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Impairments of speech production and speech perception in aphasia.

The basis of speech production and speech perception deficits in aphasia relates to implementation and access rather than to the underlying representation or knowledge base of the sound structure of language. Speech production deficits occur on the phonological level in which the incorrect phonological form of the word is selected but is implemented correctly, and the phonetic level in which the correct sound segments are selected but articulatory implementation is impaired. Phonological deficits emerge regardless of lesion site, whereas phonetic deficits have a specific localized neuroanatomical substrate. Phonetic deficits are not linguistic but affect particular articulatory movements. Speech perception impairments emerge in nearly all aphasic patients, suggesting that the neural basis for speech perception is broadly distributed in the language hemisphere. The impairment reflects the misperception of phonetic features rather than a deficit in the auditory processing of speech and emerges particularly as the sound properties of speech contact the lexicon.

Aphasia↗

Patterns of phoneme perception errors by listeners with cochlear implants as a function of overall speech perception ability.

Many studies have noted great variability in speech perception ability among postlingually deafened adults with cochlear implants. This study examined phoneme misperceptions for 30 cochlear implant listeners using either the Nucleus-22 or Clarion version 1.2 device to examine whether listeners with better overall speech perception differed qualitatively from poorer listeners in their perception of vowel and consonant features. In the first analysis, simple regressions were used to predict the mean percent-correct scores for consonants and vowels for the better group of listeners from those of the poorer group. A strong relationship between the two groups was found for consonant identification, and a weak, nonsignificant relationship was found for vowel identification. In the second analysis, it was found that less information was transmitted for consonant and vowel features to the poorer listeners than to the better listeners; however, the pattern of information transmission was similar across groups. Taken together, results suggest that the performance difference between the two groups is primarily quantitative. The results underscore the importance of examining individuals' perception of individual phoneme features when attempting to relate speech perception to other predictor variables.

Adolescent↗

Face and mouth inversion effects on visual and audiovisual speech perception.

Three experiments examined whether image manipulations known to disrupt face perception also disrupt visual speech perception. Research has shown that an upright face with an inverted mouth looks strikingly grotesque whereas an inverted face and an inverted face containing an upright mouth look relatively normal. The current study examined whether a similar sensitivity to upright facial context plays a role in visual speech perception. Visual and audiovisual syllable identification tasks were tested under 4 presentation conditions: upright face-upright mouth, inverted face-inverted mouth, inverted face-upright mouth, and upright face-inverted mouth. Results revealed that for some visual syllables only the upright face-inverted mouth image disrupted identification. These results suggest that upright facial context can play a role in visual speech perception. A follow-up experiment testing isolated mouths supported this conclusion.

Adult↗

Visual speech perception without primary auditory cortex activation.

Speech perception is conventionally thought to be an auditory function, but humans often use their eyes to perceive speech. We investigated whether visual speech perception depends on processing by the primary auditory cortex in hearing adults. In a functional magnetic resonance imaging experiment, a pulse-tone was presented contrasted with gradient noise. During the same session, a silent video of a talker saying isolated words was presented contrasted with a still face. Visual speech activated the superior temporal gyrus anterior, posterior, and lateral to the primary auditory cortex, but not the region of the primary auditory cortex. These results suggest that visual speech perception is not critically dependent on the region of primary auditory cortex.

Acoustic Stimulation↗

Auditive and cognitive factors in speech perception by elderly listeners.

A key issue in research on speech perception in the elderly is whether the difficulties in understanding speech are caused by auditive and/or cognitive factors. Resolving this issue is not only scientific interest but has many practical, i.e. diagnostic and rehabilitative, implications as well. We developed a test battery comprising auditive (sensitivity, frequency selectivity and temporal resolution), cognitive (memory performance, processing speed and intellectual abilities), and speech perception tests (at the phoneme, spondee and sentence level). This test battery was administered to 72 elderly subjects (aged 60 to 93 years). The results show that the deterioration of speech perception in the elderly consists of two statistically independent components (a) a large component mainly representing the progressive high-frequency hearing loss with age which accounts for approximately two-thirds of the systematic variance of the tests of speech perception, and (b) a smaller component (accounting for one-third of the systematic variance of the speech perception tests) mainly representing a general performance decrement due to reduced mental efficiency, which is indicated by a general slowing of performance and a reduced memory capacity. Although both components are correlated with age, it was found that the balance between auditive and cognitive contributions to speech perception performance did not change with age.

