Language use within a national cohort of profoundly hearing-impaired children

Previous research has indicated that perception and production ability are significantly related among L2 learners in natural learning settings. The present study focused on the relation between these two abilities during speech training, specifically examining whether perception or production training alone led to improvements of production or perception ability, and whether the order of perception and production training influenced the improvement of the abilities. Forty-five Japanese university students received thirteen-week perception and production training on six American English contrasts (e.g., b/v, l/r). One group received perception training first, followed by production training, while the order of training was reversed for the other group. It was found that the initial perception training in the former group resulted in a significant but relatively weak transfer to improvements of production ability, while the initial production training in the latter group showed a significant and strong transfer to those of perception ability. It was also shown that the improvements of perception and production ability during the speech training were significantly related in both groups. The order of training, however, did not significantly influence the overall degree of improvements in either of the abilities. Implications for speech learning models will be discussed.

The purpose of this study was to explore the relationship between speech perception, speech production, and vocabulary abilities in children with and without speech sound disorders (SSDs), analyzing the data both by group and continuously. Sixty-one Australian English-speaking children aged 48-69 months participated in this study. Children's speech production abilities ranged along the continuum from SSDs through to typical speech. Their vocabulary abilities ranged along the continuum from typical to above average ("lexically precocious"). Children completed routine speech and language assessments in addition to an experimental Australian English lexical and phonetic judgment task. When analyzing data by group, there was no significant difference between the speech perception ability of children with SSDs and that of children without SSDs. Children with above-average vocabularies had significantly better speech perception ability than children with average vocabularies. When analyzing data continuously, speech production and vocabulary were both significant positive predictors of variance in speech perception ability, both individually in simple linear regression and when combined in multiple linear regression. There was also a significant positive correlation between perception and production of two of the four target phonemes tested (i.e., /k/ and /ʃ/) among children in the SSD group. Results from this study provide further insight into the complex relationship between speech perception, speech production, and vocabulary abilities in children. While there is a clinical and important need for categorical distinctions between SSDs and typically developing speech, findings further highlight the value of investigating speech production and vocabulary abilities continuously and categorically. By capturing the heterogeneity among children's speech production and vocabulary abilities, we can advance our understanding of SSDs in children. https://doi.org/10.23641/asha.22229674.

An extensive project that aims to assess innate phonetic talent is introduced. It investigates language performance of 103 native speakers of German in their native language, in English and (to a limited degree) in Hindi. The project’s original priority is to establish a talent score that serves as the basis for a neurolinguistic study which attempts to find correlates between phonetic talent and brain anatomy/function. For this purpose tasks investigating neurobiological, psychological, and other factors influencing performance are also conducted. Innate talent is to be distinguished from superficial proficiency by limiting or eliminating the influence of interfering factors such as language experience. The test subjects are investigated with respect to different manifestations of their production (e.g., quasi‐spontaneous speech, reading), perception (e.g., discrimination, identification), and imitation abilities in both German and English. A first analysis of the interactions between all perception and production scores shows a significant correlation at the level of p < 0.05. The correlation is especially high (p < 0.01) between perception tasks involving the interpretation of intonational features of both English and German and production abilities (again both in German and English), suggesting a certain cross‐language predictive power.

