Audiovisual Benefit Research Articles

Audiovisual Speech Perception Benefits are Stable from Preschool through Adolescence.

The ability to leverage visual cues in speech perception- especially in noisy backgrounds- is well established from infancy to adulthood. Yet, the developmental trajectory of audiovisual benefits stays a topic of debate. The inconsistency in findings can be attributed to relatively small sample sizes or tasks that are not appropriate for given age groups. We designed an audiovisual speech perception task that was cognitively and linguistically age-appropriate from preschool to adolescence and recruited a large sample ( N = 161) of children (age 4-15). We found that even the youngest children show reliable speech perception benefits when provided with visual cues and that these benefits are consistent throughout development when auditory and visual signals match. Individual variability is explained by how the child experiences their speech-in-noise performance rather than the quality of the signal itself. This underscores the importance of visual speech for young children who are regularly in noisy environments like classrooms and playgrounds.

Racialization and sentence intelligibility in older adults with hearing impairment

Previous studies have shown that the perception of a talker’s racial identity affects the intelligibility of that person’s speech to younger, normal-hearing listeners (Babel & Russell, 2015; McGowan, 2015; Tripp, Lyons, & Munson, 2022). These findings show that social perception influences intelligibility. These effects are thought to reflect varied experiences interacting with racially diverse individuals, attitudes and beliefs about different racial groups, or a combination of these factors. The current experiment examines whether the strength of the influence of perceived racial identity on intelligibility is similar across different age groups and levels of hearing acuity. Participants (n = 42, including 16 normal hearing [NH] younger adults, 11 NH older adults, and 15 older adults with hearing loss) were played sentences produced by four talkers who varied in racial identity, in audio-only and audiovisual conditions, in background noise and reported what they heard. Participants also completed a measure of attitudes toward the four talkers. Analyses are ongoing, and examine (1) whether the influence of presentation modality on intelligibility varies across the four talkers, (2) whether these talker differences in audiovisual benefit vary across the three listener groups, and (3) whether attitudes toward the talkers predict intelligibility. [Funding: NIH grant R21 DC018070]

A standardised test to evaluate audio-visual speech intelligibility in French

ObjectiveLipreading, which plays a major role in the communication of the hearing impaired, lacked a French standardised tool. Our aim was to create and validate an audio-visual (AV) version of the French Matrix Sentence Test (FrMST). DesignVideo recordings were created by dubbing the existing audio files. SampleThirty-five young, normal-hearing participants were tested in auditory and visual modalities alone (Ao, Vo) and in AV conditions, in quiet, noise, and open and closed-set response formats. ResultsLipreading ability (Vo) ranged from 1 % to 77%-word comprehension. The absolute AV benefit was 9.25 dB SPL in quiet and 4.6 dB SNR in noise. The response format did not influence the results in the AV noise condition, except during the training phase. Lipreading ability and AV benefit were significantly correlated. ConclusionsThe French video material achieved similar AV benefits as those described in the literature for AV MST in other languages. For clinical purposes, we suggest targeting SRT80 to avoid ceiling effects, and performing two training lists in the AV condition in noise, followed by one AV list in noise, one Ao list in noise and one Vo list, in a randomised order, in open or close set-format.

The effects of temporal cues, point-light displays, and faces on speech identification and listening effort.

Among the most robust findings in speech research is that the presence of a talking face improves the intelligibility of spoken language. Talking faces supplement the auditory signal by providing fine phonetic cues based on the placement of the articulators, as well as temporal cues to when speech is occurring. In this study, we varied the amount of information contained in the visual signal, ranging from temporal information alone to a natural talking face. Participants were presented with spoken sentences in energetic or informational masking in four different visual conditions: audio-only, a modulating circle providing temporal cues to salient features of the speech, a digitally rendered point-light display showing lip movement, and a natural talking face. We assessed both sentence identification accuracy and self-reported listening effort. Audiovisual benefit for intelligibility was observed for the natural face in both informational and energetic masking, but the digitally rendered point-light display only provided benefit in energetic masking. Intelligibility for speech accompanied by the modulating circle did not differ from the audio-only conditions in either masker type. Thus, the temporal cues used here were insufficient to improve speech intelligibility in noise, but some types of digital point-light displays may contain enough phonetic detail to produce modest improvements in speech identification in noise.

