Effects of communication mode on skills of long-term cochlear implant users.
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Child↗
Biomedical subjects
N Tye-Murray
Publications and source records attributed to N Tye-Murray.
The production of English inflectional morphology, speech production and listening performance in children with cochlear implants.
OBJECTIVE: To compare how children who use either cochlear implants (CIs) or hearing aids (HAs) express English inflectional morphemes during conversation, i.e., with voice, with sign, or with both. A secondary objective was to investigate the relationship between morpheme use in pediatric CI users and their speech perception skills, length of experience with the device, and accuracy of phoneme production. DESIGN: Group 1 consisted of 25 children who used CIs, and Group 2 consisted of 13 children who used HAs. All children were prelingually deafened and all used simultaneous communication. A 12 minute spontaneous conversation was elicited, transcribed and coded. Between group comparisons were performed to evaluate differences in modality and number of morphemes used. Additionally, use of morpheme endings was related to length of CI experience, accuracy of phoneme production, and closed-set speech recognition performance. RESULTS: Children who had CI experience produced significantly more English inflected morphemes than children in the HA group. CI participants also expressed the inflected endings by using voice-only mode 91% of the time, whereas HA participants used voice-only mode 1% of the time. In the CI group, a strong relationship was found between number of morpheme endings used and speech recognition scores, length of CI experience and accuracy of phoneme production. The results of this study indicate that input from the CI facilitates children's ability to perceive and comprehend bound morphemes.
Adolescent↗
Differences in children's sound production when speaking with a cochlear implant turned on and turned off.
Twenty children who have worn a Cochlear Corporation cochlear implant for an average of 33.6 months participated in a device-on/off experiment. They spoke 14 monosyllabic words three times each after having not worn their cochlear implant speech processors for several hours. They then spoke the same speech sample again with their cochlear implants turned on. The utterances were phonetically transcribed by speech-language pathologists. On average, no difference between speaking conditions on indices of vowel height, vowel place, initial consonant place, initial consonant voicing, or final consonant voicing was found. Comparisons based on a narrow transcription of the speech samples revealed no difference between the two speaking conditions. Children who were more intelligible were no more likely to show a degradation in their speech production in the device-off condition than children who were less intelligible. In the device-on condition, children sometimes nasalized their vowels and inappropriately aspirated their consonants. Their tendency to nasalize vowels and aspirate initial consonants might reflect an attempt to increase proprioceptive feedback, which would provide them with a greater awareness of their speaking behavior.
Child↗
Initial evaluation of an interactive test of sentence gist recognition.
The laser videodisc-based Sentence Gist Recognition (SGR) test consists of sets of topically related sentences that are cued by short film clips. Clients respond to test items by selecting picture illustrations and may interact with the talker by using repair strategies when they do not recognize a test item. The two experiments, involving 40 and 35 adult subjects, respectively, indicated that the SGR may better predict subjective measures of speechreading and listening performance than more traditional audiologic sentence and nonsense syllable tests. Data from cochlear implant users indicated that the SGR accounted for a greater percentage of the variance for selected items of the Communication Profile for the Hearing-Impaired and the Speechreading Questionnaire for Cochlear-Implant Users than two other audiologic tests. As in previous work, subjects were most apt to ask the talker to repeat an utterance that they did not recognize than to ask the talker to restructure it. It is suggested that the SGR may reflect the interactive nature of conversation and provide a simulated real-world listening and/or speechreading task. The principles underlaying this test are consistent with the development of other computer technologies and concepts, such as compact discinteractive and virtual reality.
Adult↗
Acquisition of speech by children who have prolonged cochlear implant experience.
The four purposes of this investigation were to assess whether children acquire intelligible speech following prolonged cochlear-implant experience and examine their speech error patterns, to examine how age at implantation influences speech acquisition, to assess how speech production and speech perception skills relate, and to determine whether cochlear implant recipients who formerly used simultaneous communication (speech and manually coded English) begin to use speech without sign to communicate. Twenty-eight prelinguistically deafened children who use a Nucleus cochlear implant were assigned to one of three age groups, according to age at implantation: 2-5 yrs (N = 12), 5-8 yrs (N = 9), and 8-15 yrs (N = 7). All subjects had worm a cochlear implant for at least 24 mos, and an average of 36 mos. All subjects used simultaneous communication at the time of implantation. Subjects performed both imitative and structured spontaneous sampling speech tasks. The results permit the following conclusions: (a) children who have used a cochlear implant for at least 2 yrs acquire some intelligible speech; (b) children who receive a cochlear implant before the age of 5 yrs appear to show greater benefit in their speech production skills than children who are older, at least after a minimum of 2 yrs of use; (c) children who recognize more speech while wearing their cochlear implants are likely to speak more intelligibly; and, (d) signing does not disappear from a child's communication mode following implantation.
