 10.1080/02699206.2018.1513564] [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: 10/13/2017] [Revised: 08/12/2018] [Accepted: 08/15/2018] [Indexed: 06/08/2023]
Abstract
Acoustic measurements have shown that the speech of hearing-impaired (HI) children differs from that of normally hearing (NH) children, even after several years of device use. This study focuses on the perception of HI speech in comparison to NH children's speech. The purpose of this study was to investigate whether adult listeners can identify the speech of NH and HI children. Moreover, it is studied whether listeners' experience and the children's length of device use play a role in that assessment. For this study, short utterances of 7 children with a cochlear implant (CI), 7 children with an acoustic hearing aid (HA) and 7 children with NH were presented to 90 listeners who were required to specify the hearing status of each speech sample. The judges had different degrees of familiarity with hearing disorders: there were 30 audiologists, 30 primary schoolteachers and 30 inexperienced listeners. The results show that the speech of children with NH and HI can reliably be identified. However, listeners do not manage to distinguish between children with CI and HA. Children with CI are increasingly identified as NH with increasing length of device use. For children with HA, there is no similar change with longer device use. Also, experienced listeners seem to display a more lenient attitude towards atypical speech, whereas inexperienced listeners are stricter and generally consider more utterances to be produced by children with HI.
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Affiliation(s)
- Nathalie Boonen
- a Computational Linguistics & Psycholinguistics Research Centre , University of Antwerp , Antwerp , Belgium
| | - Hanne Kloots
- a Computational Linguistics & Psycholinguistics Research Centre , University of Antwerp , Antwerp , Belgium
| | - Jo Verhoeven
- a Computational Linguistics & Psycholinguistics Research Centre , University of Antwerp , Antwerp , Belgium
- b School of Health Sciences, Phonetics Laboratory, City , University of London , London , UK
| | - Steven Gillis
- a Computational Linguistics & Psycholinguistics Research Centre , University of Antwerp , Antwerp , Belgium
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Turgeon C, Trudeau-Fisette P, Fitzpatrick E, Ménard L. Vowel intelligibility in children with cochlear implants: An acoustic and articulatory study. Int J Pediatr Otorhinolaryngol 2017; 101:87-96. [PMID: 28964317 DOI: 10.1016/j.ijporl.2017.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 10/19/2022]
Abstract
In child cochlear implant (CI) users, early implantation generally results in highly intelligible speech. However, for some children developing a high level of speech intelligibility may be problematic. Studies of speech production in CI users have principally been based on perceptual judgment and acoustic measures. Articulatory measures, such as those collected using ultrasound provide the opportunity to more precisely evaluate what makes child CI users more intelligible. This study investigates speech production and intelligibility in children with CI using acoustic and articulatory measures. Ten children with unilateral or bilateral CIs and 13 children with normal hearing (NH) participated in the study. Participants repeated five English vowels (/a/, /e/, /i/, /o/, /u/) with and without auditory feedback. Ultrasound was used to capture tongue positions and acoustic signals were recorded simultaneously. The results showed that, despite quite similar acoustic results, the two speaker groups made different use of the tongue to implement vowel contrasts. Indeed, the tongue position was lower in the feedback OFF condition than the feedback ON condition for all participants, but the magnitude of this difference was larger for CI users than for their NH peers. This difference led to diminished intelligibility scores for CI users. This study shows the limitation of acoustic measurements alone and demonstrates how the use of articulatory measurements can explain intelligibility patterns. Moreover, our results show that when cochlear implantation occurs early in life and auditory feedback is available, CI users' intelligibility is comparable to that of their NH peers.
