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PubMed1985

Auditory implants and tactile aids for the profoundly deaf.

This paper reviews data on speech perception via implanted electrodes and via tactile aids. The two approaches are compared in terms of amount and types of aid provided to communication. Related issues discussed are the performance levels with multi-versus single-channel implants, promontory electrical stimulators versus implants, use of minimal residual hearing, implants for children, and the possible design of complementary systems combining auditory implant and tactile information. The diversity of the test methods and subjects used in implant versus tactile research precludes definitive comparisons of speech perception performance. However, it appears from the available data that, at present and for the foreseeable future, neither approach can provide more than a modest aid to lipreading. Speech reception test results from multichannel-implanted subjects are better, on the average, than for single-channel subjects. However, the best single-channel results are comparable to the best multichannel in tests using simple sentences. There is great variation among subjects with the same implant. Tactile aid performance by highly practiced subjects seems comparable to that of the better implant subjects.

Adolescent↗
PubMedDate not supplied

Diagnostic factors bearing on the use of cued speech with hearing-impaired children.

Cued Speech is a system which utilizes eight hand configurations and four locations of either hand for supplementing the visible manifestations of normal speech in such a way as to effectively eliminate the ambiguities of lipreading. Its effects upon language development and oral communication skills, supported by research data, suggest that it is a useful technique for inclusion in the array of tools available for use with young, hearing-impaired children. Use of diagnostic teaching, in addition to audiometric and other evaluations, is recommended for evaluation of conditions which suggest or discourage the choice of Cued Speech as a communication modality. Children are exposed to diagnostic teaching sequences in a progression which begins with auditory-only, then auditory/oral, then auditory/oral/cued speech, and finally (in some cases), manually coded English. In each stage, data should be collected on significant reactions and behavior for use in recommending a choice of communication mode.

Child↗
PubMed1987

Relationships among selected measures of single-channel cochlear implant performance.

Relationships among a number of pre- and postimplant variables measured in 20 adults implanted with a single-channel cochlear implant were examined through a variety of univariate and multivariate statistical techniques. A large number of variables were analyzed to yield information on the relationships between pre- and postimplant performance, and among a variety of postimplant measures. Variables included: age; etiology and nature of deafness; type of implant worn; pre- and postimplant warble tone and speech detection thresholds; postimplant performance on the Monosyllable-Trochee-Spondee (MTS) and Environmental Sounds tests; postimplant electrical thresholds, uncomfortable loudness levels, and dynamic range; I.Q. scores; and postimplant discourse tracking performance with and without the implant. The difference score on the discourse tracking task, representing the auditory advantage over performance with lipreading alone, related substantively to a combination of variables including type of unit worn (Sigma versus Alpha), nature of deafness (progressive versus sudden), and etiology (meningitis versus nonmeningitis). Additionally, MTS and Environmental Sounds test scores were found to relate to one another and to etiology and nature of deafness.

Adolescent↗
PubMed2005

Development of audiovisual comprehension skills in prelingually deaf children with cochlear implants.

OBJECTIVE: The present study investigated the development of audiovisual comprehension skills in prelingually deaf children who received cochlear implants. DESIGN: We analyzed results obtained with the Common Phrases (Robbins et al., 1995) test of sentence comprehension from 80 prelingually deaf children with cochlear implants who were enrolled in a longitudinal study, from pre-implantation to 5 years after implantation. RESULTS: The results revealed that prelingually deaf children with cochlear implants performed better under audiovisual (AV) presentation compared with auditory-alone (A-alone) or visual-alone (V-alone) conditions. AV sentence comprehension skills were found to be strongly correlated with several clinical outcome measures of speech perception, speech intelligibility, and language. Finally, pre-implantation V-alone performance on the Common Phrases test was strongly correlated with 3-year postimplantation performance on clinical outcome measures of speech perception, speech intelligibility, and language skills. CONCLUSIONS: The results suggest that lipreading skills and AV speech perception reflect a common source of variance associated with the development of phonological processing skills that is shared among a wide range of speech and language outcome measures.

Auditory Perception↗
PubMed1978

Vibratory perception by deaf children.