Adolescent↗
Effects of talker familiarity on communication breakdown in conversations with adult cochlear-implant users.
This investigation had three objectives: a) to determine the types of repair strategies that cochlear-implant users implement to rectify communication breakdowns during ongoing conversation when talking to either familiar or unfamiliar communication partners, b) to determine how communication partners respond to particular types of repair strategies, and c) to describe the use of conversational behaviors that might circumvent communication difficulties. In Experiment 1, cochlear-implant subjects were videotaped while talking to familiar and then unfamiliar communication partners. In Experiment 2, a second group of cochlear-implant subjects were videotaped while speaking with an unfamiliar partner for 6.5 minutes. Analysis of the videotapes revealed that the cochlear-implant subjects in the two experiments most commonly asked "what?," "huh," or "pardon?" after not recognizing a spoken message (e.g., following a communication breakdown), regardless of whether the communication partner was familiar or unfamiliar. Communication partners' more common response to this repair strategy was to repeat the original message. When cochlear-implant subjects repeated back the segment of a message that they understood, communication partners most often confirmed or corrected them. When they requested information, communication partners usually provided it. The cochlear-implant subjects were more likely to use controlling conversational behaviors when interacting with unfamiliar than familiar communication partners. We conclude that repair strategy-response adjacency pairs may emerge during spontaneous conversations. Use of both specific and nonspecific repair strategies may indicate cochlear-implant users' adherence to a cooperative principle.
Adult↗
Relationships between speech production and speech perception skills in young cochlear-implant users.
The purpose of this investigation was to examine the relationships between young cochlear-implant users' abilities to produce the speech features of nasality, voicing, duration, frication, and place of articulation and their abilities to utilize the features in three different perceptual conditions: audition-only, vision-only, and audition-plus-vision. Subjects were 23 prelingually deafened children who had at least 2 years of experience with a Cochlear Corporation Nucleus cochlear implant, and an average of 34 months. They completed both the production and perception version of the Children's Audio--visual Feature Test, which is comprised of ten consonant--vowel syllables. An information transmission analysis performed on the confusion matrices revealed that children produced the place of articulation fairly accurately and voicing, duration, and frication less accurately. Acoustic analysis indicated that voiced sounds were not distinguished from unvoiced sounds on the basis of voice onset time or syllabic duration. Subjects who were more likely to produce the place feature correctly were likely to have worn their cochlear implants for a greater length of time. Pearson correlations revealed that subjects who were most likely to hear the place of articulation, nasality, and voicing features in an audition-only condition were also most likely to speak these features correctly. Comparisons of test results collected longitudinally also revealed improvements in production of the features, probably as a result of cochlear-implant experience and/or maturation.
Adolescent↗
Results of multichannel cochlear implants in congenital and acquired prelingual deafness in children: five-year follow-up.
Postlingually deafened children, using multichannel cochlear implants, have achieved substantial improvement in their speech perception abilities and, in many instances, the results are better than in postlingually deafened adults. It has been suggested that children with prelingually acquired and congenital deafness would not receive similar benefits, since they have not developed an auditory memory. The purpose of this study is to analyze the speech perception and production performance over time of prelingually deafened children who have been using a multichannel cochlear implant for 1-5 years. Preliminary results comparing the effects of age at implantation and etiology of deafness on performance are also examined.
Adolescent↗
Vowel and diphthong production by young users of cochlear implants and the relationship between the phonetic level evaluation and spontaneous speech.