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Affiliation(s)
- Christine Turgeon
- Department of Linguistics, Université du Québec à Montréal, Montreal, QC, Canada; Center for Research on Brain, Language, and Music, Montreal, QC, Canada.
| | - Pamela Trudeau-Fisette
- Department of Linguistics, Université du Québec à Montréal, Montreal, QC, Canada; Center for Research on Brain, Language, and Music, Montreal, QC, Canada
| | - Elizabeth Fitzpatrick
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada; Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lucie Ménard
- Department of Linguistics, Université du Québec à Montréal, Montreal, QC, Canada; Center for Research on Brain, Language, and Music, Montreal, QC, Canada
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Iyer SN, Jung J, Ertmer DJ. Consonant Acquisition in Young Cochlear Implant Recipients and Their Typically Developing Peers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:413-427. [PMID: 28474085 PMCID: PMC5544364 DOI: 10.1044/2016_ajslp-16-0073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/04/2016] [Accepted: 11/04/2016] [Indexed: 05/30/2023]
Abstract
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.
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Yang J, Vadlamudi J, Yin Z, Lee CY, Xu L. Production of word-initial fricatives of Mandarin Chinese in prelingually deafened children with cochlear implants. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:153-164. [PMID: 27063694 DOI: 10.3109/17549507.2016.1143972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE This study examined the production of fricatives by prelingually deafened Mandarin-speaking children with cochlear implants (CIs). METHOD Fourteen cochlear implant (CI) children (2.9-8.3 years old) and 60 age-matched normal-hearing (NH) children were recorded producing a list of 13 Mandarin words with four fricatives, /f, s, ɕ, ʂ/, occurring at the syllable-initial position evoked with a picture-naming task. Two phonetically-trained native Mandarin speakers transcribed the fricative productions. Acoustic analysis was conducted to examine acoustic measures including duration, normalised amplitude, spectral peak location and four spectral moments. RESULT The CI children showed much lower accuracy rates and more diverse error patterns on all four fricatives than their NH peers. Among these four fricatives, both CI and NH children showed the highest rate of mispronunciation of /s/. The acoustic results showed that the speech of the CI children differed from the NH children in spectral peak location, normalised amplitude, spectral mean and spectral skewness. In addition, the fricatives produced by the CI children showed less distinctive patterns of acoustic measures relative to the NH children. CONCLUSION In general, these results indicate that the CI children have not established distinct categories for the Mandarin fricatives in terms of the place of articulation.
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Affiliation(s)
- Jing Yang
- a Communication Sciences and Disorders, Speech Language and Hearing Center, University of Central Arkansas , Conway , AR , USA
| | - Jessica Vadlamudi
- b Communication Sciences and Disorders, Ohio University , Athens , OH , USA , and
| | - Zhigang Yin
- c Institute of Linguistics, Chinese Academy of Social Sciences , Beijing , PR China
| | - Chao-Yang Lee
- b Communication Sciences and Disorders, Ohio University , Athens , OH , USA , and
| | - Li Xu
- b Communication Sciences and Disorders, Ohio University , Athens , OH , USA , and
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Faes J, Gillis S. Word initial fricative production in children with cochlear implants and their normally hearing peers matched on lexicon size. CLINICAL LINGUISTICS & PHONETICS 2016; 30:959-982. [PMID: 27599559 DOI: 10.1080/02699206.2016.1213882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
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.
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Affiliation(s)
- Jolien Faes
- a Computational Linguistics & Psycholinguistics (CLiPS) Research Center , University of Antwerp , Antwerp , Belgium
| | - Steven Gillis
- a Computational Linguistics & Psycholinguistics (CLiPS) Research Center , University of Antwerp , Antwerp , Belgium
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Salas-Provance MB, Spencer L, Nicholas JG, Tobey E. Emergence of speech sounds between 7 and 24 months of cochlear implant use. Cochlear Implants Int 2013; 15:222-9. [PMID: 24074439 DOI: 10.1179/1754762813y.0000000046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES To investigate the process of speech development in five 42-month-old children with profound deafness who received cochlear implants (CIs) between 19 and 36 months of age and five normal hearing (NH) age mates. METHODS Conversational samples were collected and transcribed. Sounds produced correctly within meaningful words (target sounds) and recognizable sounds produced in spontaneous productions (target-less sounds) were analyzed for all 10 children. RESULTS Revealed that there was overlap in the total number of vowels and consonants produced by the two groups. The differences between the two groups were more evident in the target condition, whereas the two groups were more similar in the target-less condition. DISCUSSION The similarities documented in the target-less repertoire of CI and NH children underscore the importance of examining the emerging sound system to predict the end-point sound system in children with CIs. Using target and target-less speech sound comparisons offers a supplementary view of the emergent process of speech sound development and is a valid method of analysis. Results suggest that early implantation may help some children with profound deafness develop speech sounds in a manner similar to NH age mates.
