Speechreading in Deaf Adults with Cochlear Implants: Evidence for Perceptual Compensation

Previous research has provided evidence for a speechreading advantage in congenitally deaf adults compared to hearing adults. A ‘perceptual compensation’ account of this finding proposes that prolonged early onset deafness leads to a greater reliance on visual, as opposed to auditory, information when perceiving speech which in turn results in superior visual speech perception skills in deaf adults. In the current study we tested whether previous demonstrations of a speechreading advantage for profoundly congenitally deaf adults with hearing aids, or no amplificiation, were also apparent in adults with the same deafness profile but who have experienced greater access to the auditory elements of speech via a cochlear implant (CI). We also tested the prediction that, in line with the perceptual compensation account, receiving a CI at a later age is associated with superior speechreading skills due to later implanted individuals having experienced greater dependence on visual speech information. We designed a speechreading task in which participants viewed silent videos of 123 single words spoken by a model and were required to indicate which word they thought had been said via a free text response. We compared congenitally deaf adults who had received CIs in childhood or adolescence (N = 15) with a comparison group of hearing adults (N = 15) matched on age and education level. The adults with CI showed significantly better scores on the speechreading task than the hearing comparison group. Furthermore, within the group of adults with CI, there was a significant positive correlation between age at implantation and speechreading performance; earlier implantation was associated with lower speechreading scores. These results are both consistent with the hypothesis of perceptual compensation in the domain of speech perception, indicating that more prolonged dependence on visual speech information in speech perception may lead to improvements in the perception of visual speech. In addition our study provides metrics of the ‘speechreadability’ of 123 words produced in British English: one derived from hearing adults (N = 61) and one from deaf adults with CI (N = 15). Evidence for the validity of these ‘speechreadability’ metrics come from correlations with visual lexical competition data

How auditory experience differentially influences the function of left and right superior temporal cortices

To investigate how hearing status, sign language experience and task demands influence functional responses in the human superior temporal cortices (STC) we collected fMRI data from deaf and hearing participants (male and female), who either acquired sign language early or late in life. Our stimuli in all tasks were pictures of objects. We varied the linguistic and visuospatial processing demands in three different tasks that involved decisions about (1) the sublexical (phonological) structure of the British Sign Language (BSL) signs for the objects; (2) the semantic category of the objects; and (3) the physical features of the objects. Neuroimaging data revealed that in participants who were deaf from birth, STC showed increased activation during visual processing tasks. Importantly, this differed across hemispheres. Right STC was consistently activated regardless of the task whereas left STC was sensitive to task demands. Significant activation was detected in the left STC only for the BSL phonological task. This task, we argue, placed greater demands on visuospatial processing than the other two tasks. In hearing signers, enhanced activation was absent in both left and right STC during all three tasks. Lateralisation analyses demonstrated that the effect of deafness was more task-dependent in the left than the right STC whereas it was more task-independent in the right than the left STC. These findings indicate how the absence of auditory input from birth leads to dissociable and altered functions of left and right STC in deaf participants

Speechreading Development in Deaf and Hearing Children: Introducing the Test of Child Speechreading

Purpose: In this article, the authors describe the development of a new instrument, the Test of Child Speechreading (ToCS), which was specifically designed for use with deaf and hearing children. Speechreading is a skill that is required for deaf children to access the language of the hearing community. ToCS is a deaf-friendly, computer-based test that measures child speechreading (silent lipreading) at 3 psycholinguistic levels: (a) Words, (b) Sentences, and (c) Short Stories. The aims of the study were to standardize the ToCS with deaf and hearing children and to investigate the effects of hearing status, age, and linguistic complexity on speechreading ability. / Method: Eighty-six severely and profoundly deaf children and 91 hearing children participated. All children were between the ages of 5 and 14 years. The deaf children were from a range of language and communication backgrounds, and their preferred mode of communication varied. / Results: Speechreading skills significantly improved with age for both groups of children. There was no effect of hearing status on speechreading ability, and children from both groups showed similar performance across all subtests of the ToCS. / Conclusion: The ToCS is a valid and reliable assessment of speechreading ability in school-age children that can be used to measure individual differences in performance in speechreading ability

The impact of early language exposure on the neural system supporting language in deaf and hearing adults

