Use of Visual Feedback to Treat Negative Intraoral Air Pressures of Preschoolers With Cochlear Implants

Abstract

The primary purpose of this study was to determine if negative intraoral air pressures (−P o ) produced by young deaf children can be treated effectively with visual feedback. We used two forms of visual feedback. One was a display of the P o signal on an oscilloscope, and the other was movement of cellophane streamers placed in front of the children’s mouths. Participants were two 5-year-old boys who had been using cochlear implants (CIs) for less than 6 months. Both children were congenitally deafened and had very limited speech production and perception skills. In addition to frequent usage of −P o , both children exhibited deviant phonatory behaviors, so phonatory goals were incorporated into treatment. The magnitude and direction of P o was monitored, as well as fundamental frequency and electroglottograph cycle width. Data were collected at baseline, before and after treatment sessions, and 7 weeks after termination of treatment. One child responded well to treatment of −P o with both forms of visual feedback, and progress was maintained at follow-up. For the other child, +P o occurred more frequently as the study progressed, and he rarely produced −P o by the end of the investigation. However, because changes were evident in baseline as well as during treatment, it is difficult to attribute his more frequent use of +P o specifically to treatment. The phonation of the two children changed in ways that were consistent with their phonatory goals, although the degree of change was not always significant. Change was more evident for phonatory behaviors that could be shaped with visual feedback. Although both children exhibited some undesirable speech/voice behaviors in response to visual feedback, there was no evidence of long-lasting mislearning. Although our data are limited, it appears that treatment of −P o can be efficacious for some young children with CIs, even those with very poor speech perception and speech production skills. Further, treatment of −P o can be incorporated effectively with other speech production goals.