Outcome after cochlear implantation and auditory verbal training in terms of speech perception, speech production and language.
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Adolescent↗
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Results for “Speech Perception”
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Cochlear implants in young children: the relationship between speech perception and speech intelligibility.
OBJECTIVE: To determine the relationship between measures of speech perception and speech production after cochlear implantation of young children with profound congenital and prelingual deafness. DESIGN: A prospective study was undertaken on a consecutive group of children with profound deafness. There were 126 children at the preimplantation interval and 71, 50, 26, and 20 children, respectively, at the 2, 3, 4, and 5 yr follow-up after implantation. Speech perception and speech intelligibility were assessed using hierarchical rating scales. Spearman rank correlation coefficients were used to determine the statistical correlations. All patients were either congenitally deaf or deafened before the age of 3 yr and were implanted before age 7 yr. The patients all received the Nucleus multichannel cochlear implant system with the most appropriate speech encoding strategy. RESULTS: Speech intelligibility at 5 yr was strongly correlated with speech perception at the 2, 3, 4, and 5 yr intervals after implantation (Spearman coefficients 0.77, 0.81, 0.58, 0.58; p < or = 0.01). Speech intelligibility at the 2, 3, and 4 yr intervals also correlated in a similar manner with earlier speech perception abilities (p < or = 0.01). CONCLUSIONS: The results suggest that speech intelligibility between 2 and 5 yr after implantation in young children with congenital and prelingual profound deafness can be predicted by measures of earlier speech perception.
Age Factors↗
The effects of input-output configuration in syllabic compression on speech perception.
Speech perception was tested through a broad-band syllabic compressor with four different static input-output configurations. All other parameters of the compressor were held constant. The compressor was implemented digitally and incorporated a delay to reduce overshoot. We studied four different input-output configurations, including a linear reference condition. Normal-hearing and hearing-impaired subjects participated in the experiments testing perception of meaningful sentences as well as nonsense CVCs in carrier phrases. The speech materials were presented in quiet and in noise. The results from the CVCs were analyzed quantitatively in terms of scores and qualitatively in terms of phoneme confusions. Differences in speech perception due to the different input-output configurations were small. The input-output configuration with the highest amplification of low amplitude sounds yielded the best results. Detailed analysis of the results included a correlational analysis with a number of auditory functions characterizing the ears tested. The pure-tone audiogram provided parameters of auditory sensitivity: average audiometric loss and audiometric slope. Psychophysical tests provided parameters of temporal resolution and frequency selectivity: the temporal resolution factor, temporal gap detection, and auditory filter shape. The correlational analysis showed that the subjects with better temporal acuity obtained better results.
Adolescent↗
Speech perception and speech intelligibility in children after cochlear implantation.
OBJECTIVE: This study aimed to evaluate the long-term speech perception and speech intelligibility of congenitally and prelingually deaf children after cochlear implantation. It was a longitudinal study following 63 congenitally or prelingually deaf children up to 5 years after implantation. They each received a nucleus multichannel cochlear implant before they were 10 years old. METHODS: Perception is evaluated using the Test for the Evaluation of Voice Perception and Production (TEPP) and concerns closed- and open-set word and sentence perception without lip-reading. The intelligibility is classified according to the Speech Intelligibility Rating (SIR). The evaluations have been made every 3 months for 1 year, then at 18 months, 2 years, 3 years and 5 years after the cochlear implantation. RESULTS: After 5 years of implantation, the median percentage of closed-words speech perception (CSW) is 95.5%-93.67% for closed-sentence speech perception (CSS) and 76.3% for open-sentence speech perception (OSS); the median Speech Intelligibility Rating is 3.83. CONCLUSIONS: Congenitally and prelingually deaf children who receive cochlear implant before the age of 10 years develop speech perception and speech intelligibility abilities. The closed-set perception progresses quickly and seems to reaching a plateau at 5 years post implantation. The improvement of open-sentence perception is not significant until the first year post implantation. The speech intelligibility improves regularly the five first year post implantation.
Audiometry, Speech↗
Development of speech perception and speech production in a primary school-age child using Tactaid VII.
An 11-year-old, profoundly deaf boy was fitted with a Tactaid VII in 1993, and he has received fortnightly training sessions since. There have been significant and functional gains in speech perception, speech production, and speech-reading, particularly in the perception and production of spectral features. These changes and the assessment results obtained will be discussed in the paper.
Child↗
Speech perception and speech production skills of children with multichannel cochlear implants.