Audiologists and educators of the deaf have become interested in vibratory perception of speech because: (1) research suggests that profoundly deaf children feel rather than hear amplified speech through their ears, and educators must help them to use this acoustic (vibratory) speech information; and (2) vibratory transducers already are used in many classrooms for deaf children to provide supplementary speech input, and educators must learn how to present vibratory stimuli most effectively for perceptual learning. Vibration provides mainly the gross time-intensity information in speech. This paper describes the variety of speech cues that are available through the vibratory sense, for example, number of syllables; syllable rate, stress, and onset/decay; pause; and roughness. An optical analog (tracings from a storage oscilloscope) is used to show the type of information available to deaf persons through vibration. Deaf children are able to perform not only closed-set recognition tasks but also can learn to identify general characteristics of vibratory speech patterns. Although vibratory perception alone is limited for communication, vibratory input can serve as a supplement to lipreading and also as a speech-training aid for profoundly deaf persons.

Bone Conduction↗
PubMed2005

Improved speech perception in adult congenitally deafened cochlear implant recipients.

OBJECTIVE: To determine whether congenitally deafened adults achieve improved speech perception when auditory and visual speech information is available after cochlear implantation. STUDY DESIGN: Repeated-measures single subject analysis of speech perception in visual-alone, auditory-alone, and audiovisual conditions. SETTING: Neurotologic private practice and research institute. SUBJECTS: Eight subjects with profound congenital bilateral hearing loss who underwent cochlear implantation as adults (aged 18-55 years) between 1995 and 2002 and had at least 1 year of experience with the implant. MAIN OUTCOME MEASURES: Auditory, visual, and audiovisual speech perception. RESULTS: The median for speech perception scores were as follows: visual-alone, 25.9% (range, 12.7-58.1%); auditory-alone, 5.2% (range, 0-49.4%); and audiovisual, 50.7% (range, 16.5-90.8%). Seven of eight subjects did as well or better in the audiovisual condition than in either auditory-alone or visual-alone conditions alone. Three subjects had audiovisual scores greater than what would be expected from a simple additive effect of the information from the auditory-alone and visual-alone conditions alone, suggesting a superadditive effect of the combination of auditory-alone and visual-alone information. Three subjects had a simple additive effect of speech perception in the audiovisual condition. CONCLUSION: Some congenitally deafened subjects who undergo implantation as adults have significant gains in speech perception when auditory information from a cochlear implant and visual information by lipreading is available. This study shows that some congenitally deafened adults are able to integrate auditory information provided by the cochlear implant (despite the lack of auditory speech experience before implantation) with visual speech information.

Adult↗
PubMed1998

Everyday speechreading: understanding seen speech action.

How does speechreading (lipreading) work at the cognitive and neurobiological level? In this review I summarise work over the last fifteen years that has used everyday speechreading in hearing participants to illuminate issues of cerebral localisation and cognitive function. The implications of this work for deepening our understanding of speechreading in a remedial context are highlighted.

Brain Mapping↗
PubMed1996

Issues in comparing the speechreading abilities of hearing-impaired and hearing 15 to 16 year-old pupils.

The speechreading skills of 57 hearing-impaired 15 to 16-year-olds were compared with a sample of 30 hearing pupils in the same school year. Previous comparative studies have included a complete population of hearing-impaired pupils or have been confined to those who are severely-profoundly deaf. In the present study only pupils who had sufficient verbal memory to be able to repeat up to six words in a sentence were included. The test stimuli consisted of two word lists, one from the AB isophonemic word lists and the other from the New Manchester Picture Test together with a sentence list from the Manchester Speechreading (Lipreading) Test. The hearing-impaired pupils were placed full time in mainstream units for the hearing impaired and special schools for the hearing impaired. The sample also contained a small group of five who were placed in schools for children with moderate learning difficulties. The hearing-impaired group scored significantly better than the hearing group in all of the lists. Intelligence factors assessed by the Raven's Standard Progressive Matrices were not a major influence except for the MLD group. The superiority of the hearing-impaired sample is attributed to a greater need for speechreading and the practice derived from it. Evidence from this study supports the view that sufficient development in memory for spoken language needs to occur for a child to maximise speechreading skills.

Adolescent↗
PubMed1978

Investigating the MESA (multipoint electrotactile speech aid): the transmission of segmental features of speech.

