Phonological abilities of hearing-impaired Cantonese-speaking children with cochlear implants or hearing AIDS

Validity and Reliability of the Turkish Version of the Emotional Communication in Hearing Questionnaire

PURPOSE

The Emotional Communication in Hearing Questionnaire (EMO-CHeQ) is designed to evaluate awareness of vocal emotion information and perception of emotion. This study sought to translate the EMO-CHeQ into Turkish in accordance with international standards and to ascertain its validity and reliability statistically by administering it to native Turkish-speaking subjects.

METHOD

This empirical study involved collecting data from participants using a scale. A total of 460 individuals, comprising 158 women and 302 men (Mage = 33.43 ± 13.14 years), participated. The data encompassed 295 subjects with normal hearing, 101 hearing aid users, and 64 cochlear implant users. Exploratory factor analysis, followed by confirmatory factor analysis, was employed to ensure construct validity. Internal consistency was assessed with Cronbach's alpha reliability analysis, and content validity was applied to examine how effectively the Turkish version of the scale fulfilled its intended purpose.

RESULTS

The total Cronbach's alpha internal consistency coefficient of the scale was .949, and the explained variance was 74.385%. The Turkish version of the EMO-CHeQ demonstrated high construct validity, internal consistency, and explanatory efficacy. The scale revealed significant differences (p < .05) in emotional communication among the normal-hearing group, hearing aid users, and cochlear implant users.

CONCLUSIONS

The Turkish adaptation of the EMO-CHeQ is a credible and robust tool for evaluating how individuals perceive emotion in speech. Emotion perception was found to be suboptimal among hearing aid users compared to cochlear implant users, although it was most proficient in those with normal hearing.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24520624.

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.

Cultural Identity of Young Deaf Adults with Cochlear Implants in Comparison to Deaf without Cochlear Implants and Hard-of-Hearing Young Adults

This study examined the relationships between cultural identity, severity of hearing loss (HL), and the use of a cochlear implant (CI). One hundred and forty-one adolescents and young adults divided into three groups (deaf with CI, deaf without CI, and hard-of-hearing (HH)) and 134 parents participated. Adolescents and young adults completed questionnaires on cultural identity (hearing, Deaf, marginal, bicultural-hearing, and bicultural-deaf) and communication proficiencies (hearing, spoken language, and sign language). Parents completed a speech quality questionnaire. Deaf participants without CI and those with CI differed in all identities except marginal identity. CI users and HH participants had similar identities except for a stronger bicultural-deaf identity among CI users. Three clusters of participants evolved: participants with a dominant bicultural-deaf identity, participants with a dominant bicultural-hearing identity and participants without a formed cultural identity. Adolescents and young adults who were proficient in one of the modes of communication developed well-established bicultural identities. Adolescents and young adults who were not proficient in one of the modes of communication did not develop a distinguished cultural identity. These results suggest that communication proficiencies are crucial for developing defined identities.

Mandarin Lexical Tone Acquisition in Cochlear Implant Users With Prelingual Deafness: A Review

PURPOSE

The purpose of this review article is to synthesize evidence from the fields of developmental linguistics and cochlear implant technology relevant to the production and perception of Mandarin lexical tone in cochlear implant users with prelingual deafness. The aim of this review was to identify potential factors that determine outcomes for tonal-language speaking cochlear implant users and possible directions for further research.

METHOD

A computerized database search of MEDLINE, CINAHL, Academic Search Premier, Web of Science, and Google Scholar was undertaken in June and July 2014. Search terms used were lexical tone AND tonal language, speech development AND/OR speech production AND/OR speech perception AND cochlear implants, and pitch perception AND cochlear implants, anywhere in the title or abstract.

CONCLUSION

Despite the demonstrated limitations of pitch perception in cochlear implant users, there is some evidence that typical production and perception of lexical tone is possible by cochlear implant users with prelingual deafness. Further studies are required to determine the factors that contribute to better outcomes to inform rehabilitation processes for cochlear implant users in tonal-language environments.