The acquisition of speech perception and speech production skills emerges over a protracted time course in congenitally deaf children with multichannel cochlear implants (CI). Only through comprehensive, longitudinal studies can the full impact of cochlear implantation be assessed. In this study, the performance of CI users was examined longitudinally on a battery of speech perception measures and compared with subjects with profound hearing loss who used conventional hearing aids (HA). The average performance of the multichannel cochlear implant users gradually increased over time and continued to improve even after 5 years of CI use. Speech intelligibility was assessed from recordings of the subjects' elicited speech and played to panels of listeners. Intelligibility was scored in terms of percentage of words correctly understood. The average scores for subjects who had used their CI for 4 years or more exceeded 40%.
Child, Preschool↗
Left posterior auditory-related cortices participate both in speech perception and speech production: Neural overlap revealed by fMRI.
Recent neuroimaging studies and neuropsychological data suggest that there are regions in posterior auditory cortex that participate both in speech perception and speech production. An outstanding question is whether the same neural regions support both perception and production or whether there exist discrete cortical fields subserving these functions. Previous neurophysiological studies suggest that there is indeed regional overlap between these systems, but those studies used a rehearsal task to assess production. The present study addressed this question in an event-related fMRI experiment in which subjects listened to speech and in separate trials, performed a covert object naming task. Single subject analysis revealed regions of coactivation for speech perception and production in the left posterior superior temporal sulcus (pSTS), left area Spt (a region in the Sylvian fissure at the parietal-temporal boundary), and left inferior frontal gyrus. These results are consistent with lesion data and previous physiological data indicating that posterior auditory cortex plays a role in both reception and expression of speech. We discuss these findings within the context of a neuroanatomical framework that proposes these neural sites are a part of an auditory-motor integration system.
Auditory Cortex↗
Using links between speech perception and speech production to evaluate different acoustic metrics: a preliminary report.
This paper examines whether correlations between speech perception and speech production exist, and, if so, whether they might provide a way of evaluating different acoustic metrics. The cues listeners use for many phonemic distinctions are not known, often because many different acoustic cues are highly correlated with one another, making it difficult to distinguish among them. Perception-production correlations may provide a new means of doing so. In the present paper, correlations were examined between acoustic measures taken on listeners' perceptual prototypes for a given speech category and on their average production of members of that category. Significant correlations were found for VOT among stop consonants, and for spectral peaks (but not centroids or skewness) for voiceless fricatives. These results suggest that correlations between speech perception and production may provide a methodology for evaluating different proposed acoustic metrics.
Female↗
Conversion from the SPEAK to the ACE strategy in children using the nucleus 24 cochlear implant system: speech perception and speech production outcomes.
OBJECTIVE: The main objective of this study was to assess whether speech perception and speech production in children using the Nucleus 24 cochlear implant system improved with a change in speech processing strategy from the SPEAK to the Advanced Combination Encoder (ACE) strategy. The major difference between the two strategies is that ACE uses a higher stimulation rate (in this study the stimulation rate was 900 Hz per channel) compared with the SPEAK strategy, where the stimulation rate is 250 Hz per channel. Information also was obtained regarding the adjustment period after conversion to the ACE strategy. DESIGN: An ABA experimental design was used where scores were initially obtained using the SPEAK strategy' (in the initial A time interval), and subsequently performance was assessed using the ACE strategy (B time interval) and then again with the SPEAK strategy (second A time interval). The duration of the B interval was 10 wk, and the duration for the second A interval was 4 wk. Seven children aged between 9 and 16 yr who had at least 6 mo experience with the SPEAK strategy participated. Open-set monosyllabic CNC word perception in quiet and Speech Intelligibility Test sentence perception in noise was evaluated at the end of each of the time intervals. Word perception was also monitored at fortnightly intervals during the B time interval. Speech production was assessed at the end of the initial A time interval and at the end of the B time interval. RESULTS: Mean word and phoneme scores for open-set words in quiet for the group of seven children were significantly higher with the ACE strategy as compared with the SPEAK strategy scores obtained in both of the A time intervals. For sentences in noise, mean scores using the ACE strategy as well as the SPEAK strategy at the second A evaluation point were significantly higher than the scores using the SPEAK strategy measured at the first A time interval. This suggests that learning effects may have influenced outcomes. For some subjects, an initial decrease in scores was found during the initial 2-wk period after fitting the ACE strategy; however, scores subsequently were found to be similar to or higher than those when using the initial SPEAK strategy. Analysis of speech production assessments showed an improvement in the medial consonant scores after using the ACE strategy. CONCLUSIONS: This study demonstrated that some children were able to benefit from the additional information provided by the ACE strategy as compared with the SPEAK strategy. However, the differences in overall performance between the two strategies appear to be relatively small.