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Fulcher A, Purcell AA, Baker E, Munro N. Listen up: children with early identified hearing loss achieve age-appropriate speech/language outcomes by 3 years-of-age. Int J Pediatr Otorhinolaryngol 2012; 76:1785-94. [PMID: 23084781 DOI: 10.1016/j.ijporl.2012.09.001] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/23/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Age-appropriate speech/language outcomes for children with early identified hearing loss are a possibility but not a certainty. Identification of children most likely to achieve optimal outcomes is complicated by the heterogeneity of the children involved in outcome research, who present with a range of malleable (e.g. age of identification and cochlear implantation, type of intervention, communication mode) and non-malleable (e.g. degree of hearing loss) factors. This study considered whether a homogenous cohort of early identified children (≤ 12 months), with all severities of hearing loss and no other concomitant diagnoses could not only significantly outperform a similarly homogenous cohort of children who were later identified (>12 months to <5 years), but also achieve and maintain age-appropriate speech/language outcomes by 3, 4 and 5 years of age. METHODS A mixed prospective/retrospective comparative study of a homogenous cohort of 45 early identified (≤ 12 months) and 49 late identified (> 12 months to < 5 years) children with hearing loss was conducted. The children all attended the same oral auditory-verbal early intervention programme. Speech/language assessments standardized on typically developing hearing children were conducted at 3, 4 and 5 years of age. RESULTS The early identified children significantly outperformed the late identified at all ages and for all severities of HL. By 3 years of age, 93% of all early identified participants scored within normal limits (WNL) for speech; 90% were WNL for understanding vocabulary; and 95% were WNL for receptive and expressive language. Progress was maintained and improved so that by 5 years of age, 96% were WNL for speech, with 100% WNL for language. CONCLUSIONS This study found that most children with all severities of hearing loss and no other concomitant diagnosed condition, who were early diagnosed; received amplification by 3 months; enrolled into AV intervention by 6 months and received a cochlear implant by 18 months if required, were able to "keep up with" rather than "catch up to" their typically hearing peers by 3 years of age on measures of speech and language, including children with profound hearing loss. By 5 years, all children achieved typical language development and 96% typical speech.
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Ertmer DJ, Kloiber DT, Jung J, Kirleis KC, Bradford D. Consonant production accuracy in young cochlear implant recipients: developmental sound classes and word position effects. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2012; 21:342-53. [PMID: 22846882 DOI: 10.1044/1058-0360(2012/11-0118)] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To compare young cochlear implant (CI) recipients' consonant production accuracy with that of age- and gender-matched peers who were typically developing (TD). In addition to examining initial consonants, the authors compiled new data regarding the accuracy of final consonants and the order of consonant acquisition. METHODS Eleven young CI recipients with 24 months of CI experience and 11 age- and gender-matched TD peers produced target words in short sentences. Consonant production accuracy was examined for total scores, initial and final word positions, and three developmental sound classes: Early, Middle, and Late. RESULTS Initial consonants were produced with relatively greater accuracy than were final consonants by the TD and CI groups. Whereas initial consonants appeared to be acquired in a typical order, descriptive data suggest that this might not be the case for final consonants. CONCLUSIONS Although still delayed compared to age-matched peers, young CI recipients showed substantial progress in consonant acquisition. Their accuracy levels after 2 years of CI experience support the notion that implantation at a young age has added value for phonological development.