Cantonese tone production performance of mainstream school children with hearing impairment

This study investigated the Cantonese tone production ability of children with hearing impairment studying in mainstream schools. The participants were 87 Cantonese-speaking children with mild-to-profound degrees of hearing loss aged 5.92-13.58 in Hong Kong. Most of the children were fitted with hearing aids (n = 65); 17 of them had profound hearing impairment, one who had severe hearing loss had cochlear implantation, and four who had mild hearing loss were without any hearing device. The Hong Kong Cantonese Articulation Test was administered, and the tones produced were rated by two of the authors and a speech-language pathologist. Group effects of tones, hearing loss level, and also an interaction of the two were found to be significant. The children with profound hearing impairment performed significantly worse than most of the other children. Tone 1 was produced most accurately, whereas tone 6 productions were the poorest. No relationship was found between the number of years of mainstreaming and tone production ability. Tone production error pattern revealed that confusion patterns in tone perception coincided with those in production. Tones having a similar fundamental frequency (F0) at the onset also posed difficulty in tone production for children with hearing impairment.

Mandarin lexical tones identification among children with cochlear implants or hearing aids

OBJECTIVES

Mandarin Chinese is a lexical tone language that has four tones, with a change in tone denoting a change in lexical meaning. There are few studies regarding lexical tone identification abilities in deafened children using either cochlear implants (CIs) or hearing aids (HAs). Furthermore, no study has compared the lexical tone identification abilities of deafened children with their hearing devices turned on and off. The present study aimed to investigate the lexical tone identification abilities of deafened children with CIs or HAs.

METHODS

Forty prelingually deafened children (20 with CIs and 20 with HAs) participated in the study. In the HA group, 20 children were binaurally aided. In the CI group, all of the children were unilaterally implanted. All of the subjects completed a computerized lexical tone pairs test with their hearing devices turned on and off. The correct answers of all items were recorded as the total score and the correct answers of the tone pairs were recorded as subtotal scores.

RESULTS

No significant differences in the tone pair identification scores were found between the CI group and HA group either with the devices turned on or off (t=1.62, p=0.11; t=1.863, p=0.07, respectively). The scores in the aided condition were higher than in the unaided condition regardless of the device used (t=22.09, p<0.001, in the HA group; t=20.20, p<0.001, in the CI group). Significantly higher scores were found in the tone pairs that contained tone 4. Age at fitting of the devices was correlated with tone identification abilities in both the CI and HA groups. Other demographic factors were not correlated with tone identification ability.

CONCLUSIONS

The hearing device, whether a hearing aid or cochlear implant, is beneficial for tone identification. The lexical tone identification abilities were similar regardless of whether the subjects wore a HA or CI. Lexical tone pairs with different durations and dissimilar tone contour patterns are more easily identified. Receiving devices at earlier age tends to produce better lexical tone identification abilities in prelingually deafened children.

Mandarin consonant contrast recognition among children with cochlear implants or hearing aids and normal-hearing children

HYPOTHESIS

The purpose of the present study was to investigate the consonant recognition of Mandarin-speaking children with cochlear implants (CIs) and hearing aids (HAs) and to determine if they reach a level of consonant recognition similar to that of normal-hearing (NH) children.

BACKGROUND

Little information is available in the literature regarding the consonant perception abilities of prelingually deafened young children with either CIs or HAs. No studies have compared Mandarin-Chinese consonant contrast recognition in CI and HA children.

METHODS

Forty-one prelingually deafened children with CIs, 26 prelingually deafened children with HAs, and 30 NH children participated in this study. The 3 groups were matched for chronologic age (3-5 yr). The hearing-impaired groups were matched for age at fitting of the devices, duration of device use, and aided hearing threshold. All subjects completed a computerized Mandarin consonant phonetic contrast perception test.

RESULTS

CI and HA children scored, on average, approximately 8 percentage points below the mean NH group performance on the consonant contrast recognition. Approximately 40% of the CI and HA children had not reached a performance level of the NH group. No significant differences in the consonant recognition scores were found between the CI and HA groups. Age of implantation was correlated with consonant contrast recognition in the CI group.

CONCLUSION

When age at fitting of the devices, duration of device use, and aided thresholds are matched at the group level, consonant recognition is similar between the CI and HA children after 2 years of device use. Early implantation tends to yield better consonant contrast recognition in the young children with CIs. However, a large amount of variance in performance was not accounted for by the demographic variables studied.