This investigation assessed how the vowel and diphthong production of young users of cochlear implants varied over time and how performance on the Phonetic Level Evaluation (PLE, Ling, 1976) corresponded with vowel and diphthong production during spontaneous speech. Eight children with prelingual deafness were tested with the PLE on five occasions: before receiving a Cochlear Corporation Nucleus cochlear implant and at the following points after receiving a cochlear implant: 6 months, 12 months, 18 months, and 24 or 36 months. An audiovideo recording of spontaneous speech was obtained at each test session. Performance on the PLE was scored with the scoring system designed by Kirk and Hill-Brown (1985). Performance during spontaneous speaking was scored by referencing a transcription of the spoken message to a transcription of the signed message. The correlations between the PLE and the spontaneous speech measures were weak, suggesting that performance on the PLE has low predictive value for vowel and diphthong production during spontaneous speaking. The results from the spontaneous speech samples collected over time suggest that two changes occurred: (a) vowel and diphthong production became more diverse and (b) production became more accurate. It is suggested that increased access to formant information enables subjects to enlarge their system of phonological performance and refine their motoric ability to establish vowel and diphthong targets.
Child↗
Reported use of communication strategies by SHHH members: client, talker, and situational variables.
Two hundred and twelve members of the Self Help for Hard of Hearing People (SHHH) organization completed a survey that evaluated their use of communication strategies. Reported use of strategies was correlated with attitudinal variables and social-interaction indices. On average, subjects agreed most strongly with questionnaire items stating they would ask a talker to repeat a misperceived utterance. They agreed less strongly with items stating they would ask the talker to restructure or elaborate an utterance. Subjects agreed strongly that they would use the communication strategies with familiar talkers, and less strongly that they would use them with unfamiliar talkers. Subjects who appeared less likely to say nothing after misperceiving an utterance were more likely to disagree that they were frustrated with their speechreading skills, and they appeared less likely to avoid social interactions. Subjects who indicated a greater likelihood of using anticipatory strategies, such as reviewing potential vocabulary before an appointment, were on average more likely to avoid social interactions. They also agreed more strongly that poor speechreaders appear less intelligent.
Adult↗
Performance over time with a nucleus or Ineraid cochlear implant.
This investigation determined whether the audiological performance of cochlear implant users varied with experience. Thirteen Nucleus and 14 Ineraid subjects were evaluated at 1, 9, and 18 mo after cochlear implant connection. Ten Nucleus and five Ineraid subjects were tested at 30 mo. On average, the ability of the subjects to recognize words and phonemes in an audition-only condition improved during the first 9 mo, as did their ability to recognize spondees in noise. The phoneme scores continued to improve during the next 9 mo. Environmental sound recognition improved gradually; significant improvement from the 1 mo scores was not noted until 18 mo. About half of the subjects who demonstrated poor word recognition at 1 mo showed significantly improved percent word correct scores by 18 mo. The Nucleus and Ineraid subjects did not differ in their patterns of change over time. An information transmission analysis performed on the subjects' consonant confusion matrices showed relatively little change for the nasality and place features during the first 18 mo, and relatively large change for the voice, duration, and frication features. Most improvement in the feature scores occurred during the first 9 mo.
Cochlear Implants↗
Young cochlear implant users' response to delayed auditory feedback.
This investigation determined whether the signal provided by the Cochlear Corporation Nucleus cochlear implant can convey enough speech information to induce a response to delayed auditory feedback (DAF), and whether prelingually deafened children who received a cochlear implant relatively late in their speech development are susceptible. Ten children with the Nucleus cochlear implant spoke simple phrases, first without and then with DAF. Three prelingually deafened subjects and the only two postlingually deafened subjects demonstrated longer phrase durations when speaking with DAF than without it. Two of the prelingually deafened subjects who demonstrated a response received their cochlear implants at the age of 5 years.
Attention↗
The use of static and dynamic vowel cues by multichannel cochlear implant users.
