Reading and reading-related skills in children using cochlear implants: prospects for the influence of cued speech

Nasal/Oral Vowel Perception in French-Speaking Children With Cochlear Implants and Children With Typical Hearing

PURPOSE

The present study investigates the perception of vowel nasality in French-speaking children with cochlear implants (CIs; CI group) and children with typical hearing (TH; TH group) aged 4-12 years. By investigating the vocalic nasality feature in French, the study aims to document more broadly the effects of the acoustic limitations of CI in processing segments characterized by acoustic cues that require optimal spectral resolution. The impact of various factors related to children's characteristics, such as chronological/auditory age, age of implantation, and exposure to cued speech, has been studied on performance, and the acoustic characteristics of the stimuli in perceptual tasks have also been investigated.

METHOD

Identification and discrimination tasks involving French nasal and oral vowels were administered to two groups of children: 13 children with CIs (CI group) and 25 children with TH (TH group) divided into three age groups (4-6 years, 7-9 years, and 10-12 years). French nasal vowels were paired with their oral phonological counterpart (phonological pairing) as well as to the closest oral vowel in terms of phonetic proximity (phonetic pairing). Post hoc acoustic analyses of the stimuli were linked to the performance in perception.

RESULTS

The results indicate an effect of the auditory status on the performance in the two tasks, with the CI group performing at a lower level than the TH group. However, the scores of the children in the CI group are well above chance level, exceeding 80%. The most common errors in identification were substitutions between nasal vowels and phonetically close oral vowels as well as confusions between the phoneme /u/ and other oral vowels. Phonetic pairs showed lower discrimination performance in the CI group with great variability in the results. Age effects were observed only in TH children for nasal vowel identification, whereas in children with CIs, a positive impact of cued speech practice and early implantation was found. Differential links between performance and acoustic characteristics were found within our groups, suggesting that in children with CIs, selective use of certain acoustic features, presumed to be better transmitted by the implant, leads to better perceptual performance.

CONCLUSIONS

The study's results reveal specific challenges in children with CIs when processing segments characterized by fine spectral resolution cues. However, the CI children in our study appear to effectively compensate for these difficulties by utilizing various acoustic cues assumed to be well transmitted by the implant, such as cues related to the temporal resolution of stimuli.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25328704.

Exposure to Canadian French Cued Speech Improves Consonant Articulation in Children With Cochlear Implants: Acoustic and Articulatory Data

PURPOSE

One of the strategies that can be used to support speech communication in deaf children is cued speech, a visual code in which manual gestures are used as additional phonological information to supplement the acoustic and labial speech information. Cued speech has been shown to improve speech perception and phonological skills. This exploratory study aims to assess whether and how cued speech reading proficiency may also have a beneficial effect on the acoustic and articulatory correlates of consonant production in children.

METHOD

Eight children with cochlear implants (from 5 to 11 years of age) and with different receptive proficiency in Canadian French Cued Speech (three children with low receptive proficiency vs. five children with high receptive proficiency) are compared to 10 children with typical hearing (from 4 to 11 years of age) on their production of stop and fricative consonants. Articulation was assessed with ultrasound measurements.

RESULTS

The preliminary results reveal that cued speech proficiency seems to sustain the development of speech production in children with cochlear implants and to improve their articulatory gestures, particularly for the place contrast in stops as well as fricatives.

CONCLUSION

This work highlights the importance of studying objective data and comparing acoustic and articulatory measurements to better characterize speech production in children.

Speech rehabilitation in children with cochlear implants using a multisensory (French Cued Speech) or a hearing-focused (Auditory Verbal Therapy) approach

Introduction

Early exposure to a rich linguistic environment is essential as soon as the diagnosis of deafness is made. Cochlear implantation (CI) allows children to have access to speech perception in their early years. However, it provides only partial acoustic information, which can lead to difficulties in perceiving some phonetic contrasts. This study investigates the contribution of two spoken speech and language rehabilitation approaches to speech perception in children with CI using a lexicality judgment task from the EULALIES battery. Auditory Verbal Therapy (AVT) is an early intervention program that relies on auditory learning to enhance hearing skills in deaf children with CI. French Cued Speech, also called Cued French (CF), is a multisensory communication tool that disambiguates lip reading by adding a manual gesture.

Methods

In this study, 124 children aged from 60 to 140 months were included: 90 children with typical hearing skills (TH), 9 deaf children with CI who had participated in an AVT program (AVT), 6 deaf children with CI with high Cued French reading skills (CF+), and 19 deaf children with CI with low Cued French reading skills (CF-). Speech perception was assessed using sensitivity (d') using both the hit and false alarm rates, as defined in signal-detection theory.

Results

The results show that children with cochlear implants from the CF- and CF+ groups have significantly lower performance compared to children with typical hearing (TH) (p < 0.001 and p = 0.033, respectively). Additionally, children in the AVT group also tended to have lower scores compared to TH children (p = 0.07). However, exposition to AVT and CF seems to improve speech perception. The scores of the children in the AVT and CF+ groups are closer to typical scores than those of children in the CF- group, as evidenced by a distance measure.

Discussion

Overall, the findings of this study provide evidence for the effectiveness of these two speech and language rehabilitation approaches, and highlight the importance of using a specific approach in addition to a cochlear implant to improve speech perception in children with cochlear implants.

Arabic phoneme-grapheme correspondence by non-native, deaf children with cochlear implants and normal hearing children

OBJECTIVE

This study aimed to compare the error patterns of Arabic phoneme-grapheme correspondence by a group of Malay children with cochlear implants (CIs) and normal hearing (NH) and the effects of the visual graphical features of Arabic graphemes (no-dot, single-dot, and multiple-dots) on the phoneme-grapheme correspondence.

