Phonological Priming in Children with Hearing Loss: Effect of Speech Mode, Fidelity, and Lexical Status

Phonological Priming as a Lens for Phonological Organization in Children With Cochlear Implants

OBJECTIVES

To evaluate the subconscious knowledge of between-word phonological similarities in children with cochlear implants as compared with children with typical hearing.

DESIGN

Participants included 30 children with cochlear implants between the ages of five and seven who used primarily spoken English to communicate, 30 children matched for chronological age, and 30 children matched for vocabulary size. Participants completed an animacy judgment task in either a (a) neutral condition, (b) a phonological prime condition where the consonant and vowel onset of the pictured word was presented prior to the visual target's appearance, (c) an inhibition prime condition where a consonant and vowel onset not matching the pictured word was presented prior to the target's appearance. Reaction times were recorded.

RESULTS

Children with cochlear implants reacted differently and more slowly than children with typical hearing in both groups to the primes: children with typical hearing experienced a phonological facilitation effect in the phonological prime condition, whereas children with cochlear implants did not. Children with cochlear implants also had reaction times that, overall, were slower than children matched for chronological age but similar to children matched for vocabulary size.

CONCLUSIONS

The different experience of children with cochlear implants with phonological facilitation and inhibition effects may indicate children with cochlear implants have phonological organization strategies that are different from those of children with typical hearing.

Detection and Attention for Auditory, Visual, and Audiovisual Speech in Children with Hearing Loss

OBJECTIVES

Efficient multisensory speech detection is critical for children who must quickly detect/encode a rapid stream of speech to participate in conversations and have access to the audiovisual cues that underpin speech and language development, yet multisensory speech detection remains understudied in children with hearing loss (CHL). This research assessed detection, along with vigilant/goal-directed attention, for multisensory versus unisensory speech in CHL versus children with normal hearing (CNH).

DESIGN

Participants were 60 CHL who used hearing aids and communicated successfully aurally/orally and 60 age-matched CNH. Simple response times determined how quickly children could detect a preidentified easy-to-hear stimulus (70 dB SPL, utterance "buh" presented in auditory only [A], visual only [V], or audiovisual [AV] modes). The V mode formed two facial conditions: static versus dynamic face. Faster detection for multisensory (AV) than unisensory (A or V) input indicates multisensory facilitation. We assessed mean responses and faster versus slower responses (defined by first versus third quartiles of response-time distributions), which were respectively conceptualized as: faster responses (first quartile) reflect efficient detection with efficient vigilant/goal-directed attention and slower responses (third quartile) reflect less efficient detection associated with attentional lapses. Finally, we studied associations between these results and personal characteristics of CHL.

RESULTS

Unisensory A versus V modes: Both groups showed better detection and attention for A than V input. The A input more readily captured children's attention and minimized attentional lapses, which supports A-bound processing even by CHL who were processing low fidelity A input. CNH and CHL did not differ in ability to detect A input at conversational speech level. Multisensory AV versus A modes: Both groups showed better detection and attention for AV than A input. The advantage for AV input was facial effect (both static and dynamic faces), a pattern suggesting that communication is a social interaction that is more than just words. Attention did not differ between groups; detection was faster in CHL than CNH for AV input, but not for A input. Associations between personal characteristics/degree of hearing loss of CHL and results: CHL with greatest deficits in detection of V input had poorest word recognition skills and CHL with greatest reduction of attentional lapses from AV input had poorest vocabulary skills. Both outcomes are consistent with the idea that CHL who are processing low fidelity A input depend disproportionately on V and AV input to learn to identify words and associate them with concepts. As CHL aged, attention to V input improved. Degree of HL did not influence results.

CONCLUSIONS

Understanding speech-a daily challenge for CHL-is a complex task that demands efficient detection of and attention to AV speech cues. Our results support the clinical importance of multisensory approaches to understand and advance spoken communication by CHL.

Developmental Shifts in Detection and Attention for Auditory, Visual, and Audiovisual Speech

PURPOSE

Successful speech processing depends on our ability to detect and integrate multisensory cues, yet there is minimal research on multisensory speech detection and integration by children. To address this need, we studied the development of speech detection for auditory (A), visual (V), and audiovisual (AV) input.