Age sensitivity in the acquisition of lexical tone production: evidence from children with profound congenital hearing impairment after cochlear implantation

OBJECTIVES

This study investigated the effects of implant experience and age at implantation on the Cantonese tone production of children with cochlear implants. The study also examined whether there was a particular age at which children were more responsive to acquiring tones.

METHODS

The study included 45 children who had received unilateral cochlear implants at a mean age of 65.56 months. The subjects were grouped according to their age at cochlear implantation and were assessed annually for 5 years thereafter. A picture-naming task was used to measure their tone production performance.

RESULTS

A simple effect of age at implantation was significant at all testing intervals except at the preoperative data point. Children who were younger than 4 years of age when they received their implants scored significantly higher than did the 2 older groups at various testing intervals. A significant simple effect of implant experience was also found. Progress was most striking in children who received their implants before the age of 4 years.

CONCLUSIONS

For the most effective acquisition of Cantonese lexical tones, children should undergo early cochlear implantation. For children who receive implants before the age of 4 years, benefits are noted in tone production ability in terms of a faster rate of improvement within a shorter period of time.

Transcribing the speech of children with cochlear implants: clinical application of narrow phonetic transcriptions

PURPOSE

The phonological systems of children with cochlear implants may include segment inventories that contain both target and nontarget speech sounds. These children may not consistently follow phonological rules of the target language. These issues present a challenge for the clinical speech-language pathologist who uses phonetic transcriptions to evaluate speech production skills and to develop a plan of care. The purposes of this tutorial are to (a) identify issues associated with phonetic transcriptions of the speech of children with cochlear implants and (b) discuss implications for assessment.

METHOD

Narrow transcription data from an ongoing, longitudinal research study were catalogued and reviewed. Study participants had at least 5 years of cochlear implant experience and used spoken American English as a primary means of communication. In this tutorial, selected phonetic symbols and phonetic phenomena are reviewed.

CONCLUSIONS

A set of principles for phonetic transcriptions is proposed. Narrow phonetic transcriptions that include all segment possibilities in the International Phonetic Alphabet and extensions for disordered speech are needed to capture the subtleties of the speech of children with cochlear implants. Narrow transcriptions also may play a key role in planning treatment.

Articulation skills in Turkish speaking children with cochlear implant

OBJECTIVE

The benefits of using cochlear implant (CI) on speech perception and production have been documented. The aim of this study is to investigate the effect of age of cochlear implantation performed and length of auditory experience with CI on the development of articulation skills in prelingual children with CI.

METHODS

For this purpose, 14 children with CI were administered through the standardized articulation test named AAT (Ankara Articulation Test). In order to evaluate the development of articulation skills, AAT was applied to each child with CI at the first and the fourth years of CI. The test group was selected among those congenitally hearing impaired children who had used hearing aids bilaterally before the age of one and a half, and received intervention after fitting hearing aids. The test group was divided into two subgroups: Group 1 consisted of the children implanted at and below the age of 3 and Group 2 consisted of the children implanted after the age of 3. Evaluations of articulation skills between groups and within groups were performed in the first and fourth years of implantation. In the study, nonparametric statistics have been used to compare the test scores. Mann-Whitney U-test and Wilcoxon test have been used in the comparisons made between groups and within groups, respectively.

RESULTS

While there has not been observed any statistically significant difference between the first year articulation skills of children with CI at and below the age of three and children with CI above the age of 3, for the fourth year this difference has been found to be statistically significant.

CONCLUSIONS

The results demonstrate the importance of the early application of CI and length of auditory experience with CI in the development of articulation skills.

Communication disorders in speakers of tone languages: etiological bases and clinical considerations

Lexical tones are a phonetic contrast necessary for conveying meaning in a majority of the world's languages. Various hearing, speech, and language disorders affect the ability to perceive or produce lexical tones, thereby seriously impairing individuals' communicative abilities. The number of tone language speakers is increasing, even in otherwise English-speaking nations, yet insufficient emphasis has been placed on clinical assessment and rehabilitation of lexical tone disorders. The similarities and dissimilarities between lexical tones and other speech sounds make a richer scientific understanding of their physiological bases paramount to more effective remediation of speech and language disorders in general. Here we discuss the cognitive and biological bases of lexical tones, emphasizing the neural structures and networks that support their acquisition, perception, and cognitive representation. We present emerging research on lexical tone learning in the context of the clinical disorders of hearing, speech, and language that this body of research will help to address.