This study aimed to profile the speech perception and language abilities of a cohort of pediatric cochlear implant (CI) users in primary school years. It also aimed to understand the intercorrelations among audiological, child, and environmental characteristics, speech perception, and language skills and to explore the predictors of speech perception and language skills. A cross-sectional design was used for the study. The participants were 222 pediatric CI users (106 boys; 116 girls) with a mean chronological age of 10.51 (SD ± 1.28) years. Participants had received CIs at a mean age of 2.93 (SD ± 0.95) years, with the mean duration of CI use being 7.43 (SD ± 1.15) years at the time of assessment. Participants completed an assessment battery comprising speech perception (phoneme discrimination, open-set speech perception in quiet) and language (semantics, syntax) tasks. Selected audiological, child, and environmental characteristics were documented. The mean and SDs of the measures across age categories (8 to 12 years) and the proportion of children attaining scores better than 80%, between 50 and 80%, and poorer than 50% of the total possible score in each task were computed to generate a profile of speech perception and language abilities. Correlational and regression analyses assessed the intercorrelations among the variables and predictors of speech perception and language abilities. A large proportion (79.0%) of children in the study group obtained scores better than 80% for phoneme discrimination, whereas only 17.8% scored better than 80% for open-set speech perception in quiet. Additionally, 42.8 and 20.8% of children scored better than 80% for semantics and syntax, respectively. Speech perception and language abilities demonstrated moderate-strong intercorrelations, contributing to a significant proportion of the total variance explained in phoneme discrimination (42.9%), open-set speech perception (61.8%), semantics (63.0%), and syntax (60.8%). Phoneme discrimination and open-set speech perception emerged as large contributors to variance in overall language abilities. Among the audiological factors, only hearing age contributed to a small proportion of variance (3 to 6%) across children's speech perception and language performance. Children using CI demonstrated highly variable performance in speech perception and expressive language skills during primary school. Although children demonstrated improved performance in phoneme discrimination and semantics, they continued to face challenges in the (quiet) speech perception and syntax abilities. The effect of audiological, child, and environmental factors was minimal in explaining the variance in speech perception and language abilities, which shared a bidirectional relationship. The findings relating to mid-term outcomes, ranging from 4 to 9 years after cochlear implantation, suggest the need for continued support and targeted interventions for developing speech perception and language abilities in the primary school years to optimize outcomes among pediatric CI users.

IntroductionThe use of the bilateral cochlear implants can promote the symmetrical development of the central auditory pathways, thus benefiting the development of auditory abilities and improving sound localization and the ability of auditory speech perception in situations of competitive noise. ObjectiveTo evaluate the ability of speech perception in children and adolescents using sequential bilateral cochlear implants, considering the association of these variables: age at surgery, time of device use and interval between surgeries. MethodsA total of 14 individuals between 10 and 16 years of age, who demonstrated surgical indication for the use of sequential bilateral cochlear implants as intervention in the auditory habilitation process, were assessed. The speech perception ability was assessed through sentence lists constructed in the Portuguese language, presented in two situations: in silence, with fixed intensity of 60dB SPL, and in competitive noise, with a signal-to-noise ratio of +15dB. The evaluation was performed under the following conditions: unilateral with the first activated cochlear implant, unilateral with the second activated cochlear implant and bilateral with both devices activated. ResultsThe results of the speech perception tests showed better performance in both silence and in noise for the bilateral cochlear implant condition when compared to the 1st cochlear implant and the 2nd cochlear implant alone. A worse result of speech perception was found using the 2nd cochlear implant alone. No statistically significant correlation was found between age at the surgical procedure, interval between surgeries and the time of use of the 2nd cochlear implant, and the auditory speech perception performance for all assessed conditions. The use of a hearing aid prior to the 2nd cochlear implant resulted in benefits for auditory speech perception with the 2nd cochlear implant, both in silence and in noise. ConclusionThe bilateral cochlear implant provided better speech perception in silence and in noise situations when compared to the unilateral cochlear implant, regardless of the interval between surgeries, age at the surgical procedure and the time of use of the 2nd cochlear implant. Speech perception with the 1st cochlear implant was significantly better than with the 2nd cochlear implant, both in silence and in noise. The use of the hearing aid prior to the 2nd cochlear implant influenced speech perception performance with the 2nd cochlear implant, both in silence and in noise.

Motivated by the fact that English vowel grapheme is pronounced as 3 different vowel sounds, the current study purports to investigate how Korean EFL students perceive and produce English words with grapheme and whether the difficulty associated with perceiving and producing can be improved by training. To this end, perception and production tasks were conducted to 31 Korean EFL students in the forms of the pre-test and post-test. The overall results showed that participants' production abilities were significantly improved while the perception abilities were not. Thus, the effect of training was attested only in production. Significant improvement for individual target vowels was also found in the production domain but not in the perception domain, suggesting that acquisition patterns differ for perception and production. In order to account for the asymmetry in training effects, cross-participant correlational approach was adopted. Since no correlation between perception and production accuracy of the participants was found, it was concluded that perception and production abilities of the participants were developing independently and thus, different acquisition patterns were not surprising.