Deaf late signers provide a unique perspective on the impact of impoverished early language exposure on the neurobiology of language: insights that cannot be gained from research with hearing people alone. Here we contrast the effect of age of sign language acquisition in hearing and congenitally deaf adults to examine the potential impact of impoverished early language exposure on the neural systems supporting a language learnt later in life. We collected fMRI data from deaf and hearing proficient users (N = 52) of British Sign Language (BSL), who learnt BSL either early (native) or late (after the age of 15 years) whilst they watched BSL sentences or strings of meaningless nonsense signs. There was a main effect of age of sign language acquisition (late > early) across deaf and hearing signers in the occipital segment of the left intraparietal sulcus. This finding suggests that late learners of sign language may rely on visual processing more than early learners, when processing both linguistic and nonsense sign input - regardless of hearing status. Region-of-interest analyses in the posterior superior temporal cortices (STC) showed an effect of age of sign language acquisition that was specific to deaf signers. In the left posterior STC, activation in response to signed sentences was greater in deaf early signers than deaf late signers. Importantly, responses in the left posterior STC in hearing early and late signers did not differ, and were similar to those observed in deaf early signers. These data lend further support to the argument that robust early language experience, whether signed or spoken, is necessary for left posterior STC to show a 'native-like' response to a later learnt language

Sign and speech share partially overlapping conceptual representations

Conceptual knowledge is fundamental to human cognition. Yet the extent to which it is influenced by language is unclear. Studies of semantic processing show that similar neural patterns are evoked by the same concepts presented in different modalities (e.g. spoken words and pictures or text) [1–3]. This suggests that conceptual representations are ‘modality independent’. However, an alternative possibility is that the similarity reflects retrieval of common spoken language representations. Indeed, in hearing spoken language users, text and spoken language are co-dependent [4,5] and pictures are encoded via visual and verbal routes [6]. A parallel approach investigating semantic cognition, shows that bilinguals activate similar patterns for the same words in their different languages [7,8]. This suggests that conceptual representations are ‘language independent’. However, this has only been tested in spoken language bilinguals. If different languages evoke different conceptual representations, this should be most apparent comparing languages that differ greatly in structure. Hearing people with signing deaf parents are bilingual in sign and speech: languages conveyed in different modalities. Here we test the influence of modality and bilingualism on conceptual representation by comparing semantic representations elicited by spoken British English and British Sign Language in hearing early, sign-speech bilinguals. We show that representations of semantic categories are shared for sign and speech, but not for individual spoken words and signs. This provides evidence for partially shared representations for sign and speech, and shows that language acts as a subtle filter through which we understand and interact with the world

How auditory experience differentially influences the function of left and right superior temporal cortices

To investigate how hearing status, sign language experience and task demands influence functional responses in the human superior temporal cortices (STC) we collected fMRI data from deaf and hearing participants (male and female), who either acquired sign language early or late in life. Our stimuli in all tasks were pictures of objects. We varied the linguistic and visuospatial processing demands in three different tasks that involved decisions about (1) the sublexical (phonological) structure of the British Sign Language (BSL) signs for the objects; (2) the semantic category of the objects; and (3) the physical features of the objects.Neuroimaging data revealed that in participants who were deaf from birth, STC showed increased activation during visual processing tasks. Importantly, this differed across hemispheres. Right STC was consistently activated regardless of the task whereas left STC was sensitive to task demands. Significant activation was detected in the left STC only for the BSL phonological task. This task, we argue, placed greater demands on visuospatial processing than the other two tasks. In hearing signers, enhanced activation was absent in both left and right STC during all three tasks. Lateralisation analyses demonstrated that the effect of deafness was more task-dependent in the left than the right STC whereas it was more task-independent in the right than the left STC. These findings indicate how the absence of auditory input from birth leads to dissociable and altered functions of left and right STC in deaf participants.SIGNIFICANCE STATEMENTThose born deaf can offer unique insights into neuroplasticity, in particular in regions of superior temporal cortex (STC) that primarily respond to auditory input in hearing people. Here we demonstrate that in those deaf from birth the left and the right STC have altered and dissociable functions. The right STC is activated regardless of demands on visual processing. In contrast, the left STC is sensitive to the demands of visuospatial processing. Furthermore, hearing signers, with the same sign language experience as the deaf participants, did not activate the STCs. Our data advance current understanding of neural plasticity by determining the differential effects that hearing status and task demands can have on left and right STC function

Motor excitability during visual perception of known and unknown spoken languages

It is possible to comprehend speech and discriminate languages by viewing a speaker’s articulatory movements. Transcranial magnetic stimulation studies have shown that viewing speech enhances excitability in the articulatory motor cortex. Here, we investigated the specificity of this enhanced motor excitability in native and non-native speakers of English. Both groups were able to discriminate between speech movements related to a known (i.e., English) and unknown (i.e., Hebrew) language. The motor excitability was higher during observation of a known language than an unknown language or non-speech mouth movements, suggesting that motor resonance is enhanced specifically during observation of mouth movements that convey linguistic information. Surprisingly, however, the excitability was equally high during observation of a static face. Moreover, the motor excitability did not differ between native and non-native speakers. These findings suggest that the articulatory motor cortex processes several kinds of visual cues during speech communication

Identification of the regions involved in phonological assembly using a novel paradigm.