METHODS

Participants were matched for hearing age (Mean, M = 7 ± 1.03 years) and duration of exposure to Arabic sounds (M = 2.7 ± 1.2 years). All 28 Arabic phonemes were presented through a loudspeaker and participants pointed to the graphemes associated with the presented phonemes.

RESULTS

A total of 336 and 616 tokens were collected for six children with CI and 11 NH children for each task, i.e., phonemes repetition and phoneme-grapheme correspondence. Both groups found it easier to repeat phonemes than the phoneme-grapheme correspondence. The children with CIs showed more confusion ([ظ, ز, ذ, ض, خ, ب, ه, س, ع, & ث] >10% correct scores) in phoneme-grapheme correspondence than the NH children ([ظ:14%] and [ث: 27%]). There was a significant interaction (p = 0.001) among the three visual graphical features and hearing status (CI and NH).

CONCLUSION

Our results infer that non-native Malay children with CIs and NH use different strategies to process the Arabic graphemes' visual features for phoneme-grapheme correspondence.

Contemporary Speech and Oral Language Care for Deaf and Hard-of-Hearing Children Using Hearing Devices

Contemporary speech and language interventions are not limited to disabilities but embrace the pragmatics of communication behaviors from the perspective of functional social participation. Accordingly, current speech and language therapies for deaf and hard-of-hearing children include a broad spectrum of approaches and techniques. This paper explores contemporary approaches and techniques for speech and oral language interventions for deaf and hard-of-hearing children using hearing devices, evidence of efficacy and how they are implemented in diverse clinical practices.

Effect of age at cochlear implantation and at exposure to Cued Speech on literacy skills in deaf children

The aim of this study was to investigate how age at cochlear implantation (CI) and age at exposure to Cued Speech (CS, Manual system that resolves the ambiguity inherent lipreading) could impact literacy skills in deaf children. Ninety deaf children fitted with CI (early vs late) and exposed to CS (early vs late) from primary schools (from Grade 2 to Grade 5) took part in this study. Five literacy skills were assessed: phonological skills through phoneme deletion, reading (decoding and sentence comprehension), word spelling and vocabulary. The results showed that both age at CI and age at first exposure to CS had some influence on literacy skills but there was no interaction between these factors. This implies that the positive effects of age at CI, especially on all literacy skills in the younger children, were not strengthened by age at exposure to CS.

Cued Speech and the Development of Reading in English: Examining the Evidence

Even though Cued Speech has been a communication option for 50 years, it has not been widely adopted among users of English or in the country where it was created (i.e., the United States). This situation has led scholars and practitioners in the field of deafness to question whether the original intent of creating this system has been realized and if there is an adequate research base to support the use of Cued Speech in developing English reading abilities. The purpose of this review was to examine the available research to determine whether there is evidence available to address the persistent questions about Cued Speech and English. Information from four areas of literature was reviewed and summarized, with converging findings from the available data sources revealing support for the role Cued Speech plays in developing reading abilities in English. Limitations of the current literature base and directions for future research are explored.

Infants Discriminate Voicing and Place of Articulation With Reduced Spectral and Temporal Modulation Cues

PURPOSE

This study assessed the role of spectro-temporal modulation cues in the discrimination of 2 phonetic contrasts (voicing and place) for young infants.

METHOD

A visual-habituation procedure was used to assess the ability of French-learning 6-month-old infants with normal hearing to discriminate voiced versus unvoiced (/aba/-/apa/) and labial versus dental (/aba/-/ada/) stop consonants. The stimuli were processed by tone-excited vocoders to degrade frequency-modulation cues while preserving: (a) amplitude-modulation (AM) cues within 32 analysis frequency bands, (b) slow AM cues only (<16 Hz) within 32 bands, and (c) AM cues within 8 bands.

RESULTS

Infants exhibited discrimination responses for both phonetic contrasts in each processing condition. However, when fast AM cues were degraded, infants required a longer exposure to vocoded stimuli to reach the habituation criterion.

CONCLUSIONS

Altogether, these results indicate that the processing of modulation cues conveying phonetic information on voicing and place is "functional" at 6 months. The data also suggest that the perceptual weight of fast AM speech cues may change during development.

Phonetic processing during the acquisition of new words in 3-to-6-year-old French-speaking deaf children with cochlear implants

The present study explores phonetic processing in deaf children with cochlear implants (CIs) when they have to learn phonetically similar words. Forty-six 34-to-78-month-old French-speaking deaf children with CIs were tested on 16 different trials. In each trial, they were first trained with two word-object pairings, and then a third object was presented and labeled with one of the familiar words. Children were asked to match one of the previously labeled objects with the third (same-labeled) object. Each pair of words contrasted on either the initial consonant or the first vowel by one or several phonetic features. The results show that deaf children with CIs are able to establish a new referential link between a word and an object. However, their performance is lower than that previously observed in normal-hearing children (NH). In such a situation, they process contrasts involving several phonetic features correctly, but show difficulties with minimal contrasts. The ability to recruit fine phonetic sensitivity during word learning appears to be influenced mainly by duration of implant use, with an overall increase of performance during the 3 years after implantation. There was no chronological age effect, nor age at implantation effect on the quality of processing. Difficulty with minimal contrasts and the absence of any age at implantation effects in this age range are discussed in light of recent studies on lexical development.

LEARNING OUTCOMES

After reading this article, the reader will be able to recognize the perceptual skills of children with cochlear implants and distinguish those perceptual features that are difficult for the children to perceive.