Auditory development in children with hearing loss, including the perception of prosody, depends on having adequate input from cochlear implants and/or hearing aids. Lack of adequate auditory stimulation can lead to delayed speech and language development. Nevertheless, prosody perception and production in people with hearing loss have received less attention than other aspects of language. The perception of auditory information conveyed through prosody using variations in the pitch, amplitude, and duration of speech is not usually evaluated clinically. This study (1) compared prosody perception and production abilities in children with hearing loss and children with normal hearing; and (2) investigated the effect of age, hearing level, and musicality on prosody perception. Participants were 16 children with hearing loss and 16 typically developing controls matched for age and gender. Fifteen of the children with hearing loss were tested while using amplification (n = 9 hearing aids, n = 6 cochlear implants). Six receptive subtests of the Profiling Elements of Prosody in Speech-Communication (PEPS-C), the Child Paralanguage subtest of Diagnostic Analysis of Nonverbal Accuracy 2 (DANVA 2), and Contour and Interval subtests of the Montreal Battery of Evaluation of Amusia (MBEA) were used. Audio recordings of the children's reading samples were rated using a perceptual prosody rating scale by nine experienced listeners who were blinded to the children's hearing status. Thirty two children, 16 with hearing loss (mean age = 8.71 yr) and 16 age- and gender-matched typically developing children with normal hearing (mean age = 8.87 yr). Assessments were completed in one session lasting 1-2 hours in a quiet room. Test items were presented using a laptop computer through loudspeaker at a comfortable listening level. For children with hearing loss using hearing instruments, all tests were completed with hearing devices set at their everyday listening setting. All PEPS-C subtests and total scores were significantly lower for children with hearing loss compared to controls (p < 0.05). The hearing loss group performed more poorly than the control group in recognizing happy, sad, and fearful emotions in the DANVA 2 subtest. Musicality (composite MBEA scores and musical experience) was significantly correlated with prosody perception scores, but this link was not evident in the regression analyses. Regression modeling showed that age and hearing level (better ear pure-tone average) accounted for 55.4% and 56.7% of the variance in PEPS-C and DANVA 2 total scores, respectively. There was greater variability for the ratings of pitch, pitch variation, and overall impression of prosody in the hearing loss group compared to control group. Prosody perception (PEPS-C and DANVA 2 total scores) and ratings of prosody production were not correlated. Children with hearing loss aged 7-12 yr had significant difficulties in understanding different aspects of prosody and were rated as having more atypical prosody overall than controls. These findings suggest that clinical assessment and speech-language therapy services for children with hearing loss should be expanded to target prosodic difficulties. Future studies should investigate whether musical training is beneficial for improving receptive prosody skills.

It has been postulated that subjects with high levels of oral sensory perception and motor ability are able to achieve higher standards of oral hygiene even under different dietary regimes. In this study, eleven dental personnel volunteers were started on a low-sucrose diet for one week, followed by a high-sucrose diet for another week, while eleven others followed a reverse-order dietary regime. Oral sensory perception and motor ability were assessed by the oral stereognosis test and a test for oral motor ability. There was a greater trend for subjects to have more plaque on their teeth when they were on the high-sucrose diet, even when normal oral hygiene procedures were taken. There were no significant correlations between the state of oral hygiene and levels of oral sensory perception and motor ability. These results do not support the hypothesis that subjects with high levels of oral sensory perception and motor ability are likely to achieve better oral hygiene.