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Tseng SC, Kuei K, Tsou PC. Acoustic characteristics of vowels and plosives/affricates of Mandarin-speaking hearing-impaired children. CLINICAL LINGUISTICS & PHONETICS 2011; 25:784-803. [PMID: 21453033 DOI: 10.3109/02699206.2011.565906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This article presents the results of an acoustic analysis of vowels and plosives/affricates produced by 45 Mandarin-speaking children with hearing impairment. Vowel production is represented and categorized into three groups by vowel space size calculated with normalized F1 and F2 values of corner vowels. The correlation between speech intelligibility and language abilities assessed by the level of word comprehension and the complexity of sentence structure is statistically significant. Vowel space grouping is correlated with speech intelligibility and spike percentage of plosives/affricates production. The generalized linear model analysis also shows that the level of word comprehension and the degree of hearing loss are the two most significant factors in predicting speech intelligibility. The statistical results suggest that the interplay of acoustic characteristic and speech ability is complex.
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Ertmer DJ, Goffman L. Speech production accuracy and variability in young cochlear implant recipients: comparisons with typically developing age-peers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2011; 54:177-89. [PMID: 20689030 PMCID: PMC3385414 DOI: 10.1044/1092-4388(2010/09-0165)] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE The speech production accuracy and variability scores of 6 young cochlear implant (CI) recipients with 2 years of device experience were compared with those of typically developing (TD) age-peers. METHOD Words from the First Words Speech Test (FWST; Ertmer, 1999) were imitated 3 times to assess the accuracy and variability of initial consonants, vowels, and words. The initial consonants in the 4 sets of the FWST followed a typical order of development. RESULTS The TD group produced targets with high accuracy and low variability. Their scores across FWST sets reflected the expected order of development. The CI group produced most targets less accurately and with more variability than the TD children. Relatively high accuracy for the consonants of Sets 1 and 2 indicated that these phonemes were acquired early and in a typical developmental order. A trend toward greater accuracy for Set 4 as compared with Set 3 suggested that later-emerging consonants were not acquired in the expected order. Variability was greatest for later-emerging initial consonants and whole words. DISCUSSION Although considerable speech production proficiency was evident, age-level performance was not attained after 2 years of CI experience. Factors that might influence the order of consonant acquisition are discussed.
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Affiliation(s)
- David J Ertmer
- Department of Speech, Language, and Hearing Sciences, Purdue University, 500 Oval Drive, West Lafayette, IN 47907, USA.
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A comparison of the consonant production between Dutch children using cochlear implants and children using hearing aids. Int J Pediatr Otorhinolaryngol 2010; 74:416-21. [PMID: 20185184 DOI: 10.1016/j.ijporl.2010.01.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 01/22/2010] [Accepted: 01/26/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The main purpose of the present study was to compare the consonant error patterns of Dutch prelingually deaf CI children with prelingually hearing-impaired hearing aid (HA) children. The authors hypothesized that subjects using conventional hearing aids would have poorer consonant production skills. Additionally, the impact of the age at implantation (CI) and the degree of hearing loss (HA) was determined. METHODOLOGY This is a comparative study of 29 prelingually deaf CI children (m.a. 9;0 y) and 32 prelingually hearing-impaired HA children (m.a. 9;11 y) who received their first hearing aid before the age of 2 years. Nineteen CI children were implanted before the age of 5 years. Nine HA children had thresholds above 90dB (range: 91-105dB), 15 between 70 and 90dB (range: 72-90dB) and 8 below 70dB (range: 58-68dB). Speech samples of all the children were elicited by means of a picture naming test and were video-recorded for further phonetic and phonological analysis. RESULTS Considerably more phonetic and phonologic errors were observed in the HA children with thresholds above 70dB (range: 72-105dB). No notable differences could be found between deaf CI children and HA children with thresholds below 70dB. Even children implanted after the age of 5 years showed significantly fewer phonetic and phonological errors than HA children. CONCLUSION The consonant production of implanted children is more adequate than the consonant production of HA children with a hearing loss of 70dB or more. In addition, the results also indicate that even after the age of 5 years, implantation can still have an advantageous effect on a child's consonant production.
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