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Biomedical subjects

Liat Kishon-Rabin

Publications and source records attributed to Liat Kishon-Rabin.

At least 19 recordsLinked to original sources

Connexin-associated deafness and speech perception outcome of cochlear implantation.

OBJECTIVE: To compare performance after cochlear implantation in children with mutations in connexin (Cx) 26 (GJB2) or Cx30 (GJB6) and children with deafness of unknown etiology. DESIGN: Genetic analysis and speech perception evaluation was performed in the children with and without Cx mutations who had undergone cochlear implantation. Speech perception performance was retrospectively analyzed 6, 12, 24, 36, and 48 months after implantation. Test material was selected according to the child's age and cognitive and language abilities. SETTING: The study took place at speech and hearing and genetic centers of a hospital in the central part of Israel and the genetics departments of 3 additional centrally located hospitals. PATIENTS: A total of 30 children who had undergone cochlear implantation were selected for the study, with control patients matched according to age at implantation, duration of implant use, and mode of communication. There was no evidence for additional disabilities or handicaps in either group. MAIN OUTCOME MEASURES: Speech perception measurements included a questionnaire, as well as closed and open-set tests. RESULTS: Overall, the 2 groups showed significant improvement in speech perception results after implantation. Four years after implantation, both groups achieved mean open-set speech perception scores of approximately 60%, 75%, and 90% for monosyllabic, 2 syllables, and words in sentences tests, respectively. CONCLUSIONS: There were no apparent differences in speech perception performance after implantation between the children with Cx mutations and children with deafness of unknown etiology. These data have important implications as a prognostic indicator when counseling candidates for cochlear implantation.

Child↗

Identification of syllables in noise: electrophysiological and behavioral correlates.

This study was designed to characterize the effect of background noise on the identification of syllables using behavioral and electrophysiological measures. Twenty normal-hearing adults (18-30 years) performed an identification task in a two-alternative forced-choice paradigm. Stimuli consisted of naturally produced syllables [da] and [ga] embedded in white noise. The noise was initiated 1000 ms before the onset of the speech stimuli in order to separate the auditory event related potentials (AERP) response to noise onset from that to the speech. Syllables were presented in quiet and in five SNRs: +15, +3, 0, -3, and -6 dB. Results show that (1) performance accuracy, d', and reaction time were affected by the noise, more so for reaction time; (2) both N1 and P3 latency were prolonged as noise levels increased, more so for P3; (3) [ga] was better identified than [da], in all noise conditions; and (4) P3 latency was longer for [da] than for [ga] for SNR 0 through -6 dB, while N1 latency was longer for [ga] than for [da] in most listening conditions. In conclusion, the unique stimuli structure utilized in this study demonstrated the effects of noise on speech recognition at both the physical and the perceptual processing levels.

Acoustic Stimulation↗

Speech perception of children using Nucleus, Clarion or Med-El cochlear implants.

OBJECTIVE: The purpose of this study was to present speech perception achievements of implanted children using commercially available cochlear implant devices: Nucleus, Clarion or Med-El. STUDY DESIGN: A retrospective analysis. METHODS: Speech perception data of 96 hearing-impaired children: 27 with Clarion, 49 with Nucleus and 20 with Med-El were collected. Speech tests included the Hebrew Infant Toddlers Meaningful Auditory Integration Scale (HIT-MAIS) for the infants, the Hebrew Early Speech Perception (HESP) closed-set word-identification test and Hebrew Arthur Boothroyd (HAB) open-set one-syllable word recognition test were used for the older children. RESULTS: I HIT-MAIS: (1) Infants showed similar rate of progress, regardless of device. (2) Children implanted under two years of age reached performance within normal development on this test. II HAB: (1) Most children achieved open set results with mean HAB between 40 and 50%, within 1-1.5 years post implantation. (2) Linear regression analyses revealed no statistical differences between the Clarion the Nucleus and the Med-El devices on the mean final measurement of this test. (3) Age of implantation and mode of communication were significant covariate variables: (a) the younger the child is implanted the better the results and (b) oral communication prior to implantation results in better performance than sign language. CONCLUSIONS: There are no apparent differences in speech perception performance between implant devices when considering background variables. The data have important implications on the rehabilitation process of hearing impaired children with cochlear implants in relation to device selection, age at implantation and mode of communication prior to implantation.

