Speech intelligibility and prosody production in children with cochlear implants

Objectives—The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods—The Beginner\u27s Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood. Results—Percent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant. Discussion—The findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and th

Parent Interaction Between an Infant with a Cochlear Implant and Additional Disabilities

Pediatric hearing loss has many spoken language learning issues that can impact parent-infant interaction. Moreover, additional disabilities are likely to increase stress, which could have cascading effects on communication. The purpose of the study was to examine interactions between mother- and father-child dyads with and without hearing loss and/or Autism Spectrum Disorder (ASD), Cytomegalovirus (CMV), and global delay. Recordings of the parents speaking with six infants in the study were analyzed: an infant with cochlear implants and ASD (low socioeconomic status, SES), two infants with cochlear implants and normal development (high SES and low SES), one infant with a cochlear implant and CMV (average SES), one infant with a cochlear implant and global delay (average SES), and one infant who was typically developing and had normal hearing (high SES). After analyzing the results for communication measures, such as vocalization attempts, turn-taking in utterances, mean-length of utterances, and type-token ratio, it was concluded that maternal and paternal interaction was negatively affected due not only to the difficulty of the hearing loss and/or additional disability, but rather due to a combination of factors, including the disability, SES, maternal and paternal education, and the home environment

A longitudinal study of audiovisual speech perception by hearing-impaired children with cochlear implants

The present study investigated the development of audiovisual speech perception skills in children who are prelingually deaf and received cochlear implants. We analyzed results from the Pediatric Speech Intelligibility (Jerger, Lewis, Hawkins, & Jerger, 1980) test of audiovisual spoken word and sentence recognition skills obtained from a large group of young children with cochlear implants enrolled in a longitudinal study, from pre-implantation to 3 years post-implantation. The results revealed better performance under the audiovisual presentation condition compared with auditory-alone and visual-alone conditions. Performance in all three conditions improved over time following implantation. The results also revealed differential effects of early sensory and linguistic experience. Children from oral communication (OC) education backgrounds performed better overall than children from total communication (TC backgrounds. Finally, children in the early-implanted group performed better than children in the late-implanted group in the auditory-alone presentation condition after 2 years of cochlear implant use, whereas children in the late-implanted group performed better than children in the early-implanted group in the visual-alone condition. The results of the present study suggest that measures of audiovisual speech perception may provide new methods to assess hearing, speech, and language development in young children with cochlear implants

Effects of congenital hearing loss and cochlear implantation on audiovisual speech perception in infants and children

Purpose: Cochlear implantation has recently become available as an intervention strategy for young children with profound hearing impairment. In fact, infants as young as 6 months are now receiving cochlear implants (CIs), and even younger infants are being fitted with hearing aids (HAs). Because early audiovisual experience may be important for normal development of speech perception, it is important to investigate the effects of a period of auditory deprivation and amplification type on multimodal perceptual processes of infants and children. The purpose of this study was to investigate audiovisual perception skills in normal-hearing (NH) infants and children and deaf infants and children with CIs and HAs of similar chronological ages. Methods: We used an Intermodal Preferential Looking Paradigm to present the same woman\u27s face articulating two words ( judge and back ) in temporal synchrony on two sides of a TV monitor, along with an auditory presentation of one of the words. Results: The results showed that NH infants and children spontaneously matched auditory and visual information in spoken words; deaf infants and children with HAs did not integrate the audiovisual information; and deaf infants and children with CIs initially did not initially integrate the audiovisual information but gradually matched the auditory and visual information in spoken words. Conclusions: These results suggest that a period of auditory deprivation affects multimodal perceptual processes that may begin to develop normally after several months of auditory experience

Synchrony, complexity and directiveness in mothers\u27 interactions with infants pre- and post-cochlear implantation