The objectives of this study were to identify variables that are associated with differences in outcome among hearing-impaired children and to control those variables while assessing the impact of cochlear implantation. In a cross-sectional study, the parents and teachers of a representative sample of hearing-impaired children were invited to complete questionnaires about children's auditory performance, spoken communication skills, educational achievements, and quality of life. Multiple regression was used to measure the strength of association between these outcomes and variables related to the child (average hearing level, age at onset of hearing impairment, age, gender, number of additional disabilities), the family (parental occupational skill level, ethnicity, and parental hearing status), and cochlear implantation. Questionnaires were returned by the parents of 2858 children, 468 of whom had received a cochlear implant, and by the teachers of 2241 children, 383 of whom had received an implant. Across all domains, reported outcomes were better for children with fewer disabilities in addition to impaired hearing. Across most domains, reported outcomes were better for children who were older, female, with a more favorable average hearing level, with a higher parental occupational skill level, and with an onset of hearing-impairment after 3 years. When these variables were controlled, cochlear implantation was consistently associated with advantages in auditory performance and spoken communication skills, but less consistently associated with advantages in educational achievements and quality of life. Significant associations were found most commonly for children who were younger than 5 years when implanted, and had used implants for more than 4 years. These children, whose mean (preoperative, unaided) average hearing level was 118 dB, were reported to perform at the same level as nonimplanted children with average hearing levels in the range from 80 dB to 104 dB, depending on the outcome measure. When rigorous statistical control is exercised in comparing implanted and nonimplanted children, pediatric cochlear implantation is associated with reported improvements both in spoken communication skills and in some aspects of educational achievements and quality of life, provided that children receive implants before 5 years of age.

Japanese speakers were trained to produce American English (AE) /r/ and /l/ using a computer-assisted learning system which was developed to investigate how to provide useful and effective feedback to second-language learners regarding the goodness of their production in an automatic way. In experiment 1, two groups of Japanese speakers were trained to produce /r/ and /l/ in a reproduction task. In one group, spectrographic representations with formant-tracking results overlayed were used as feedback, and in another group, acoustic scores produced by an HMM-based speech recognition system were used as feedback. Learners in both groups significantly improved from pretest to post-test in their production ability as evaluated by AE judges. Experiment 2 investigated the order effect of production training and perception training. One group of trainees received production training before perception training, and a different group received training in the opposite order. Both groups improved in their production ability by an equal amount from pretest to post-test. However, the production-to-perception training group improved more in perception ability than did the perception-to-production training group, suggesting the relevance of training order in perception ability.

With Russian as the target language, a proof of concept study was undertaken to determine whether it is possible to identify linguistic features, control over which is implicated in progress on the Interagency Linguistic Roundtable (ILR) proficiency scale, thereby better to inform the instructional process. Following its development in an instrumentation study, a revised version of a computer-delivered battery of 33 perception and production tasks was administered to 68 participants—57 learners between levels 2 and 3 (21 at ILR 2, 18 at 2+, and 18 at 3) on the ILR scale, and 11 native speaker controls—whose proficiency was tested via an ILR oral proficiency telephone interview. The tasks sampled subjects’ control of Russian phonology, morphology, syntax, lexis, and collocations. Relationships between control of the linguistic features and the ILR levels of interest were assessed statistically. All 33 tasks, 18 of which assessed learners’ abilities in perception and 15 of which assessed their abilities in production, were found to differentiate ILR proficiency levels 2 and 3, and a subset was found to also distinguish levels 2 and 2+, and 2+ and 3. On the basis of the results, a checklist of linguistic features pegged to proficiency levels was produced that can be useful for syllabus designers, teachers, and learners themselves as well as providing the basis for future diagnostic tests.

Objective: This paper reviewed the literature on the development of and factors affecting speech perception of Mandarin-speaking children with cochlear implantation (CI). We also summarized speech outcome measures in standard Mandarin for evaluating auditory and speech perception of children with CI.Method: A comprehensive search of Google Scholar and PubMed was conducted from March to June 2021. Search terms used were speech perception/lexical tone recognition/auditory perception AND cochlear implant AND Mandarin/Chinese.Conclusion: Unilateral CI recipients demonstrated continuous improvements in auditory and speech perception for several years post-activation. Younger age at implantation and longer duration of CI use contribute to better speech perception. Having undergone a hearing aid trial before implantation and having caregivers whose educational level is higher may lead to better performance. While the findings that support the use of CI to improve speech perception continue to grow, much research is needed to validate the use of unilateral and bilateral implantation. Evidence to date, however, revealed bimodal benefits over CI-only conditions in lexical tone recognition and sentence perception in noise. Due to scarcity of research, conclusions on the benefits of bilateral CIs compared to unilateral CI or bimodal CI use cannot be drawn. Therefore, future research on bimodal and bilateral CIs is needed to guide evidence-based clinical practice.