Aged↗

Within-subject comparison of speech perception benefits for congenitally deaf adolescents with an electrotactile speech processor and a cochlear implant.

This study assessed speech perception benefits for three congenitally deaf adolescents who used an electrotactile speech processor (Tickle Talker(TM)) and subsequently went on to use a Nucleus Minisystem 22 cochlear implant. Both devices provided significant and comparable benefits for all children in the device plus lipreading condition. All children benefited from the additional information provided by either the Tickle Talker(TM) or the cochlear implant, and were able to perceive speech information with these devices that was not available through either aided residual hearing or lipreading. None of the three children were able to understand open-set words or sentences using either hearing aids alone or Tickle Talker(TM) alone, without the aid of lipreading. Two of the children showed significant open-set speech perception benefits while using their cochlear implant alone.

Adolescent↗

[Speech perception test in Italian language for profoundly deaf children].

Speech perception tests are an important part of procedures for diagnosing pre-verbal hearing loss. Merely establishing a child's hearing threshold with and without a hearing aid is not sufficient to ensure an adequate evaluation with a view to selecting cases suitable for cochlear implants because it fails to indicate the real benefit obtained from using a conventional hearing aid reliably. Speech perception tests have proved useful not only for patient selection, but also for subsequent evaluation of the efficacy of new hearing aids, such as tactile devices and cochlear implants. In clinical practice, the tests most commonly adopted with small children are: The Auditory Comprehension Test (ACT), Discrimination after Training (DAT), Monosyllable, Trochee, Spondee tests (MTS), Glendonald Auditory Screening Priocedure (GASP), Early Speech Perception Test (ESP), Rather than considering specific results achieved in individual cases, reference is generally made to the four speech perception classes proposed by Moog and Geers of the CID of St. Louis. The purpose of this classification, made on the results obtained with suitably differentiated tests according to the child's age and language ability, is to detect differences in perception of a spoken message in ideal listening conditions. To date, no italian language speech perception test has been designed to establish the assessment of speech perception level in children with profound hearing impairment. We attempted, therefore, to adapt the existing English tests to the Italian language taking into consideration the differences between the two languages. Our attention focused on the ESP test since it can be applied to even very small children (2 years old). The ESP is proposed in a standard version for hearing-impaired children over the age of 6 years and in a simplified version for younger children. The rationale we used for selecting Italian words reflect the rationale established for the original version, but the choice of single words follows different criteria from the original version. In fact, the two languages differ in important linguistic features so that the test can not be not adapted to the Italian language by simply translating the words involved. As currently there is no children's language dictionary in Italian arranged according to age bracket, we chose words used in children and in pre-school reading material.

Child↗

Testing between the TRACE model and the fuzzy logical model of speech perception.

The TRACE model of speech perception (McClelland & Elman, 1986) is contrasted with a fuzzy logical model of perception (FLMP) (Oden & Massaro, 1978). The central question is how the models account for the influence of multiple sources of information on perceptual judgment. Although the two models can make somewhat similar predictions, the assumptions underlying the models are fundamentally different. The TRACE model is built around the concept of interactive activation, whereas the FLMP is structured in terms of the integration of independent sources of information. The models are tested against test results of an experiment involving the independent manipulation of bottom-up and top-down sources of information. Using a signal detection framework, sensitivity and bias measures of performance can be computed. The TRACE model predicts that top-down influences from the word level influence sensitivity at the phoneme level, whereas the FLMP does not. The empirical results of a study involving the influence of phonological context and segmental information on the perceptual recognition of a speech segment are best described without any assumed changes in sensitivity. To date, not only is a mechanism of interactive activation not necessary to describe speech perception, it is shown to be wrong when instantiated in the TRACE model.

Adult↗

Speech perception and cortical event related potentials in children with auditory neuropathy.