Multichannel cochlear implant users vary greatly in their word-recognition abilities. This study examined whether their word recognition was related to the use of either highly dynamic or relatively steady-state vowel cues contained in /bVb/ and /wVb/ syllables. Nine conditions were created containing different combinations of formant transition, steady-state, and duration cues. Because processor strategies differ, the ability to perceive static and dynamic information may depend on the type of cochlear implant used. Ten Nucleus and ten Ineraid subjects participated, along with 12 normal-hearing control subjects. Vowel identification did not differ between implanted groups, but both were significantly poorer at identifying vowels than the normal-hearing group. Vowel identification was best when at least two kinds of cues were available. Using only one type of cue, performance was better with excised vowels containing steady-state formants than in "vowelless" syllables, where the center vocalic portion was deleted and transitions were joined. In the latter syllable type, Nucleus subjects identified vowels significantly better when /b/ was the initial consonant; the other two groups were not affected by specific consonantal context. Cochlear implant subjects' word-recognition was positively correlated with the use of dynamic vowel cues, but not with steady-state cues.
Adult↗
Preparing for communication interactions: the value of anticipatory strategies for adults with hearing impairment.
Some people with hearing impairment may use anticipatory strategies to prepare for an upcoming communication interaction, such as a doctor's appointment. They may consider vocabulary and statements that might occur, and they may practice speechreading a partner saying the items. Experiment 1 evaluated the effectiveness of two types of anticipatory strategies: workbook activities and situation-specific lipreading practice. Two groups of normal-hearing subjects were asked to prepare for a communication interaction in a bank setting where they would be required to recognize speech using only the visual signal. Each group was assigned to one type of anticipatory strategy. A third group served as a control group. Experiment 2 evaluated whether multifaceted anticipatory practice improved cochlear implant users' ability to recognize statements and words audiovisually that might occur in a doctor's office, bank, movie theater, and gas station. One group of implanted subjects received 4 days of training, 1 day for each setting, and a second group served as a control group. In both experiments, subjects who used anticipatory strategies did not improve their performance on situation-specific sentence tests more than the control subjects.
Cochlear Implants↗
The establishment of open articulatory postures by deaf and hearing talkers.
Previous researchers have proposed that prelingually deafened talkers do not displace the tongue body to establish vowel steady-state postures and displace the jaw excessively. The purpose of this investigation was to evaluate the opening gesture lingual displacement patterns of three deaf and two hearing adult talkers. Cinefluorography and x-ray microbeam data indicated that the deaf subjects displaced their tongue bodies during the opening gestures. However, their glossal movement trajectories were qualitatively dissimilar to those of the hearing subjects. Whereas the hearing subjects moved the tongue differently for different vowel contexts, the deaf subjects had similar trajectories for all contexts. The common trajectories suggest that some deaf talkers contract their tongue muscles such that the tongue body moves similarly for all vowels. The deaf subjects also appeared to have a less flexible tongue body during speech production than the hearing subjects. Means for quantifying and comparing the lingual behaviors of deaf and hearing talkers are considered.
Adult↗
Scaling and transcription measures of intelligibility for populations with disordered speech.
Although Samar and Metz (1988) have addressed significant issues regarding the assessment of the intelligibility of hearing-impaired talkers, we cannot agree with their interpretation of their findings. Because the transcription and rating-scale measures were performed on different types of speech samples, the two sets of scores cannot be compared. Moreover, transcription and scaling measures may provide fundamentally different estimates of speech performance. Investigators should select which measure to use after considering the appropriate construct validity and the purpose of the measurement.
Hearing Disorders↗
Repair strategy usage by hearing-impaired adults and changes following communication therapy.
This investigation documented how hearing-impaired individuals use communication repair strategies in structured settings and determined whether these strategies could be changed by communication therapy. Eight hearing-impaired adults with mild to severe sensorineural hearing losses practiced using five repair strategies when they did not correctly speechread a videotaped sentence. The strategies included asking the talker to (a) repeat the sentence, (b) simplify it, (c) rephrase it, (d) say an important key word, and (e) speak two sentences. Therapy consisted of computerized interactive activities and role-playing with a clinician. Seven hearing-impaired adults served as control subjects and received no therapy. Before and during therapy, subjects usually wanted a misperceived sentence to be repeated. On average, subjects changed their use of repair strategies following therapy. They utilized the repeat strategy less often and other strategies more often.
Adult↗
Aural rehabilitation.
Aural rehabilitation involves a complete evaluation of the communication deficits and needs of the hearing-impaired patient as well as the provision of counselling and therapy. This article describes listening-assistive devices, speech production, and audiovisual training. Issues related to educational placement and tinnitus also are reviewed.
Cochlear Implants↗