Effects of noise and noise reduction on audiovisual speech perception in cochlear implant users: An ERP study

ObjectiveHearing with a cochlear implant (CI) is difficult in noisy environments, but the use of noise reduction algorithms, specifically ForwardFocus, can improve speech intelligibility. The current event-related potentials (ERP) study examined the electrophysiological correlates of this perceptual improvement. MethodsTen bimodal CI users performed a syllable-identification task in auditory and audiovisual conditions, with syllables presented from the front and stationary noise presented from the sides. Brainstorm was used for spatio-temporal evaluation of ERPs. ResultsCI users revealed an audiovisual benefit as reflected by shorter response times and greater activation in temporal and occipital regions at P2 latency. However, in auditory and audiovisual conditions, background noise hampered speech processing, leading to longer response times and delayed auditory-cortex-activation at N1 latency. Nevertheless, activating ForwardFocus resulted in shorter response times, reduced listening effort and enhanced superior-frontal-cortex-activation at P2 latency, particularly in audiovisual conditions. ConclusionsForwardFocus enhances speech intelligibility in audiovisual speech conditions by potentially allowing the reallocation of attentional resources to relevant auditory speech cues. SignificanceThis study shows for CI users that background noise and ForwardFocus differentially affect spatio-temporal cortical response patterns, both in auditory and audiovisual speech conditions.

Effects of acoustic-phonetic access on audiovisual speech perception in children

Visual speech helps compensate for degraded acoustic input, especially when redundancy between the accessible acoustic and visual cues is low. Recent findings indicate that children who are hard of hearing benefit more from visual speech than their peers with normal hearing, yet the two groups demonstrate similar speechreading ability. It is unclear whether this increased benefit reflects differences in auditory and multisensory development or differences in redundancy between the visual and acoustic cues available to each group. This study examines the extent to which acoustic-phonetic access (acoustic frequency content) influences auditory and audiovisual word recognition in children with normal hearing. Isolated word and word-in-sentence recognition accuracy are measured for auditory-only and audiovisual speech that were high-pass filtered and low-pass filtered with a 2 kHz cutoff frequency. Data collection is ongoing. We hypothesize that children will demonstrate greater audiovisual benefit when acoustic speech is low-pass filtered than when it is high-pass filtered, because low-frequency acoustic content is less redundant with visual speech cues than high-frequency acoustic content. These findings will elucidate whether acoustic-phonetic access can explain differences in audiovisual benefit between children with normal hearing and children who are hard of hearing. [Work supported by NIH R21DC020544.]

Differential Auditory and Visual Phase-Locking Are Observed during Audio-Visual Benefit and Silent Lip-Reading for Speech Perception.

Speech perception in noisy environments is enhanced by seeing facial movements of communication partners. However, the neural mechanisms by which audio and visual speech are combined are not fully understood. We explore MEG phase-locking to auditory and visual signals in MEG recordings from 14 human participants (6 females, 8 males) that reported words from single spoken sentences. We manipulated the acoustic clarity and visual speech signals such that critical speech information is present in auditory, visual, or both modalities. MEG coherence analysis revealed that both auditory and visual speech envelopes (auditory amplitude modulations and lip aperture changes) were phase-locked to 2-6 Hz brain responses in auditory and visual cortex, consistent with entrainment to syllable-rate components. Partial coherence analysis was used to separate neural responses to correlated audio-visual signals and showed non-zero phase-locking to auditory envelope in occipital cortex during audio-visual (AV) speech. Furthermore, phase-locking to auditory signals in visual cortex was enhanced for AV speech compared with audio-only speech that was matched for intelligibility. Conversely, auditory regions of the superior temporal gyrus did not show above-chance partial coherence with visual speech signals during AV conditions but did show partial coherence in visual-only conditions. Hence, visual speech enabled stronger phase-locking to auditory signals in visual areas, whereas phase-locking of visual speech in auditory regions only occurred during silent lip-reading. Differences in these cross-modal interactions between auditory and visual speech signals are interpreted in line with cross-modal predictive mechanisms during speech perception.SIGNIFICANCE STATEMENT Verbal communication in noisy environments is challenging, especially for hearing-impaired individuals. Seeing facial movements of communication partners improves speech perception when auditory signals are degraded or absent. The neural mechanisms supporting lip-reading or audio-visual benefit are not fully understood. Using MEG recordings and partial coherence analysis, we show that speech information is used differently in brain regions that respond to auditory and visual speech. While visual areas use visual speech to improve phase-locking to auditory speech signals, auditory areas do not show phase-locking to visual speech unless auditory speech is absent and visual speech is used to substitute for missing auditory signals. These findings highlight brain processes that combine visual and auditory signals to support speech understanding.