This study investigated effects of profound hearing loss on mother–infant interactions before and after cochlear implantation with a focus on maternal synchrony, complexity, and directiveness. Participants included two groups of mother–infant dyads: 9 dyads of mothers and infants with normal hearing; and 9 dyads of hearing mothers and infants with profound hearing loss. Dyads were observed at two time points: Time 1, scheduled to occur before cochlear implantation for infants with profound hearing loss (mean age = 13.6 months); and Time 2 (mean age = 23.3 months), scheduled to occur approximately six months after cochlear implantation. Hearing infants were age-matched to infants with hearing loss at both time points. Dependent variables included the proportion of maternal utterances that overlapped infant vocalizations, maternal mean length of utterance, infant word use, and combined maternal directives and prohibitions. Results showed mothers’ utterances overlapped the vocalizations of infants with hearing loss more often before cochlear implantation than after, mothers used less complex utterances with infants with cochlear implants compared to hearing peers (Time 2), and mothers of infants with profound hearing loss used frequent directives and prohibitions both before and after cochlear implantation. Together, mothers and infants adapted relatively quickly to infants’ access to cochlear implants, showing improved interactional synchrony, increased infant word use, and levels of maternal language complexity compatible with infants’ word use, all within seven months of cochlear implant activation

Neuro-electronic technology in medicine and beyond

This dissertation looks at the technology and social issues involved with interfacing electronics directly to the human nervous system, in particular the methods for both reading and stimulating nerves. The development and use of cochlea implants is discussed, and is compared with recent developments in artificial vision. The final sections consider a future for non-medicinal applications of neuro-electronic technology. Social attitudes towards use for both medicinal and non-medicinal purposes are discussed, and the viability of use in the latter case assessed

Auditory training strategies for adult users of cochlear implants

There has been growing interest recently in whether computer-based training can improve speech perception among users of cochlear implants (Fu et al., 2005; Oba et al., 2011; Ingvalson et al., 2013). This paper reports a series of experiments which first evaluated the effectiveness of different training strategies with normal-hearing participants who listened to noise-vocoded speech, before conducting a small-scale study with users of cochlear implants. Our vocoder studies revealed (1) that ‘High-Variability’ training led to greater generalisation to new talkers than training with a single talker, and (2) that word-and sentence-based training materials led to greater improvements than an approach based on phonemes in nonsense syllables. Informed by these findings, we evaluated the effectiveness of a computer-based training package that included word-and sentence-based tasks, with materials recorded by 20 talkers. We found good compliance with the training protocol, with 8 out of the 11 participants completing 15 hours of training as instructed. Following training, there was a significant improvement on a consonant test, but in general the improvements were small, highly variable, and not statistically significant. A large-scale randomised controlled trial is needed before we can be confident that computer-based auditory training is worthwhile for users of cochlear implants

Frontal brain asymmetries as effective parameters to assess the quality of audiovisual stimuli perception in adult and young cochlear implant users

How is music perceived by cochlear implant (CI) users? This question arises as "the next step" given the impressive performance obtained by these patients in language perception. Furthermore, how can music perception be evaluated beyond self-report rating, in order to obtain measurable data? To address this question, estimation of the frontal electroencephalographic (EEG) alpha activity imbalance, acquired through a 19-channel EEG cap, appears to be a suitable instrument to measure the approach/withdrawal (AW index) reaction to external stimuli. Specifically, a greater value of AW indicates an increased propensity to stimulus approach, and vice versa a lower one a tendency to withdraw from the stimulus. Additionally, due to prelingually and postlingually deafened pathology acquisition, children and adults, respectively, would probably differ in music perception. The aim of the present study was to investigate children and adult CI users, in unilateral (UCI) and bilateral (BCI) implantation conditions, during three experimental situations of music exposure (normal, distorted and mute). Additionally, a study of functional connectivity patterns within cerebral networks was performed to investigate functioning patterns in different experimental populations. As a general result, congruency among patterns between BCI patients and control (CTRL) subjects was seen, characterised by lowest values for the distorted condition (vs. normal and mute conditions) in the AW index and in the connectivity analysis. Additionally, the normal and distorted conditions were significantly different in CI and CTRL adults, and in CTRL children, but not in CI children. These results suggest a higher capacity of discrimination and approach motivation towards normal music in CTRL and BCI subjects, but not for UCI patients. Therefore, for perception of music CTRL and BCI participants appear more similar than UCI subjects, as estimated by measurable and not self-reported parameters

Early exposure to both sign and spoken language for children who are deaf or hard of hearing: Might it help spoken language development?

The literature on the benefits and deficits of bilingualism is reviewed with an emphasis on sign/spoken bilingualism and on the population of deaf or hard of hearing children. Since there are a limited number of reports on sign/spoken bilingualism for these children, a research plan is outlined for a large study whose results could have a significant impact on oral education policy and spoken language development in deaf or hard of hearing children