Simultaneous communication supports learning in noise by cochlear implant users

Listening Difficulties of Children With Cochlear Implants in Mainstream Secondary Education

OBJECTIVES

Previous research has shown that children with cochlear implants (CIs) encounter more communication difficulties than their normal-hearing (NH) peers in kindergarten and elementary schools. Yet, little is known about the potential listening difficulties that children with CIs may experience during secondary education. The aim of this study was to investigate the listening difficulties of children with a CI in mainstream secondary education and to compare these results to the difficulties of their NH peers and the difficulties observed by their teachers.

DESIGN

The Dutch version of the Listening Inventory for Education Revised (LIFE-R) was administered to 19 children (mean age = 13 years 9 months; SD = 9 months) who received a CI early in life, to their NH classmates (n = 239), and to their teachers (n = 18). All participants were enrolled in mainstream secondary education in Flanders (first to fourth grades). The Listening Inventory for Secondary Education consists of 15 typical listening situations as experienced by students (LIFEstudent) during class activities (LIFEclass) and during social activities at school (LIFEsocial). The teachers completed a separate version of the Listening Inventory for Secondary Education (LIFEteacher) and Screening Instrument for Targeting Educational Risk.

RESULTS

Participants with CIs reported significantly more listening difficulties than their NH peers. A regression model estimated that 75% of the participants with CIs were at risk of experiencing listening difficulties. The chances of experiencing listening difficulties were significantly higher in participants with CIs for 7 out of 15 listening situations. The 3 listening situations that had the highest chance of resulting in listening difficulties were (1) listening during group work, (2) listening to multimedia, and (3) listening in large-sized classrooms. Results of the teacher's questionnaires (LIFEteacher and Screening Instrument for Targeting Educational Risk) did not show a similar significant difference in listening difficulties between participants with a CI and their NH peers. According to teachers, NH participants even obtained significantly lower scores for staying on task and for participation in class than participants with a CI.

CONCLUSIONS

Although children with a CI seemingly fit in well in mainstream schools, they still experience significantly more listening difficulties than their NH peers. Low signal to noise ratios (SNRs), distortions of the speech signal (multimedia, reverberation), distance, lack of visual support, and directivity effects of the microphones were identified as difficulties for children with a CI in the classroom. As teachers may not always notice these listening difficulties, a list of practical recommendations was provided in this study, to raise awareness among teachers and to minimize the difficulties.

The Role of Multiple Articulatory Channels of Sign-Supported Speech Revealed by Visual Processing

Purpose The use of sign-supported speech (SSS) in the education of deaf students has been recently discussed in relation to its usefulness with deaf children using cochlear implants. To clarify the benefits of SSS for comprehension, 2 eye-tracking experiments aimed to detect the extent to which signs are actively processed in this mode of communication. Method Participants were 36 deaf adolescents, including cochlear implant users and native deaf signers. Experiment 1 attempted to shift observers' foveal attention to the linguistic source in SSS from which most information is extracted, lip movements or signs, by magnifying the face area, thus modifying lip movements perceptual accessibility (magnified condition), and by constraining the visual field to either the face or the sign through a moving window paradigm (gaze contingent condition). Experiment 2 aimed to explore the reliance on signs in SSS by occasionally producing a mismatch between sign and speech. Participants were required to concentrate upon the orally transmitted message. Results In Experiment 1, analyses revealed a greater number of fixations toward the signs and a reduction in accuracy in the gaze contingent condition across all participants. Fixations toward signs were also increased in the magnified condition. In Experiment 2, results indicated less accuracy in the mismatching condition across all participants. Participants looked more at the sign when it was inconsistent with speech. Conclusions All participants, even those with residual hearing, rely on signs when attending SSS, either peripherally or through overt attention, depending on the perceptual conditions. Supplemental Material https://doi.org/10.23641/asha.8121191.

Multimodal and Spectral Degradation Effects on Speech and Emotion Recognition in Adult Listeners

For cochlear implant (CI) users, degraded spectral input hampers the understanding of prosodic vocal emotion, especially in difficult listening conditions. Using a vocoder simulation of CI hearing, we examined the extent to which informative multimodal cues in a talker’s spoken expressions improve normal hearing (NH) adults’ speech and emotion perception under different levels of spectral degradation (two, three, four, and eight spectral bands). Participants repeated the words verbatim and identified emotions (among four alternative options: happy, sad, angry, and neutral) in meaningful sentences that are semantically congruent with the expression of the intended emotion. Sentences were presented in their natural speech form and in speech sampled through a noise-band vocoder in sound (auditory-only) and video (auditory–visual) recordings of a female talker. Visual information had a more pronounced benefit in enhancing speech recognition in the lower spectral band conditions. Spectral degradation, however, did not interfere with emotion recognition performance when dynamic visual cues in a talker’s expression are provided as participants scored at ceiling levels across all spectral band conditions. Our use of familiar sentences that contained congruent semantic and prosodic information have high ecological validity, which likely optimized listener performance under simulated CI hearing and may better predict CI users’ outcomes in everyday listening contexts.

Communication skills of deaf and hard-of-hearing college students: Objective measures and self-assessment

Objectively measured speech reception, speech production and expressive and receptive sign skills were compared with the self-assessment ratings of those skills in 96 college students with hearing loss. Participants with no aidable hearing used cochlear implants (CIs) or nothing. Participants with aidable hearing used either hearing aids (HAs) or nothing. Results revealed that individuals using CIs had speech reception and production skills that were as good as or better than students with more hearing who used HAs. Students using CIs or HAs had better speech reception and production skills than those without sensory aids. There was no difference in measured receptive sign skills across groups, despite differences in age of sign acquisition. Students typically provided accurate self-assessments of their communication skills with two notable exceptions: CI users overestimated their speech skills and nonusers overestimated their receptive sign skills. This study extends our knowledge regarding speech reception, production, sign skills and the ability to self-assess those skills in college students with hearing loss. Students who do not use sensory aids may be at academic risk with regard to receiving input via speech or sign.