Speech and non-speech measures of audiovisual integration are not correlated.

Many natural events generate both visual and auditory signals, and humans are remarkably adept at integrating information from those sources. However, individuals appear to differ markedly in their ability or propensity to combine what they hear with what they see. Individual differences in audiovisual integration have been established using a range of materials, including speech stimuli (seeing and hearing a talker) and simpler audiovisual stimuli (seeing flashes of light combined with tones). Although there are multiple tasks in the literature that are referred to as "measures of audiovisual integration," the tasks themselves differ widely with respect to both the type of stimuli used (speech versus non-speech) and the nature of the tasks themselves (e.g., some tasks use conflicting auditory and visual stimuli whereas others use congruent stimuli). It is not clear whether these varied tasks are actually measuring the same underlying construct: audiovisual integration. This study tested the relationships among four commonly-used measures of audiovisual integration, two of which use speech stimuli (susceptibility to the McGurk effect and a measure of audiovisual benefit), and two of which use non-speech stimuli (the sound-induced flash illusion and audiovisual integration capacity). We replicated previous work showing large individual differences in each measure but found no significant correlations among any of the measures. These results suggest that tasks that are commonly referred to as measures of audiovisual integration may be tapping into different parts of the same process or different constructs entirely.

Revisiting the relationship between implicit racial bias and audiovisual benefit for nonnative-accented speech.

Speech intelligibility is improved when the listener can see the talker in addition to hearing their voice. Notably, though, previous work has suggested that this "audiovisual benefit" for nonnative (i.e., foreign-accented) speech is smaller than the benefit for native speech, an effect that may be partially accounted for by listeners' implicit racial biases (Yi et al., 2013, The Journal of the Acoustical Society of America, 134[5], EL387-EL393.). In the present study, we sought to replicate these findings in a significantly larger sample of online participants. In a direct replication of Yi et al. (Experiment 1), we found that audiovisual benefit was indeed smaller for nonnative-accented relative to native-accented speech. However, our results did not support the conclusion that implicit racial biases, as measured with two types of implicit association tasks, were related to these differences in audiovisual benefit for native and nonnative speech. In a second experiment, we addressed a potential confound in the experimental design; to ensure that the difference in audiovisual benefit was caused by a difference in accent rather than a difference in overall intelligibility, we reversed the overall difficulty of each accent condition by presenting them at different signal-to-noise ratios. Even when native speech was presented at a much more difficult intelligibility level than nonnative speech, audiovisual benefit for nonnative speech remained poorer. In light of these findings, we discuss alternative explanations of reduced audiovisual benefit for nonnative speech, as well as methodological considerations for future work examining the intersection of social, cognitive, and linguistic processes.

Speech-Driven Facial Animations Improve Speech-in-Noise Comprehension of Humans.

Understanding speech becomes a demanding task when the environment is noisy. Comprehension of speech in noise can be substantially improved by looking at the speaker’s face, and this audiovisual benefit is even more pronounced in people with hearing impairment. Recent advances in AI have allowed to synthesize photorealistic talking faces from a speech recording and a still image of a person’s face in an end-to-end manner. However, it has remained unknown whether such facial animations improve speech-in-noise comprehension. Here we consider facial animations produced by a recently introduced generative adversarial network (GAN), and show that humans cannot distinguish between the synthesized and the natural videos. Importantly, we then show that the end-to-end synthesized videos significantly aid humans in understanding speech in noise, although the natural facial motions yield a yet higher audiovisual benefit. We further find that an audiovisual speech recognizer (AVSR) benefits from the synthesized facial animations as well. Our results suggest that synthesizing facial motions from speech can be used to aid speech comprehension in difficult listening environments.