Inclusive library services for deaf people: an overview from the social model perspective.

Aim The UN convention on rights of children advocates the rights of disabled children, including those with hearing impairment. Furthermore, UK national guidelines recommend cochlear implants (CI) in newborns with severe-to-profound sensorineural deafness as early as possible, thereby enabling children to overcome barriers and integrate better with the society. The aim is to explore the ethical dilemma underpinning parental refusal for CI. Method This is a retrospective case study and discussion on ethical issues arising. Results A first-born baby boy presented with congenital bilateral severe-to-profound sensorineural deafness identified through newborn hearing screening. His non-consanguineous Asian parents had normal hearing. He was given powerful bilateral digital hearing aids and was well-supported by multi-agency community services. Despite this early auditory habilitation, subsequent aided hearing levels remained inadequate for speech perception. Hence, he was referred for CI assessment and consequently deemed suitable. There were no otological, audiological, medical or anaesthetic contraindications. Parents had counselling and discussions on CI rehabilitation. They were aware of the critical window of brain plasticity for auditory and speech development and understood the benefits versus risks. There were no safeguarding concerns. Despite the extensive multi-professional input and support, parents declined consent for CI. At 2 years, the child’s verbal communication remained significantly impaired. The child is now 3 years and continues to use digital hearing aids and communicates by British Sign Language (BSL). Parents were slow to accept and use BSL. Conclusion This case highlights the ethical dilemma faced by professionals when parents refuse the provision of a well-accepted form of communication rehabilitation. The multi-professional team has provided all possible opportunities for parents to make their choice. However, it is the parents’ autonomy to refuse treatment. Although this is a non-life threatening scenario, CI rehabilitation enables life-changing outcomes if implanted in the first 2– 3 years in children with pre-lingual deafness. The dilemma arises when parental choice contradicts professional advice. Amidst this dilemma, a key factor would be the child’s own views, limited at this young age, on such a life changing intervention. Therefore, to clarify and guide our practice, we have seeked further legal and professional advice.

The purpose of this investigation was to determine how suddenly diminished auditory feedback affects articulatory behaviors for prelingually deafened children with cochlear implants (CIs). Two 6-yr-old children served as participants. Considering their level of hearing impairment, one child had above average speech perception and production skills while the other child had exceptionally good speech perception and production abilities. Baseline data were collected four times over the course of 2 days with the children wearing their CIs. For three additional days, data were collected while the children wore their CIs (ON condition) and then again after their CIs had been deactivated for 1 hr (OFF condition). Variables assessed included amount of jaw opening, F1, F2, nasal air flow, voice onset time (VOT), voicing duration, and the magnitude and duration of intraoral air pressure (Po). Findings were related to each other and to previously reported phonatory findings from the same two children (Higgins, McCleary, & Schulte, 1999) to determine whether changes in articulatory variables in the OFF condition were consistent with a direct effect of diminished auditory feedback or an indirect influence of suprasegmental parameters. Both children exhibited consistent and significant changes in articulatory parameters in the absence of auditory feedback. Such changes occurred more often for the child who had especially proficient speech perception and production skills. Some changes (i.e., reduced Po for [p] and reduced nasal air flow for [m]) appeared related to the influence of suprasegmental parameters, in particular, reduced subglottal air pressure. Other effects (i.e., increased F2 for [a] and reduced VOT for [p]) were suggestive of changes in the children's abilities to maintain appropriate articulatory placements and timing. Finally, a few changes (reduced jaw opening for [i] and increased Po duration for [p]) may have reflected compensatory strategies to maintain correct tongue placement and enhance temporal distinctions in the absence of auditory feedback. Based on the data of our two participants, it appears that some prelingually deafened children with CIs and good speech perception/production skills rely on auditory feedback to maintain articulatory precision. In the absence of auditory feedback, such children may demonstrate changes in articulatory placement and timing. In addition, data from one of our participants are consistent with the idea that some children may be aware that their articulatory control is compromised in the absence of auditory feedback and attempt to compensate by altering articulatory durations or the range of associated articulatory movements.