OBJECTIVES: 1) To investigate the unaided and aided speech perception abilities of children with auditory neuropathy (AN) and to compare their performance to children with sensorineural hearing loss. 2) To establish whether cortical event related potentials (ERPs) could be recorded in children with AN, and to determine the relationship between the presence of these responses and speech perception. DESIGN: Unaided and aided speech perception assessments (PBK words), and cortical-ERP testing was carried out in a group of 18 children with AN. Data also were obtained from a cohort of age and hearing level matched children with sensorineural hearing loss. RESULTS: The speech perception performance of the 15 children with AN able to complete a PBK-word assessment, fell into two distinct categories. The children either showed no open-set speech perception ability (7/15 cases), or performance levels similar to their sensorineural counterparts (8/15 cases). Approximately 50% of children with AN showed ERPs of normal latency, amplitude and morphology. In all cases, response presence (at normal latencies) was consistent with reasonable speech perception ability, and response absence was consistent with negligible speech perception. CONCLUSIONS: In approximately 50% of children with auditory neuropathy, the provision of amplification results in significant open-set speech perception improvements. The results confirm the previously published reports that speech perception ability cannot be reliably estimated from the behavioral audiogram in children with AN. Obligatory ERP test results may offer a means of predicting perceptual skills in newly diagnosed youngsters as the presence of ERPs (with age-appropriate latency and morphology) was correlated with significant open set speech perception abilities and amplification benefit. The absence of the ERP in contrast, indicated profound hearing disability evidenced by profound hearing loss and/or extremely poor speech perception.

Adolescent↗

Models of speech perception and phonological processing in reading.

Multiple measures of speech perception, phonological awareness, naming speed, verbal short-term memory, and word reading were concurrently administered to 136 third- and fourth-grade children. Structural equation modeling was used to contrast 5 models of the relations of speech perception and phonological processing skills to reading with IQ controlled. The best-fitting model, the Indirect Model, was one in which the effect of speech perception on reading was mediated by its relations with phonological processing abilities. Naming speed was particularly highly associated with speech perception, possible evidence for the Motor Theory. Phonological awareness was also substantially correlated with speech perception.

Child↗

Factors associated with development of speech perception skills in children implanted by age five.

OBJECTIVE: This study investigated factors contributing to speech perception outcomes in children with prelingual deafness after 4 to 7 yr of multichannel cochlear implant use. The analysis controlled for the effects of child, family and implant characteristics so that educational factors most conducive to maximum implant benefit could be identified. DESIGN: One hundred eighty-one 8- and 9-yr-old children from across the US and Canada who received a cochlear implant by age 5 were administered a battery of speech perception tests. Type and amount of educational intervention since implantation constituted the independent variables. Characteristics of the child, the family, and the implant itself constituted intervening variables. A series of multiple regression analyses determined the amount of variance in speech perception ability accounted for by the intervening variables and the amount of additional variance attributable to independent variables. RESULTS: The children achieved an average level of about 50% open-set speech perception through listening alone and almost 80% through lipreading and listening together, but with scores for individual children ranging from 0 to 100% correct. Over half of the variance in speech perception scores was predicted by characteristics of the child, family, implant and educational program. Significant predictors of good speech perception included greater nonverbal intelligence, smaller family size, longer use of the updated SPEAK/CIS processing strategy, a fully active electrode array, greater electrical dynamic range between threshold and maximum comfort level, and greater growth of loudness with increasing stimulus intensity. After the variance due to these variables was controlled, the primary rehabilitative factor associated with good speech perception skill development was educational emphasis on oral-aural communication. CONCLUSIONS: Children with profound hearing loss achieved unprecedented levels of speech perception skill 4 to 7 yr after cochlear implantation. Use of an updated speech processor, such as SPEAK, contributed significantly to improved speech perception skills, even in children who were initially fitted with an earlier strategy, such as M-PEAK. In addition, the audiologist who programs the cochlear implant makes an important contribution to the child's successful outcome with the device. A well-fitted map, as evidenced by a wide dynamic range and optimal growth of loudness characteristics, contributed substantially to the child's ability to hear speech. Finally, the classroom communication mode used in the child's school affects speech perception outcome. Children whose educational program emphasized dependence on speech and audition for communication were better able to use the information provided by the implant to understand speech.

Canada↗

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↗

Contribution of speech rate to speech perception in multichannel cochlear implant users.

This study describes the effect of speech rate (fast, 11 syllables per second; medium, 9 syllables per second; slow, 6 syllables per second) on speech perception in 10 cochlear implant users. The speech perception performance was evaluated on the basis of the percentage score of syllables that were correctly recalled in sentences composed of 4 to 6 words. The percentage scores at the fast, medium, and slow speech rates were 15.7%, 39.0%, and 56.0%, respectively. The effect of speech rate slowing was significant (p < .0001). Variations in the effect of speech rate slowing were observed in the cochlear implant users. The improvement of speech perception by speech rate slowing was significantly (p < .005) related to the word test score and the score at the fast speech rate. The results reveal that the rate of speech is an important factor in improving the speech perception of cochlear implant users.