The timecourse of multisensory speech processing in unilaterally stimulated cochlear implant users revealed by ERPs

A cochlear implant (CI) is an auditory prosthesis which can partially restore the auditory function in patients with severe to profound hearing loss. However, this bionic device provides only limited auditory information, and CI patients may compensate for this limitation by means of a stronger interaction between the auditory and visual system. To better understand the electrophysiological correlates of audiovisual speech perception, the present study used electroencephalography (EEG) and a redundant target paradigm. Postlingually deafened CI users and normal-hearing (NH) listeners were compared in auditory, visual and audiovisual speech conditions. The behavioural results revealed multisensory integration for both groups, as indicated by shortened response times for the audiovisual as compared to the two unisensory conditions. The analysis of the N1 and P2 event-related potentials (ERPs), including topographic and source analyses, confirmed a multisensory effect for both groups and showed a cortical auditory response which was modulated by the simultaneous processing of the visual stimulus. Nevertheless, the CI users in particular revealed a distinct pattern of N1 topography, pointing to a strong visual impact on auditory speech processing. Apart from these condition effects, the results revealed ERP differences between CI users and NH listeners, not only in N1/P2 ERP topographies, but also in the cortical source configuration. When compared to the NH listeners, the CI users showed an additional activation in the visual cortex at N1 latency, which was positively correlated with CI experience, and a delayed auditory-cortex activation with a reversed, rightward functional lateralisation. In sum, our behavioural and ERP findings demonstrate a clear audiovisual benefit for both groups, and a CI-specific alteration in cortical activation at N1 latency when auditory and visual input is combined. These cortical alterations may reflect a compensatory strategy to overcome the limited CI input, which allows the CI users to improve the lip-reading skills and to approximate the behavioural performance of NH listeners in audiovisual speech conditions. Our results are clinically relevant, as they highlight the importance of assessing the CI outcome not only in auditory-only, but also in audiovisual speech conditions.

Audiovisual Speech Processing in Relationship to Phonological and Vocabulary Skills in First Graders.

It is generally accepted that adults use visual cues to improve speech intelligibility in noisy environments, but findings regarding visual speech benefit in children are mixed. We explored factors that contribute to audiovisual (AV) gain in young children's speech understanding. We examined whether there is an AV benefit to speech-in-noise recognition in children in first grade and if visual salience of phonemes influences their AV benefit. We explored if individual differences in AV speech enhancement could be explained by vocabulary knowledge, phonological awareness, or general psychophysical testing performance. Thirty-seven first graders completed online psychophysical experiments. We used an online single-interval, four-alternative forced-choice picture-pointing task with age-appropriate consonant-vowel-consonant words to measure auditory-only, visual-only, and AV word recognition in noise at -2 and -8 dB SNR. We obtained standard measures of vocabulary and phonological awareness and included a general psychophysical test to examine correlations with AV benefits. We observed a significant overall AV gain among children in first grade. This effect was mainly attributed to the benefit at -8 dB SNR, for visually distinct targets. Individual differences were not explained by any of the child variables. Boys showed lower auditory-only performances, leading to significantly larger AV gains. This study shows AV benefit, of distinctive visual cues, to word recognition in challenging noisy conditions in first graders. The cognitive and linguistic constraints of the task may have minimized the impact of individual differences of vocabulary and phonological awareness on AV benefit. The gender difference should be studied on a larger sample and age range.

Bottom-up and top-down effects on the perception of children's speech

This study examined adult’s perception of spoken words produced by children and by other adults in audio-only (AO) and audiovisual (AV) contexts, to determine whether talker age affects the magnitude of AV benefit. One-syllable words produced by five 4-6 year old child talkers and five adult talkers were presented to 151 adult listeners at three signal-to-noise ratios. The SNRs were determined through pilot testing to be the ones at which adult and child talkers’ productions were recognized equally accurately in the AO condition. The magnitude of AV benefit was statistically equivalent for the adult and child talkers. However, lexical factors affected the perception of children and adults’ speech differently. Word frequency had a larger effect on the perception of children’s speech, perhaps reflecting listeners’ expectation that children would be especially unlikely to use a low frequency word. Lexical factors also affected the nature of listener errors: listeners were less likely to provide a low-frequency word when misperceiving a child than when misperceiving an adult. Listeners were also more likely to guess a word with a different CV structure than the target for children than for adults. Results suggest that listeners apply qualitatively different expectations when listening to adults and children.

Language Experience and Subjective Word Familiarity on the Multimodal Perception of Non-native Vowels.

