Influence of communication mode on speech intelligibility and syntactic structure of sentences in profoundly hearing impaired French children implanted between 5 and 9 years of age

Abstract

Objective: The purpose of this study was to examine the speech production in French profoundly hearing impaired children, focusing on word intelligibility, sentences syntax, and sentence pattern stages, by incorporating direct comparisons between speech production skills and communication modes in the same children. Design: The design of the study incorporated a within-subject, repeated measures design for assessing speech production intelligibility and syntax. Setting: Montpellier Pediatric Cochlear Implant Center. Subjects: Twelve prelingually deafened French children who received a Nucleus multichannel cochlear implant (mean age at the time of implantation was 7 years 2 months) served as subjects for the speech production assessment. Main outcome measures: Speech production intelligibility, syntax, and sentence pattern stages were assessed at 1, 2 and 3 years postimplant. Speech production skills were related to the communication mode of the children (auditory–oral, four children; cued-speech, four children; sign-language, four children). Results: Scores on word intelligibility steadily improved with increased experience with the implant, ranging from 18% before implantation to 54.5% at 36 months postimplantation in the overall population. The highest scores were found in the cued-speech group with an averaged score of 66.8% at 36 months postimplant. The number of syntactic elements increased over time with implant experience. Children receiving cued-speech education had higher scores by 3 years postimplantation than children receiving either auditory–oral or sign-language modes of communication. Language level (sentence pattern stages) also improved with increased experience with the device. By 3 years postimplantation, children receiving auditory–oral or cued-speech instruction were able to produce sentences; however, the sign-language children failed to do so at a rate comparable to the other children. Language level was significantly higher in the oralist or cued-speech educated children than in the sign-language group. Conclusions: Speech production skills improved with increased experience using a cochlear implant. Word intelligibility, syntactic structure of sentences, sentence pattern stages improved gradually over time. Production skills were greater in the cued-speech educated children group than in the auditory–oral or sign-language groups. Statistically better sentence pattern stages were found in the auditory–oral and sign-language groups.