Cochlear Implants↗

Speech perception in a communicative context: an investigation using question/answer pairs.

By diminishing the role of communicative context, traditional tests of speech perception may underestimate or misrepresent the actual speech perception abilities of adults with a hearing impairment. This study investigates this contention by devising an assessment that may better simulate some aspects of "real-life" speech perception. A group of 31 participants with a severe-to-profound hearing impairment took part in a series of speech perception tests while wearing their hearing aids. The tests used question/answer or adjacency pairs, where the stimulus sentence was preceded by a question spoken by the participant. Four conditions were included: (a) where there was no initiating sentence, as in a traditional open-set speech perception test; (b) where the initiating question was neutral (e.g. "Why?"); (c) where there was a disruptive semantic relationship between the question and answer; and (d) where there was a strong contextual relationship between the question and answer. The time delay between the question and answer was also varied. Results demonstrated that in all conditions where there was a preceding question speech perception improved, and increasing the cohesion between the question and the reply improved speech perception scores. Additionally, time delay and the relatedness of the reply interacted. The effects of semantic context appeared to diminish over a 10-s period while other linguistic effects remained more constant. These results indicate the utility of simulating communicative environments within speech perception tests.

Adult↗

Potential perceptual bases for successful use of a vibrotactile speech perception aid.

This paper examines the possibility that perception of vibrotactile speech stimuli is enhanced in adults with early and life-long use of hearing aids. We present evidence that vibrotactile aid benefit in adults is directly related to the age at which the hearing aid was fitted and the duration of its use. The stimulus mechanism responsible for this effect is hypothesized to be long-term vibrotactile stimulation by high powered hearing aids. We speculate on possible mechanisms for enhanced vibrotactile speech perception as the result of hearing aid use: (1) long-term experience receiving degraded or improverished speech stimuli results in a speech processing system that is more effective for novel stimuli, independent of perceptual modality; and/or (2) long-term sensory/perceptual experience causes neural changes that result in more effective delivery of speech information via somatosensory pathways.

Adolescent↗

Testing the concurrent and predictive relations among articulation accuracy, speech perception, and phoneme awareness.

The relations among articulation accuracy, speech perception, and phoneme awareness were examined in a sample of 97 typically developing children ages 48 to 66 months. Of these 97 children, 46 were assessed twice at ages 4 and 5 years. Children completed two tasks for each of the three skills, assessing these abilities for the target phoneme /r/ and the control phoneme /m/ in the word-initial position. Concurrent analyses revealed that phoneme-specific relations existed among articulation, awareness, and perception. Articulation accuracy of /r/ predicted speech perception and phoneme awareness for /r/ after controlling for age, vocabulary, letter-word knowledge, and speech perception or phoneme awareness for the control phoneme /m/. The longitudinal analyses confirmed the pattern of relations. The findings are consistent with a model whereby children's articulation accuracy affects preexisting differences in phonological representations and, consequently, affects how children perceive, discriminate, and manipulate speech sounds.

Child↗

Tactile-auditory speech perception by unimodally and bimodally trained normal-hearing subjects.

The following study compared the effectiveness of unimodal and bimodal training strategies at improving the perception of speech information under a variety of conditions. Normal-hearing subjects were trained in the perception of vowel and consonant stimuli. Speech information was provided either via a multiple channel electrotactile speech processing aid (the Tickle Talker), and/or by a 200-Hz low-pass filtered auditory signal. Two subjects were trained only in the combined tactile-plus-auditory (TA) condition; the remaining two were trained in both the tactile-alone (T) and auditory-alone (A) conditions; however, only one condition was used at any single time. All subjects were evaluated in the TA, T, and A conditions, both at the beginning of the study, prior to training, and at the completion of training, on closed-set vowel and consonant confusion tests, and on an open-set word test. Results indicated that whilst statistically significant improvements occurred from one evaluation period to the next, in both groups of subjects, the improvements per condition were not dependent on the type of training received. The results provide a preliminary indication that the provision of unimodal training does not impair the perception of speech information under bimodal perception conditions.

Acoustic Stimulation↗