The present study investigated native (L1) and non-native (L2) speakers' perception of the French vowels /ɔ̃, ɑ̃, ɛ̃, o/. Thirty-four American-English learners of French and 33 native speakers of Parisian French were asked to identify 60 monosyllabic words produced by a native speaker in three modalities of presentation: auditory-only (A-only); audiovisual (AV); and visual-only (V-only). The L2 participants also completed a vocabulary knowledge test of the words presented in the perception experiment that aimed to explore whether subjective word familiarity affected speech perception. Results showed that overall performance was better in the AV and A-only conditions for the two groups with the pattern of confusion differing across modalities. The lack of audiovisual benefit was not due to the vowel contrasts being not visually salient enough, as shown by the native group's performance in the V-only modality, but to the L2 group's weaker sensitivity to visual information. Additionally, a significant relationship was found between subjective word familiarity and AV and A-only (but not V-only) perception of non-native contrasts.

Development and evaluation of video recordings for the OLSA matrix sentence test

Objective The aim was to create and validate an audiovisual version of the German matrix sentence test (MST), which uses the existing audio-only speech material. Design Video recordings were recorded and dubbed with the audio of the existing German MST. The current study evaluates the MST in conditions including audio and visual modalities, speech in quiet and noise, and open and closed-set response formats. Sample One female talker recorded repetitions of the German MST sentences. Twenty-eight young normal-hearing participants completed the evaluation study. Results The audiovisual benefit in quiet was 7.0 dB in sound pressure level (SPL). In noise, the audiovisual benefit was 4.9 dB in signal-to-noise ratio (SNR). Speechreading scores ranged from 0% to 84% speech reception in visual-only sentences (mean = 50%). Audiovisual speech reception thresholds (SRTs) had a larger standard deviation than audio-only SRTs. Audiovisual SRTs improved successively with increasing number of lists performed. The final video recordings are openly available. Conclusions The video material achieved similar results as the literature in terms of gross speech intelligibility, despite the inherent asynchronies of dubbing. Due to ceiling effects, adaptive procedures targeting 80% intelligibility should be used. At least one or two training lists should be performed.

The Impact of Temporally Coherent Visual Cues on Speech Perception in Complex Auditory Environments.

Speech perception often takes place in noisy environments, where multiple auditory signals compete with one another. The addition of visual cues such as talkers’ faces or lip movements to an auditory signal can help improve the intelligibility of speech in those suboptimal listening environments. This is referred to as audiovisual benefits. The current study aimed to delineate the signal-to-noise ratio (SNR) conditions under which visual presentations of the acoustic amplitude envelopes have their most significant impact on speech perception. Seventeen adults with normal hearing were recruited. Participants were presented with spoken sentences in babble noise either in auditory-only or auditory-visual conditions with various SNRs at −7, −5, −3, −1, and 1 dB. The visual stimulus applied in this study was a sphere that varied in size syncing with the amplitude envelope of the target speech signals. Participants were asked to transcribe the sentences they heard. Results showed that a significant improvement in accuracy in the auditory-visual condition versus the audio-only condition was obtained at the SNRs of −3 and −1 dB, but no improvement was observed in other SNRs. These results showed that dynamic temporal visual information can benefit speech perception in noise, and the optimal facilitative effects of visual amplitude envelope can be observed under an intermediate SNR range.

Individuals With Mild Cognitive Impairment and Alzheimer's Disease Benefit From Audiovisual Speech Cues and Supportive Sentence Context

Purpose Speech perception in noise becomes difficult with age but can be facilitated by audiovisual (AV) speech cues and sentence context in healthy older adults. However, individuals with Alzheimer's disease (AD) may present with deficits in AV integration, potentially limiting the extent to which they can benefit from AV cues. This study investigated the benefit of these cues in individuals with mild cognitive impairment (MCI), individuals with AD, and healthy older adult controls. Method This study compared auditory-only and AV speech perception of sentences presented in noise. These sentences had one of two levels of context: high (e.g., "Stir your coffee with a spoon") and low (e.g., "Bob didn't think about the spoon"). Fourteen older controls (M age = 72.71 years, SD = 9.39), 13 individuals with MCI (M age = 79.92 years, SD = 5.52), and nine individuals with probable Alzheimer's-type dementia (M age = 79.38 years, SD = 3.40) completed the speech perception task and were asked to repeat the terminal word of each sentence. Results All three groups benefited (i.e., identified more terminal words) from AV and sentence context. Individuals with MCI showed a smaller AV benefit compared to controls in low-context conditions, suggesting difficulties with AV integration. Individuals with AD showed a smaller benefit in high-context conditions compared to controls, indicating difficulties with AV integration and context use in AD. Conclusions Individuals with MCI and individuals with AD do benefit from AV speech and semantic context during speech perception in noise (albeit to a lower extent than healthy older adults). This suggests that engaging in face-to-face communication and providing ample context will likely foster more effective communication between patients and caregivers, professionals, and loved ones.