METHOD

Participants were 115 typically developing children clustered into age groups between 4 and 14 years. Speech detection (quantified by response times [RTs]) was determined for 1 stimulus, /buh/, presented in A, V, and AV modes (articulating vs. static facial conditions). Performance was analyzed not only in terms of traditional mean RTs but also in terms of the faster versus slower RTs (defined by the 1st vs. 3rd quartiles of RT distributions). These time regions were conceptualized respectively as reflecting optimal detection with efficient focused attention versus less optimal detection with inefficient focused attention due to attentional lapses.

RESULTS

Mean RTs indicated better detection (a) of multisensory AV speech than A speech only in 4- to 5-year-olds and (b) of A and AV inputs than V input in all age groups. The faster RTs revealed that AV input did not improve detection in any group. The slower RTs indicated that (a) the processing of silent V input was significantly faster for the articulating than static face and (b) AV speech or facial input significantly minimized attentional lapses in all groups except 6- to 7-year-olds (a peaked U-shaped curve). Apparently, the AV benefit observed for mean performance in 4- to 5-year-olds arose from effects of attention.

CONCLUSIONS

The faster RTs indicated that AV input did not enhance detection in any group, but the slower RTs indicated that AV speech and dynamic V speech (mouthing) significantly minimized attentional lapses and thus did influence performance. Overall, A and AV inputs were detected consistently faster than V input; this result endorsed stimulus-bound auditory processing by these children.

Visual speech alters the discrimination and identification of non-intact auditory speech in children with hearing loss

OBJECTIVES

Understanding spoken language is an audiovisual event that depends critically on the ability to discriminate and identify phonemes yet we have little evidence about the role of early auditory experience and visual speech on the development of these fundamental perceptual skills. Objectives of this research were to determine 1) how visual speech influences phoneme discrimination and identification; 2) whether visual speech influences these two processes in a like manner, such that discrimination predicts identification; and 3) how the degree of hearing loss affects this relationship. Such evidence is crucial for developing effective intervention strategies to mitigate the effects of hearing loss on language development.

METHODS

Participants were 58 children with early-onset sensorineural hearing loss (CHL, 53% girls, M = 9;4 yrs) and 58 children with normal hearing (CNH, 53% girls, M = 9;4 yrs). Test items were consonant-vowel (CV) syllables and nonwords with intact visual speech coupled to non-intact auditory speech (excised onsets) as, for example, an intact consonant/rhyme in the visual track (Baa or Baz) coupled to non-intact onset/rhyme in the auditory track (/-B/aa or/-B/az). The items started with an easy-to-speechread/B/or difficult-to-speechread/G/onset and were presented in the auditory (static face) vs. audiovisual (dynamic face) modes. We assessed discrimination for intact vs. non-intact different pairs (e.g., Baa:/-B/aa). We predicted that visual speech would cause the non-intact onset to be perceived as intact and would therefore generate more same-as opposed to different-responses in the audiovisual than auditory mode. We assessed identification by repetition of nonwords with non-intact onsets (e.g.,/-B/az). We predicted that visual speech would cause the non-intact onset to be perceived as intact and would therefore generate more Baz-as opposed to az- responses in the audiovisual than auditory mode.

RESULTS

Performance in the audiovisual mode showed more same responses for the intact vs. non-intact different pairs (e.g., Baa:/-B/aa) and more intact onset responses for nonword repetition (Baz for/-B/az). Thus visual speech altered both discrimination and identification in the CHL-to a large extent for the/B/onsets but only minimally for the/G/onsets. The CHL identified the stimuli similarly to the CNH but did not discriminate the stimuli similarly. A bias-free measure of the children's discrimination skills (i.e., d' analysis) revealed that the CHL had greater difficulty discriminating intact from non-intact speech in both modes. As the degree of HL worsened, the ability to discriminate the intact vs. non-intact onsets in the auditory mode worsened. Discrimination ability in CHL significantly predicted their identification of the onsets-even after variation due to the other variables was controlled.

CONCLUSIONS

These results clearly established that visual speech can fill in non-intact auditory speech, and this effect, in turn, made the non-intact onsets more difficult to discriminate from intact speech and more likely to be perceived as intact. Such results 1) demonstrate the value of visual speech at multiple levels of linguistic processing and 2) support intervention programs that view visual speech as a powerful asset for developing spoken language in CHL.