Four normal-hearing young adults have been extensively trained in the use of a tactile speech-transmission system. Subjects were tested in the recognition of various phonetic elements including vowels, and stop, nasal, and fricative consonants under three receiving conditions; visual reception alone (lipreading), tactile reception alone, and tactile plus visual reception. Subjects were artificially deafened using earplugs and white noise and all speech tokens were presented live voice. Analysis of the data demonstrates that the tactile transform enables receivers to achieve excellent recognition of vowels in CVC context and the consonantal features of voicing and nasality. This, in combination with high recognition of vowels and the consonantal feature place of articulation through visual receptors, leads to recognition performance in the combined condition (visual plus tactual) which far exceeds either reception condition in isolation.

Abdomen↗
PubMed1978

A method for training and evaluating the reception of ongoing speech.

The "tracking procedure" is a method to train and evaluate the reception of ongoing speech. A talker and a receiver engage in a dialogue for a designated period of time in which the receiver reports his perception of successive segments of read text and is corrected by the talker until the text is repeated verbatim. Performance is measured in number of words of text repeated correctly per unit of time. The procedure is illustrated by its application to a project for training and evaluating use of a vibrotacile-electrotactile aid to lipreading. Differences between experimental conditions are described over time in terms of absolute words per minute, increment of aided over unaided words-per-minute scores, and percent of normal listening rate. Data from identification tests with syllables, words, and sentences are also presented. Tracking is suggested as an additional procedure for communication training in aural rehabilitation or classroom setting, and for evaluation of other communication systems.

Auditory Perception↗
PubMed1985

The contribution of fundamental frequency, amplitude envelope, and voicing duration cues to speechreading in normal-hearing subjects.

The ability to combine speechreading (i.e., lipreading) with prosodic information extracted from the low-frequency regions of speech was evaluated with three normally hearing subjects. The subjects were tested in a connected discourse tracking procedure which measures the rate at which spoken text can be repeated back without any errors. Receptive conditions included speechreading alone (SA), speechreading plus amplitude envelope cues (AM), speechreading plus fundamental frequency cues (FM), and speechreading plus intensity-modulated fundamental frequency cues (AM + FM). In a second experiment, one subject was further tested in a speechreading plus voicing duration cue condition (DUR). Speechreading performance was best in the AM + FM condition (83.6 words per minute,) and worst in the SA condition (41.1 words per minute). Tracking levels in the AM, FM, and DUR conditions were 73.7, 73.6, and 65.4 words per minute, respectively. The average tracking rate obtained when subjects were allowed to listen to the talker's normal (unfiltered) speech (NS condition) was 108.3 words per minute. These results demonstrate that speechreaders can use information related to the rhythm, stress, and intonation patterns of speech to improve their speechreading performance.

Adult↗
PubMed1999

Gap detection by early-deafened cochlear-implant subjects.

Two studies investigating gap-detection thresholds were conducted with cochlear-implant subjects whose onset of profound hearing loss was very early in life. The Cochlear Limited multiple-electrode prosthesis was used. The first study investigated the effects of pulse rate (200, 500, and 1000 pulses/s) and stimulus duration (500 and 1000 ms) on gap thresholds in 15 subjects. Average gap thresholds were 1.8 to 32.1 ms. There was essentially no effect of pulse rate and for almost all subjects, no effect of stimulus duration. For two subjects, performance was poorer for the 1000-ms stimulus duration. The second study investigated the relationships between gap thresholds, subject variables, and speech-perception scores. Data from the first study were combined with those from previous studies [Busby et al., Audiology 31, 95-111 (1992); Tong et al., J. Acoust. Soc. Am. 84, 951-962 (1988)], providing data from 27 subjects. A significant negative correlation was found between age at onset of deafness and gap thresholds and most variability in gap thresholds was for the congenitally deaf subjects. Significant negative correlations were found between gap thresholds and word scores for open-set Bamford-Kowal-Bench (BKB) sentences in the auditory-visual condition and lipreading enhancement scores for the same test.

Adolescent↗
PubMedDate not supplied

Hearing performance with the auditory prosthesis.

With their prostheses activated 12 of 13 subjects were able to respond to sound (bands of noise) at intensities (35-65 dB SPL) that typically arise in the normal acoustic environment. While this "hearing" did allow them to be aware of speech, it did not permit them to understand speech. On the other hand, this "hearing" does seem to help them with identification of common environmental sounds and with lipreading, within the context that those abilities were tested here.

Audiometry↗
PubMedDate not supplied

Comparison of two cochlear implant speech-processing strategies.