Adolescent↗

Cognitive function in idiopathic generalized epilepsy of childhood.

This study evaluated the cognitive profiles of children with idiopathic generalized epilepsy (IGE), uniformly treated with valproic acid with well-controlled seizures. Twenty-four were neuropsychologically evaluated. They comprised: 14 females, 10 males: 12 with generalized tonic-clonic seizures (GTCS), mean age 14y 4mo, SD ly 7mo, range 12y to 16y 4 mo; 12 with absence seizures (AS]) mean age 14y 5mo, SD ly 10mo, range 11y to 16y 4mo, with intellectual abilities within the normal range and age-appropriate scholastic skills, and 20 healthy controls (12 females, 8 males; mean age 14y 5mo, SD 1y 10mo, range 10y 7mo to 16y 7mo). As a group, children with IGE performed significantly poorer in all tests (non-verbal and verbal attention, verbal learning and memory, word fluency, and controlled sequential fine motor responses) excluding non-verbal memory. Analysis according to type of seizure revealed that both patient groups (AS and GTCS) had an attention deficit, whereas only children with AS showed deficits in verbal learning and memory, word fluency, and controlled fine motor responses. These results suggest a long-term risk of learning impairment for children with IGE, even if they have normal intelligence and their seizures are well controlled.

Adolescent↗

Prelexical vocalization in normal hearing and hearing-impaired infants before and after cochlear implantation and its relation to early auditory skills.

OBJECTIVES: To compare the vocalizations of hearing-impaired infants before and after cochlear implantation with those of a control group of hearing infants and to relate prelexical vocalizations by using the PRoduction Infant Scale Evaluation (PRISE) to early auditory skill attainments, using the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) in normal-hearing and hearing-impaired (HI) infants before and after cochlear implantation. DESIGN: A total of 187 infants participated in the study: 24 HI infants with severe-profound hearing loss (8 to 23 months of age) and 163 hearing infants (0.5 to 20 months of age). Prelexical vocalizations and early auditory skills were assessed by using parent questionnaires (PRISE and IT-MAIS, respectively) that reflect known milestones in the infant's vocal and auditory development. HI infant data were compared with hearing infant data according to chronological age and duration of device use (hearing aid or cochlear implant). RESULTS: Average PRISE score of aided HI infants before implantation was 50% or less (regardless of age). This score is comparable to that of hearing infants who are 6 to 7 months of age. After implantation, HI infants reached a score of 70% but did not reach normative performance. When HI infant data were compared with hearing infants by duration of device use, aided infants before implantation performed as well or worse than normative performance, whereas implanted infants performed as well as or better than hearing infants. Performance on individual PRISE questions showed limited ability by HI infants before implantation compared with hearing and implanted infants. A strong correlation was found between the IT-MAIS and the PRISE (r = 0.93 and r = 0.83, for hearing and HI infants, respectively). CONCLUSIONS: The PRISE was found to be a versatile tool for implant team clinicians who are required to assess prelinguistic skills of infants. The findings suggest that early auditory skills are related to prelexical vocalization. The data also highlighted unanswered questions related to the importance of early fitting of hearing aids on vocalization before and after implantation.

Auditory Perception↗

Cortical activity of children with dyslexia during natural speech processing: evidence of auditory processing deficiency.

Children with dyslexia have difficulties with phonological processing. It is assumed that deficits in auditory temporal processing underlie the phonological difficulties of dyslectic subjects (i.e. the processing of rapid acoustic changes that occur in speech). In this study we assessed behavioral and electrophysiological evoked brain responses of dyslectic and skilled reading children while performing a set of hierarchically structured auditory tasks. Stimuli consisted of auditory natural unmodified speech that was controlled for the parameter of changing rate of main acoustic cues: vowels (slowly changing speech cues: /i/ versus /u/) and consonant-vowel (CV) syllables (rapidly changing speech cues: /da/ versus /ga/). Brain auditory processing differed significantly between groups: reaction time of dyslectic readers was prolonged in identifying speech stimuli and increased with increased phonological demand. Latencies of auditory evoked responses (auditory event related potentials [AERPs]) recorded during syllable identification of the dyslectic group were prolonged relative to those of skilled readers. Moreover, N1 amplitudes during vowel processing were larger for the dyslectic children and P3 amplitudes during CV processing were smaller for the dyslectic children. From the results of this study it is evident that the latency and amplitude of AERPs are sensitive measures of the complexity of phonological processing in skilled and dyslectic readers. These results may be signs of deficient auditory processing of natural speech under normal listening conditions as a contributing factor to reading difficulties in dyslexia. Detecting a dysfunction in the central auditory processing pathway might lead to early detection of children who may benefit from phonetic-acoustic training methods.