Here we adopt a novel strategy to investigate phonological assembly. Participants performed a visual lexical decision task in English in which the letters in words and letterstrings were delivered either sequentially (promoting phonological assembly) or simultaneously (not promoting phonological assembly). A region of interest analysis confirmed that regions previously associated with phonological assembly, in studies contrasting different word types (e.g. words versus pseudowords), were also identified using our novel task that controls for a number of confounding variables. Specifically, the left pars opercularis, the superior part of the ventral precentral gyrus and the supramarginal gyrus were all recruited more during sequential delivery than simultaneous delivery, even when various psycholinguistic characteristics of the stimuli were controlled. This suggests that sequential delivery of orthographic stimuli is a useful tool to explore how readers, with various levels of proficiency, use sublexical phonological processing during visual word recognition

Cochlear implantation (CI) for prelingual deafness: the relevance of studies of brain organization and the role of first language acquisition in considering outcome success.

Cochlear implantation (CI) for profound congenital hearing impairment, while often successful in restoring hearing to the deaf child, does not always result in effective speech processing. Exposure to non-auditory signals during the pre-implantation period is widely held to be responsible for such failures. Here, we question the inference that such exposure irreparably distorts the function of auditory cortex, negatively impacting the efficacy of CI. Animal studies suggest that in congenital early deafness there is a disconnection between (disordered) activation in primary auditory cortex (A1) and activation in secondary auditory cortex (A2). In humans, one factor contributing to this functional decoupling is assumed to be abnormal activation of A1 by visual projections-including exposure to sign language. In this paper we show that that this abnormal activation of A1 does not routinely occur, while A2 functions effectively supramodally and multimodally to deliver spoken language irrespective of hearing status. What, then, is responsible for poor outcomes for some individuals with CI and for apparent abnormalities in cortical organization in these people? Since infancy is a critical period for the acquisition of language, deaf children born to hearing parents are at risk of developing inefficient neural structures to support skilled language processing. A sign language, acquired by a deaf child as a first language in a signing environment, is cortically organized like a heard spoken language in terms of specialization of the dominant perisylvian system. However, very few deaf children are exposed to sign language in early infancy. Moreover, no studies to date have examined sign language proficiency in relation to cortical organization in individuals with CI. Given the paucity of such relevant findings, we suggest that the best guarantee of good language outcome after CI is the establishment of a secure first language pre-implant-however that may be achieved, and whatever the success of auditory restoration

Enhanced activation of the left inferior frontal gyrus in deaf and dyslexic adults during rhyming

Hearing developmental dyslexics and profoundly deaf individuals both have difficulties processing the internal structure of words (phonological processing) and learning to read. In hearing non-impaired readers, the development of phonological representations depends on audition. In hearing dyslexics, many argue, auditory processes may be impaired. In congenitally profoundly deaf individuals, auditory speech processing is essentially absent. Two separate literatures have previously reported enhanced activation in the left inferior frontal gyrus in both deaf and dyslexic adults when contrasted with hearing non-dyslexics during reading or phonological tasks. Here, we used a rhyme judgement task to compare adults from these two special populations to a hearing non-dyslexic control group. All groups were matched on non-verbal intelligence quotient, reading age and rhyme performance. Picture stimuli were used since this requires participants to generate their own phonological representations, rather than have them partially provided via text. By testing well-matched groups of participants on the same task, we aimed to establish whether previous literatures reporting differences between individuals with and without phonological processing difficulties have identified the same regions of differential activation in these two distinct populations. The data indicate greater activation in the deaf and dyslexic groups than in the hearing non-dyslexic group across a large portion of the left inferior frontal gyrus. This includes the pars triangularis, extending superiorly into the middle frontal gyrus and posteriorly to include the pars opercularis, and the junction with the ventral precentral gyrus. Within the left inferior frontal gyrus, there was variability between the two groups with phonological processing difficulties. The superior posterior tip of the left pars opercularis, extending into the precentral gyrus, was activated to a greater extent by deaf than dyslexic participants, whereas the superior posterior portion of the pars triangularis extending into the ventral pars opercularis, was activated to a greater extent by dyslexic than deaf participants. Whether these regions play differing roles in compensating for poor phonological processing is not clear. However, we argue that our main finding of greater inferior frontal gyrus activation in both groups with phonological processing difficulties in contrast to controls suggests greater reliance on the articulatory component of speech during phonological processing when auditory processes are absent (deaf group) or impaired (dyslexic group). Thus, the brain appears to develop a similar solution to a processing problem that has different antecedents in these two populations