Development of the Mechanisms Underlying Audiovisual Speech Perception Benefit.

The natural environments in which infants and children learn speech and language are noisy and multimodal. Adults rely on the multimodal nature of speech to compensate for noisy environments during speech communication. Multiple mechanisms underlie mature audiovisual benefit to speech perception, including reduced uncertainty as to when auditory speech will occur, use of correlations between the amplitude envelope of auditory and visual signals in fluent speech, and use of visual phonetic knowledge for lexical access. This paper reviews evidence regarding infants’ and children’s use of temporal and phonetic mechanisms in audiovisual speech perception benefit. The ability to use temporal cues for audiovisual speech perception benefit emerges in infancy. Although infants are sensitive to the correspondence between auditory and visual phonetic cues, the ability to use this correspondence for audiovisual benefit may not emerge until age four. A more cohesive account of the development of audiovisual speech perception may follow from a more thorough understanding of the development of sensitivity to and use of various temporal and phonetic cues.

Audiovisual enhancement and single-word intelligibility in children's speech

It is nearly axiomatic that audiovisual (AV) speech is more intelligible than audio-only (A-only) speech, particularly when the speech is presented in a challenging listening environment, such as in background noise [e.g., MacLeod and Summerfield, Br. J. Audiol., 2 (1987)]. Surprisingly, there has been only limited exploration of differences between individual talkers in the intelligibility advantage of their AV speech over their A-only speech. In this work, we ask whether different age groups of speakers elicit systematically different AV benefits in speech intelligibility tasks. A recent study examined whether children and adults' speech elicits similar AV benefits for sentence intelligibility (Karisny et al., J. Acoust. Soc. Am. 146). In that study, children's speech elicited smaller AV benefits than adults' speech, though this comparison was complicated by suboptimal choice of different signal-to-noise ratios to equate the groups' intelligibility in A-only conditions. The current study follows up on this work by examining single-word intelligibility in the same talkers, using a single SNR for both groups. Data collection is ongoing. Results will help us understand the role of individual-speaker variation on the magnitude of AV benefit.

Recognition of Accented Speech by Cochlear-Implant Listeners: Benefit of Audiovisual Cues.

When auditory and visual speech information are presented together, listeners obtain an audiovisual (AV) benefit or a speech understanding improvement compared with auditory-only (AO) or visual-only (VO) presentations. Cochlear-implant (CI) listeners, who receive degraded speech input and therefore understand speech using primarily temporal information, seem to readily use visual cues and can achieve a larger AV benefit than normal-hearing (NH) listeners. It is unclear, however, if the AV benefit remains relatively large for CI listeners when trying to understand foreign-accented speech when compared with unaccented speech. Accented speech can introduce changes to temporal auditory cues and visual cues, which could decrease the usefulness of AV information. Furthermore, we sought to determine if the AV benefit was relatively larger in CI compared with NH listeners for both unaccented and accented speech. AV benefit was investigated for unaccented and Spanish-accented speech by presenting English sentences in AO, VO, and AV conditions to 15 CI and 15 age- and performance-matched NH listeners. Performance matching between NH and CI listeners was achieved by varying the number of channels of a noise vocoder for the NH listeners. Because of the differences in age and hearing history of the CI listeners, the effects of listener-related variables on speech understanding performance and AV benefit were also examined. AV benefit was observed for both unaccented and accented conditions and for both CI and NH listeners. The two groups showed similar performance for the AO and AV conditions, and the normalized AV benefit was relatively smaller for the accented than the unaccented conditions. In the CI listeners, older age was associated with significantly poorer performance with the accented speaker compared with the unaccented speaker. The negative impact of age was somewhat reduced by a significant improvement in performance with access to AV information. When auditory speech information is degraded by CI sound processing, visual cues can be used to improve speech understanding, even in the presence of a Spanish accent. The AV benefit of the CI listeners closely matched that of the NH listeners presented with vocoded speech, which was unexpected given that CI listeners appear to rely more on visual information to communicate. This result is perhaps due to the one-to-one age and performance matching of the listeners. While aging decreased CI listener performance with the accented speaker, access to visual cues boosted performance and could partially overcome the age-related speech understanding deficits for the older CI listeners.