Acoustic Stimulation↗

The effect of number of perceptual categories on identification functions of non-speech stimuli and the relationship to categorization of Hebrew voicing.

Category boundary (CB) of Hebrew voicing on voice-onset time (VOT) continuum was found to be different from non-speech stimuli on tone-onset time (TOT) continuum. This is in contrast to data in English, thus suggesting that CB for speech stimuli may be determined not only by general auditory sensitivities but by additional factors that may be speech specific. The data in Hebrew voicing, however, can also be explained by the fact that in Hebrew voicing, two categories were available to the listener, whereas for the TOT stimuli there were three: leading, simultaneous and lagging temporal events. The purpose of the present study was to investigate the effect of number of perceptual categories on CB of non-speech analogs of voicing in Hebrew-speaking subjects and compare them to those obtained on a VOT continuum. Twenty-four Hebrew-speaking adults participated in this study. Stimuli consisted of (a) a two-tone complex continuum that varied in the relative onset time of the lower frequency tone, and (b) a /ba-pa/ continuum which varied in VOT values similar to (a). The same TOT continuum was tested twice. In one, subjects identified TOT stimuli as belonging to one of three categories (TOT3): leading, simultaneous, or lagging; and in the other to two categories of TOT (TOT2): leading or lagging. VOT stimuli were labeled as /ba/ or /pa/. Results show that (1) when listeners were offered only two perceptual categories of temporal events, the pattern of identification functions matched one of the two functions shown for TOT3, and (2) the category boundary of VOT stimuli was similar for all subjects regarding the value calculated for TOT2. The present study supports the hypotheses that (1) CB of non-speech stimuli is not influenced by the number of perceptual categories available to the listener, and (2) different mechanisms may underlie the categorical perception of speech versus non-speech stimuli.

Acoustic Stimulation↗

Effect of age at cochlear implantation on auditory skill development in infants and toddlers.

OBJECTIVES: To investigate the effect of age at cochlear implantation on the auditory development of children younger than 3 years and to compare these children's auditory development with that of peers with normal hearing. DESIGN: Using a repeated-measures paradigm, auditory skill development was evaluated before and 3, 6, and 12 months after implantation. Data were compared with previously published data from cohorts with normal hearing. PARTICIPANTS: One hundred seven hearing-impaired children (age range, 12-36 months) who received a cochlear implant during clinical trials in North America. MAIN OUTCOME MEASURE: Auditory skill development was assessed using the Infant-Toddler Meaningful Auditory Integration Scale, a tool that provides a quantitative measure in children as young as newborns. RESULTS: Infants and toddlers who receive implants show rapid improvement in auditory skills during the first year of device use regardless of age at implantation, although younger children achieve higher scores. Children who undergo implantation at a younger age acquire auditory skills nearer to those of their peers with normal hearing at a younger age. The mean rate of acquisition of auditory skills is similar to that of infants and toddlers with normal hearing regardless of age at implantation. CONCLUSION: Performing implantation in children with profound hearing loss at the youngest age possible allows the best opportunity for them to acquire communication skills that approximate those of their peers with normal hearing.

Age Factors↗

Association between birth control pills and voice quality.