Speech processors extracting either the fundamental frequency (F0) alone, or the fundamental frequency combined with second formant information (F0-F2), have been evaluated on a totally deaf patient using a multiple-channel cochlear implant. A closed set test using 16 spondees and a modified rhyme test showed that for electrical stimulation alone the F0-F2 speech processor was significantly better than the F0 processor. The open set tests using phonetically balanced words and Central Institute for the Deaf everyday sentences showed that for electrical stimulation alone and electrical stimulation combined with lipreading, the results with the F0-F2 speech processor were all significantly better than with the F0 processor. Information transmission for consonant speech features was also better when using the F0-F2 processor.

Cochlear Implants↗
PubMed1986

The UCSF/Storz multichannel cochlear implant: patient results.

Using the four channel cochlear implant system with a vocoder-based processor developed at UCSF over an extensive period of research, clinical trials of the UCSF/Storz device were initiated in February 1985, under the sponsorship of Storz Instrument Company. To date, 13 patients have been implanted with this device, nine of whom have been fitted with their external processor and transmitter and have received at least their initial postoperative evaluation. Patient results have been extremely promising, with eight of the nine patients obtaining some open-set auditory only speech understanding. Most patients have demonstrated improvement over time and all patients have attained an enhancement in lipreading ability with the use of the UCSF/Storz device.

Adult↗
PubMed1995

Performance of prelingually and postlingually deaf patients using single-channel or multichannel cochlear implants.

The auditory and aided lipreading performance of 8 prelingually and 11 postlingually deaf patients who had received a single-channel or multichannel cochlear implant was evaluated during 2 years of follow-up. Although all the patients improved on both closed-set pattern recognition and speech discrimination tests and on a Continuous Discourse Tracking task, the most significant improvement was observed in the postlingually deaf patients who were using a multichannel implant. These patients were the only ones to achieve open-set speech recognition in the auditory-only condition. Only small differences were found between prelingually deaf patients who were using a single-channel system and those who were using a multichannel system. The users' evaluations, obtained by means of a questionnaire, were generally positive in all patients. Based on the study results, the authors concluded that it is feasible to use cochlear implants in highly motivated prelingually deaf patients who have learned to use oral-aural communication.

Adult↗
PubMedDate not supplied

Performance of adult Ineraid and Nucleus cochlear implant patients after 3.5 years of use.

Forty-two postlingually deafened adult patients, 21 with a formant extraction version of the Nucleus cochlear implant and 21 with the Ineraid cochlear implant (analog processing), were evaluated on a series of speech perception tests after using their implants for about 3.5 years. A wide range of performance was observed across patients for both devices. All but 4 patients showed an enhancement in their lipreading ability with the implant. Word recognition averaged about 14-19% correct, and word recognition in sentences averaged about 43-49% correct for the two implant groups. Average performance was superior with the Ineraid implant on consonant recognition in noise. An information transmission analysis suggested that vowel perception was influenced by first- and third-formant frequency for the Nucleus, and first-formant and fundamental frequency for the Ineraid patients. It appeared that the Ineraid device was more effective, on average, at conveying information about consonant nasality and frication. For consonant perception, nasality and frication contributed most to the total information transmitted for both implant types. Both devices had difficulty conveying information about vowel second-formant frequency and consonant place information. These scores at 3.5 years are substantially elevated from preoperative performance and, overall, the patients clearly benefit from their implant.

Adult↗
PubMedDate not supplied

Audiovisual speech reception in noise and self-perceived hearing disability in sensorineural hearing loss.

Multiple regression analyses were performed on a corpus of data from 56 sensorineurally hearing-impaired subjects. In addition to tonal thresholds, the corpus included simple, quantitative self-ratings for disability and results from speech reception tasks in auditory-only, audiovisual, quiet and noisy conditions. The aim was to evaluate to what extent the predictive power of disability formulas based on the audiogram can be enhanced, when measures derived from speech reception tasks are added to tonal thresholds as supplementary predictors. The better-ear speech reception threshold proved to be a strong exclusive predictor: if speech reception thresholds were introduced into the prediction, the contribution of better-ear pure-tone averages became redundant. Speechreading ability always significantly enhanced the prediction's accuracy. Tonal thresholds or speech reception data combined with lipreading ability scores can explain considerable amounts (42 per cent and 54 per cent, respectively) of the variance in disability ratings. The conclusion is that auditory-only, audiogram-based prediction schemes must not be abandoned, but can be tailored to individuals on the basis of realistic audiovisual speech reception performance.

Adult↗