Acoustic Stimulation↗
Cochlear implantation in children deafened by cytomegalovirus: speech perception and speech intelligibility outcomes.
BACKGROUND: Concerns have been expressed with regard to suitability for cochlear implantation of children deafened by cytomegalovirus because of possible coexisting central disorders/learning difficulties. The aim of the current study was to assess speech perception and intelligibility of speech produced by children deafened by cytomegalovirus and compare their progress with that of congenitally deaf children after cochlear implantation. METHODS: The study assessed 16 implanted children who were deafened by cytomegalovirus, using the Iowa Closed Sentence Test and Speech Intelligibility Rating. The results were compared with those of a group of 131 children who had undergone implantation who were congenitally deaf but did not have cytomegalovirus as the cause of deafness. The mean age at implantation was 3.9 years for the cytomegalovirus group (median, 3.5 years) and 4.1 years (median, 4 years) for the congenitally deaf children. They all received the Nucleus multichannel cochlear implant system. The follow-up period ranged from 1 to 5 years after implantation for both groups. RESULTS: After cochlear implantation, the intelligibility of speech produced by children deafened by cytomegalovirus had a wide range, varying from unintelligible speech to connected speech intelligible to all listeners. Relative to the median score for the control group at the last evaluation interval, 3 of the 16 children with cytomegalovirus (19%) performed better, 8 children (50%) performed more poorly, and 5 (31%) performed the same. The difference between the two groups was not statistically significant (p > 0.05). With regard to speech perception Iowa Sentence Test (Level B), relative to the median score for the control group at the last evaluation interval, 5 of the 16 children with cytomegalovirus (31%) performed better, 3 children (19%) performed more poorly, and 8 (50%) performed the same. The difference between the two groups was not statistically significant (p > 0.05). With regard to Level A and relative to the median score for the control group at the last evaluation interval, 1 of the 16 children with cytomegalovirus (6%) performed better, 6 children (38%) performed more poorly, and 9 (56%) performed the same. The difference between the two groups was statistically significant (p = 0.04). CONCLUSION: The results of the current study showed that cytomegalovirus alone, as a cause of deafness, is not a contraindication for cochlear implantation. Parents should be informed about the wide range of linguistic outcomes after implantation and that these children may need more specific or intensive rehabilitation. Although additional problems are common and outcomes may, on average, be poorer, cochlear implantation can provide useful auditory input to these children. Further research is needed to identify factors associated with cytomegalovirus that may influence the outcomes.
Case-Control Studies↗
Speech perception and speech comprehension investigations of pre-term newborns and high-risk neonates of pre-school age.
The purpose of this study is to establish whether there is any connection between neonatal morbidity and speech perception and comprehension in children of pre-school age who have previously been treated as newborn infants in an intensive care unit. The test applied is a method invented in Hungary for the analysis of global hearing, speech perception and comprehension. The authors summarize the results of their follow-up studies of 52 children with respiratory disorders as newborns, some of whom were born as pre-term and some as full-term newborns with asphyxia. The children have been put into three groups according to their maturity and their birthweight. Newborns with hearing loss and mental retardation were excluded from this study. Of the various neonatal factors the results show: complications of delivery, birthweight, hypoxia, persistent ductus arteriosus, duration of ventilation and complications of respiratory treatment are found to be correlated to perception and comprehension. Incidences of poor achievement obtained in the most characteristic subtests have been compared among the different groups of newborns. The intelligence level of pre-school children is found to be closely correlated to speech perception and comprehension.
Asphyxia Neonatorum↗
What is the reference that sound durations are compared with in speech perception?
Speech segment durations are widely used as cues in the phonetic interpretation of speech (during its perception). To devise a system of quantitative rules for the automatic phonetic interpretation of natural speech it is necessary to know with what reference the speech sound duration is to be compared. An experiment with a specially arranged set of stimuli has shown that durations of adjacent sounds in an utterance, namely vowels, are used as the reference for word stress perception in Russian.
Cues↗
Speech perception and speech intelligibility in children with multichannel cochlear implants.
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Age of Onset↗
Functional anatomy of speech perception and speech production: psycholinguistic implications.