OBJECTIVES/HYPOTHESIS: The objective was to extend our knowledge of the effect of birth control pills on voice quality in women based on various acoustic measures. STUDY DESIGN: A longitudinal comparative study of 14 healthy young women over a 36- to 45-day period. METHODS: Voices of seven women who used birth control pills and seven women who did not were recorded repeatedly approximately 20 times. Voice samples were analyzed acoustically, using an extended set of frequency perturbation parameters (jitter, relative average perturbation, pitch period perturbation quotient), amplitude perturbation parameters (shimmer, amplitude average perturbation quotient), and noise indices (noise-to-harmonics ratio, voice turbulence index). RESULTS: Voice quality and stability were found to be better among the women who used birth control pills. Lower values were found for all acoustic measures with the exception of voice turbulence index. Results also provided preliminary indication for vocal changes associated with the days preceding ovulation. CONCLUSION: In contrast to the traditional view of oral contraceptives as a risk factor for voice quality, and in keeping with the authors' previous work, the data in the present study showed that not only did oral contraceptives have no adverse effect on voice quality but, in effect, most acoustic measures showed improved voice quality among women who used the birth control pill. The differences in the noise indices between groups may also shed light on the nature of the effect of sex hormones on vocal fold activity. It was suggested that hormonal fluctuations may have more of an effect on vocal fold regulation of vibration than on glottal adduction.

Adult↗

Frequency discrimination training: is there ear symmetry?

While it is well documented that significant improvements in a frequency discrimination task occur following training of normal-hearing adult subjects, less is known about the symmetry between the ears. The objectives of the present study were (1) to compare the first obtained DLF thresholds between left and right ears, (2) to determine whether single-session training would result in similar improvements in those subjects trained in the right ear versus those trained in the left ear, and (3) to evaluate the generalization of learning to the untrained ear and compare its extent between the left and right ears. Two groups of 10 normal-hearing subjects participated in a single-session training. One group of 10 subjects was trained in the left ear and the second group of 10 additional subjects was trained in the right ear. Single-session training consisted of 10 difference limen frequency (DLF) thresholds for 1 kHz using a two-interval, two-alternative forced choice paradigm. Generalization to the untrained ear was tested 24 hours post-training. Our results show that: (1) No significant differences were found in the first obtained DLF thresholds between left and right ears; (2) Similar improvement in DLF thresholds occurred in both ears for single-session training; and (3) Twenty-four hours post-training, learning generalized to the untrained ear with similar generalization to both ears. Future studies are required in order to establish whether this symmetry is maintained with verbal stimuli and/or after multi-session training.

Acoustic Stimulation↗

Frequency discrimination thresholds: the effect of increment versus decrement detection of frequency.

Difference limen for frequency (DLF) is traditionally tested using a frequency increment detection paradigm in which listeners are requested to distinguish between a reference tone and a series of comparison tones of higher frequency. Sporadic findings indicated that an increment paradigm is not necessarily comparable to a decrement paradigm, in which the comparison tones are lower than the reference tone. The purpose of the present study was to test whether the ability to detect frequency increments is different from that of frequency decrements. DLFs of 16 young women were measured at 200 Hz and 1,000 Hz, using detection of both frequency increment and decrement paradigms. Results indicated that: (1) the frequency increment detection paradigm was significantly smaller (i.e., superior) to the decrement paradigm for the DLF task at 200 Hz, (2) for both frequencies, the number of participants who exhibited better DLF using the frequency increment detection paradigm was significantly larger than the number of those who had better DLFs using the frequency decrement paradigm, and (3) for both frequencies, strong correlations were found between DLFs obtained in the increment versus the decrement paradigms. These results have implications: (1) to studies whose subjects may have reduced sensitivities at frequencies higher than the reference tone (such as the hearing impaired), and (2) to models related to the role of auditory feedback on voice accuracy and to the underlying processes of frequency discrimination.

Acoustic Stimulation↗

Are the perceptual effects of spectral smearing influenced by speaker gender?

The purpose of this study was to determine whether the effect of loss of spectral detail on speech perception is influenced by the gender of the speaker. Spectral smearing was carried out by multiplying the speech signal by a series of low-passed white noise samples, causing tonal components in the signal to be replaced by noise. Smearing bandwidths of 0 Hz (no smearing), 250 Hz, 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz, 8,000 Hz and full bandwidth were used. Smearing was applied to 15 isophonemic lists, each with 10 one-syllable CVC Hebrew words. The words were recorded using two speakers, a male and a female, both native speakers of Hebrew. A total of 23 subjects participated in the study: eight listened to the male speaker and 15 to the female. The results show no significant differences in the effect of speaker on recognition of words, phonemes, vowels and consonants at the different smearing bandwidths. The results also show that regardless of the speaker's gender, vowels were adversely affected by spectral smearing, as compared to consonants. Interpolation of the results shows that smearing bandwidths of 1,080 Hz, 1,950 Hz, 1,590 Hz and 2,150 Hz are required to reduce word, phoneme, vowel and consonant recognition to 50%, respectively. Several tentative explanations are offered for the fact that the results were independent of gender: all smearing bandwidths were larger than the average interharmonic spacing for both speakers, and the difference between male and female formant frequencies is typically smaller then the difference in formant frequencies of the different vowels.

Acoustic Stimulation↗

Low-resolution electromagnetic tomography (LORETA) in children with cochlear implants: a preliminary report.

The current preliminary report describes the utilization of low-resolution electromagnetic tomography (LORETA) in a small group of highly performing children using the Nucleus 22 cochlear implant (CI) and in normal-hearing (NH) adults. LORETA current density estimations were performed on an averaged target P3 component that was elicited by non-speech and speech oddball discrimination tasks. The results indicated that, when stimulated with tones, patients with right implants and NH adults (regardless of stimulated ear) showed enhanced activation in the right temporal lobe, whereas patients with left implants showed enhanced activation in the left temporal lobe. When stimulated with speech, patients with right implants showed bilateral activation of the temporal and frontal lobes, whereas patients with left implants showed only left temporal lobe activation. NH adults (regardless of stimulated ear) showed enhanced bilateral activation of the temporal and parietal lobes. The differences in activation patterns between patients with CI and NH subjects may be attributed to the long-term exposure to degraded input conditions which may have resulted in reorganization in terms of functional specialization. The difference between patients with right versus left implants, however, is intriguing and requires further investigation.

Acoustic Stimulation↗

Do oral contraceptives improve vocal quality? Limited trial on low-dose formulations.

OBJECTIVE: To evaluate the effect of low-dose monophasic oral contraceptives on female vocal quality. METHODS: Acoustic voice parameters of six women who use oral contraceptives and six women who do not were evaluated repeatedly during the menstrual cycle. Frequency and amplitude variations were measured using a computerized voice analysis program. Repeated-measures analysis of variance was performed to test differences between groups for each acoustic voice parameter. RESULTS: Vocal stability among the women who use oral contraceptives was significantly better than among those who did not use oral contraceptives (P <.05). Specifically, amplitude and frequency variations between successive vocal cycles were smaller in women using oral contraceptives in comparison with the control group (.24 dB versus.37 dB and.86% versus 1.27% for amplitude and frequency variations, respectively). CONCLUSION: Contrary to the reports of adverse effects that high-dose pills have on voice, low-dose oral contraceptives show a favorable influence on voice in young women.

Adult↗

Linguistic processing in idiopathic generalized epilepsy: an auditory event-related potential study.

PURPOSE: Auditory processing of increasing acoustic and linguistic complexity was assessed in children with idiopathic generalized epilepsy (IGE) by using auditory event-related potentials (AERPs) as well as reaction time and performance accuracy. METHODS: Twenty-four children with IGE [12 with generalized tonic-clonic seizures (GTCSs), and 12 with absence seizures (ASs)] with average intelligence and age-appropriate scholastic skills, uniformly medicated with valproic acid (VPA), and 20 healthy controls, performed oddball discrimination tasks that consisted of the following stimuli: (a) pure tones; (b) nonmeaningful monosyllables that differed by their phonetic features (i.e., phonetic stimuli); and (c) meaningful monosyllabic words from two semantic categories (i.e., semantic stimuli). RESULTS: AERPs elicited by nonlinguistic stimuli were similar in healthy and epilepsy children, whereas those elicited by linguistic stimuli (i.e., phonetic and semantic) differed significantly in latency, amplitude, and scalp distribution. In children with GTCSs, phonetic and semantic processing were characterized by slower processing time, manifested by prolonged N2 and P3 latencies during phonetic processing, and prolongation of all AERPs latencies during semantic processing. In children with ASs, phonetic and semantic processing were characterized by increased allocation of attentional resources, manifested by enhanced N2 amplitudes. Semantic processing also was characterized by prolonged P3 latency. In both patient groups, processing of linguistic stimuli resulted in different patterns of brain-activity lateralization compared with that in healthy controls. Reaction time and performance accuracy did not differ among the study groups. CONCLUSIONS: AERPs exposed linguistic-processing deficits related to seizure type in children with IGE. Neurologic follow-up should therefore include evaluation of linguistic functions, and remedial intervention should be provided, accordingly.