This paper presents evidence for a new model of the functional anatomy of speech/language (Hickok & Poeppel, 2000) which has, at its core, three central claims: (1) Neural systems supporting the perception of sublexical aspects of speech are essentially bilaterally organized in posterior superior temporal lobe regions; (2) neural systems supporting the production of phonemic aspects of speech comprise a network of predominately left hemisphere systems which includes not only frontal regions, but also superior temporal lobe regions; and (3) the neural systems supporting speech perception and production partially overlap in left superior temporal lobe. This model, which postulates nonidentical but partially overlapping systems involved in the perception and production of speech, explains why psycho- and neurolinguistic evidence is mixed regarding the question of whether input and output phonological systems involve a common network or distinct networks.
Brain↗
Results of speech perception and speech production training for three prelingually deaf patients using a multiple-electrode cochlear implant.
Five studies were conducted to measure changes in the perception and production of selected speech targets, with training, in three prelingually deaf patients. The two adults and one adolescent were implanted with the Cochlear (Nucleus) multiple-electrode prosthesis. The studies were perception and production of nasal consonants; perception of syllable-final consonants; perception and production of alveolar consonants; auditory-visual perception of alveolar consonants; and perception and production of vowels. Perceptual data were collected in the audition (implant)-alone condition, except for the auditory-visual perception of alveolar consonants where the audition-alone, vision-alone, and auditory-visual conditions were used. Speech perception data in the audition-alone condition were also collected from four postlingually deaf adult implant patients, without training, to indicate differences between the two classes of patients. The three prelingually deaf patients generally showed some improvements in speech production. In perception, improvements were recorded only for individual patients in some studies. The performance of the adolescent was better than that of the two adults in all cases. The perceptual performance of the postlingually deaf patients was superior to that of the prelingually deaf patients in all cases.
Adolescent↗
[Interhemispheric brain asymmetry in speech perception by persons of different age groups and the "effect of directional attention"].
Using dichotic tests, studies have been made on the degree of functional asymmetry of the brain with respect to perception of verbal information in 3-50 years old subjects. Significant age variations were found in the volume of the percepted speech information. Interhemispheral differences in speech perception, which reveal themselves in higher perception of the right ear as compared to the left one, are more evident in children under 10 years. Significant influence of the "effect of voluntary and involuntary attention" of the subjects was noted on the degree of asymmetry of dichotic speech perception, this influence alleviating the intrinsic functional asymmetry of the brain.
Adolescent↗
[Qualitative studies of speech perception for speech audiometry. I. Auditory threshold and phonemic confusion].
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Audiometry, Speech↗
Speech perception skills and speech production intelligibility in French children with prelingual deafness and cochlear implants.
OBJECTIVE: To examine speech perception and production intelligibility in French children with prelingual deafness who received multichannel cochlear implants. DESIGN: Within-subject, repeated-measures design for assessing speech perception and a cross-sectional design for assessing overall speech intelligibility. SETTING: A pediatric cochlear implant center. SUBJECTS: Sixty-four French children with prelingual deafness who received multichannel cochlear implants (mean age at time of implantation, 3 years 11 months) underwent assessment for speech perception. A subset of 16 children who received implants by 3 years of age underwent assessment for speech intelligibility. MAIN OUTCOME MEASURES: Speech perception skills were assessed using phoneme detection, closed-set word and sentence recognition, and modified open-set (MOS) recognition. Speech intelligibility was assessed by asking 50 listeners to identify recorded speech samples from the subjects. Dependent variables for the studies consisted of percent of correct items. RESULTS: After implantation, all children were able to detect phonemes by 3 months. Closed-set word and sentence identification reached 100% accuracy by 48 months (7 children with 4 years of implantation experience). Some children (8 of 48) demonstrated some MOS recognition after 1 year. Modified open-set recognition averaged 67.9% by 42 months (12 children available) and 80% by 48 months (7 children available). Overall speech intelligibility was 4.2% after 1 year, 30.7% after 2 years, 55.2% after 3 years, and 74.2% after 4 years. Within-subject comparison of MOS recognition and overall speech intelligibility scores revealed an insignificant trend for high perceptual performance to be associated with higher speech intelligibility scores (P = .17). There also was a tendency for higher performance to be associated with longer implantation experience. CONCLUSIONS: Speech perception scores appear to increase with increased experience using a cochlear implant. Overall speech intelligibility appears to steadily improve with increased experience and appears to be poorly related to perceptual performance on MOS recognition tasks.
Child, Preschool↗