Acoustic Stimulation↗

The effect of superior auditory skills on vocal accuracy.

The relationship between auditory perception and vocal production has been typically investigated by evaluating the effect of either altered or degraded auditory feedback on speech production in either normal hearing or hearing-impaired individuals. Our goal in the present study was to examine this relationship in individuals with superior auditory abilities. Thirteen professional musicians and thirteen nonmusicians, with no vocal or singing training, participated in this study. For vocal production accuracy, subjects were presented with three tones. They were asked to reproduce the pitch using the vowel /a/. This procedure was repeated three times. The fundamental frequency of each production was measured using an autocorrelation pitch detection algorithm designed for this study. The musicians' superior auditory abilities (compared to the nonmusicians) were established in a frequency discrimination task reported elsewhere. Results indicate that (a) musicians had better vocal production accuracy than nonmusicians (production errors of 1/2 a semitone compared to 1.3 semitones, respectively); (b) frequency discrimination thresholds explain 43% of the variance of the production data, and (c) all subjects with superior frequency discrimination thresholds showed accurate vocal production; the reverse relationship, however, does not hold true. In this study we provide empirical evidence to the importance of auditory feedback on vocal production in listeners with superior auditory skills.

Adult↗

The effect of training on frequency discrimination: generalization to untrained frequencies and to the untrained ear.

While there is growing evidence that frequency discrimination improves with practice, there are, however, limited and inclusive reports regarding the generalization of learning to untrained conditions. The goals of the present study were therefore (1) to measure the effect of multi-session training on difference limen frequency (DLF) thresholds and evaluate the relative contribution of procedural and stimulus learning by comparison to a control (untrained) group; (2) to evaluate the extent of generalization of the trained frequency to two untrained frequencies known to be temporally coded; and (3) to estimate the generalization of the trained frequency to the untrained ear, for both trained and untrained frequencies. Two groups of subjects were included: a trained group (n = 5) and a control group (n = 5). For the trained group, DLF thresholds for 1 kHz (trained frequency) and 1.1 and 2.0 kHz (untrained frequencies) were obtained using a two-interval, two-alternative forced choice paradigm before and after an eight-session training. The control group was tested using the same stimuli only twice, with a 3-week interval between testing. Results showed that (1) multi-session training improves frequency discrimination in normal hearing young adults; (2) adding a control group to the study allowed estimation of the effect of limited exposure to the stimuli and task in naïve listeners and evaluation of the magnitude of procedural learning; (3) learning was generalized across frequencies that are coded by similar mechanisms; (4) generalization of learning occurred in the untrained ear for trained and untrained frequencies. These results have important clinical and theoretical implications regarding the processes underlying perceptual learning and the effectiveness of auditory habilitation strategies.

Acoustic Stimulation↗

Effect of second-formant transitions on the perception of Hebrew voiced stop consonants.

Studies in English, Dutch, Danish and French show that of the possible acoustic cues that listeners use for the perception of place of articulation, the transition of the second formant (F2) appears to be a very important cue. Although the Hebrew language shares some similarities with the above languages, one cannot assume that it either has similar acoustic-articulatory patterns or uses the same cues for perception. The general goal of the present study was, therefore, to investigate the effect of the starting frequency of F2 transition on the perception of place of articulation of Hebrew voiced plosives in initial position. Sixteen Hebrew-speaking young normal-hearing adults served as subjects. Stimuli were generated by re-synthesizing a naturally spoken /ba/ syllable into 17 test syllables by varying only the starting frequency of F2. Listeners heard each stimulus six times (total of 102) at random and were required to label the stimuli as /ba/, /da/ or /ga/. Results showed that varying only F2 transitions caused a perceptual change of place of articulation for all listeners. There was, however, large inter-subject variability in the perceived category: 75% of the subjects identified /ba/ and /da/, half of them also identified /ga/, and 25% of the subjects were able to identify /ba/ and /ga/ only. These data suggest that while F2 transitions are important for perceiving place of articulation of Hebrew voiced stops, they cannot predict the perceived category. It also supports the notion that normal-hearing listeners differ in the relative importance they assign to the cues for the perception of place of articulation.

Acoustic Stimulation↗