Speechreading Ability Research Articles

Speechreading, Phonological Skills, and Word Reading Ability in Children

Purpose: The purpose of the present study was to investigate the relationship between speechreading ability, phonological skills, and word reading ability in typically developing children. Method: Sixty-six typically developing children (6–7 years old) completed tasks measuring word reading, speechreading (words, sentences, and short stories), alliteration awareness, rhyme awareness, nonword reading, and rapid automatized naming (RAN). Results: Speechreading ability was significantly correlated with rhyme and alliteration awareness, phonological error rate, nonword reading, and reading ability (medium effect sizes) and RAN (small effect size). Multiple regression analyses showed that speechreading was not a unique predictor of word reading ability beyond the contribution of phonological skills. A speechreading error analysis revealed that children tended to use a phonological strategy when speechreading, and in particular, this strategy was used by skilled speechreaders. Conclusions: The current study provides converging evidence that speechreading and phonological skills are positively related in typically developing children. These skills are likely to have a reciprocal relationship, and children may benefit from having their attention drawn to visual information available on the lips while learning letter sounds or learning to read, as this could augment and strengthen underlying phonological representations.

Factors Affecting Visual-Only Speech Recognition in Individuals With Cochlear Implants.

Objectives: Several reports have underlined the benefits of speechreading (visual-only speech recognition) on speech recognition in individuals with hearing loss after cochlear implantation (CI). However, the factors that would affect the ability of speechreading are unclear. The aim of the present study is to assess the factors that affect speechreading abilities in CI users. Methods: A total of 104 participants were enrolled in this retrospective study. They viewed silent videos of sentences being spoken by a model and were tasked with repeating what they thought had been said. They were tested under audio-only and visual-only conditions. Factors (such as the age, the age of CI; <3 years old vs 3-8 years old; male vs female, etc) believed to affect speechreading abilities were analyzed. Results: The age range of the participants is 8 to 34 years. CI users showed significantly different speechreading abilities among themselves. The authors found that age and hearing loss at 3 to 8 years of age were positively related to superior speechreading recognition scores. Conclusions: CI users followed a more complex method of perceptual compensation. Those who have suffered hearing loss between 3 and 8 years of age are more sensitive to developing an advantage in speech recognition by using speechreading. Older age positively affects speechreading abilities; thus, the more experience CI has, the greater speechreading ability they may exhibit.

Deaf patients' preferred communication in clinical settings: implications for healthcare providers.

Deaf patients who communicate in American Sign Language (ASL) experience communication challenges leading to medical errors, treatment delays, and health disparities. Research on Deaf patient communication preferences is sparse. Researchers conducted focus groups based on the Health Belief Model with culturally Deaf patients and interpreters. The ASL focus groups were interpreted and transcribed into written English, verified by a third-party interpreting agency, and uploaded into NVivo. Deductive coding was used to identify communication methods and inductive coding was used to identify themes within each. Writing back-and-forth introduced challenges related to English proficiency, medical terminology, poor penmanship, and tendencies of providers to abbreviate. Participants had various speechreading abilities and described challenges with mask mandates. Multiple issues were identified with family and friends as proxy interpreters, including a lack of training, confidentiality issues, emotional support, and patient autonomy. Video remote interpreter challenges included technical, environmental, and interpreter qualification concerns. Participants overwhelmingly preferred on-site interpreters for communication clarity. While there was a preference for direct care, many acknowledged this is not always feasible due to lack of providers fluent in ASL. Access to on-site interpreters is vital for many Deaf patients to provide full access to critical medical information. Budgetallocation for on-call interpreters is important in emergency settings.

Tuberculose pulmonaire sur maladie de Takayasu compliquée de dissection de l’artère carotide commune

Previous studies have observed lower visual cortex activation for visual processing in cochlear implant (CI) users compared to normal hearing controls, while others reported enhanced visual speechreading abilities in CI users. The present work investigated whether lower visual cortical activation for visual processing can be explained by a more efficient visual sensory encoding in CI users. Specifically, we investigated whether CI users show enhanced stimulus-specific adaptation for visual stimuli compared to controls. Auditory sensory adaptation was also investigated to explore the sensory specificity of the predicted effect. Twenty post-lingually deafened adult CI users and twenty age-matched controls were presented with repeated visual and auditory stimuli during simultaneous acquisition of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). By integrating EEG and fNIRS signals we found significantly enhanced visual adaptation and lower visual cortex activation in CI users compared to controls. That is, responses to repeated visual stimuli decreased more prominently in CI users than in controls. The results suggest that CI users process visual stimuli more efficiently than controls.

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.]

Speech reading ability in class 3 students MI Nurul Ikhsan

Background: Reading is one of the important aspects that must be mastered by students, speech is also an important aspect in this study because it is to train students' confidence from an early age. Purpose: This study aims to determine the ability to read speech in grade 3 students of MI Nurul Ikhsan. Design and methods: This research is using quantitative descriptive methods. Results: The results of this study indicate that students who get the very good category are 10.5% for those who get the good category are 24%. which is commonly obtained by students, namely in the less good category as much as 31%. From the results of the study, it can be concluded that the ability to read speech in grade 3 students can be said to be not good.

Speech Perception Variability in Childhood Apraxia of Speech: Implications for Assessment and Intervention.

Beyond hallmark production deficits characterizing childhood apraxia of speech (CAS), largely attributed to disruption(s) in speech motor planning, children with CAS often present with co-occurring speech perception and language difficulties. Thus, careful consideration of the potential for speech perception difficulties to have cascading downstream effects on intervention responsiveness and real-life functioning for some children with CAS is highly important. The purpose of this tutorial was to consider the impact of speech perception abilities in children with CAS, which carries implications for caring for the needs of the whole child. This tutorial summarizes the current literature on speech perception and how it relates to speech production, language, and reading abilities for children with CAS. We include case illustrations that are adapted from real clinical scenarios illustrating how speech perception difficulties may impact some children with CAS and provide recommendations for incorporating speech perception into assessment and intervention practices. Although speech perception difficulties do not seem to be a core deficit of CAS, they are strongly linked to language difficulties, which are highly prevalent among children with CAS. Speech perception and language difficulties are also associated with reading difficulties and risk for lower academic achievement. Children with CAS who have co-occurring language difficulties likely also demonstrate speech perception deficits, which puts them at heightened risk for reading difficulties and struggles with academic achievement. Comprehensive assessment of children with CAS should address speech perception and production, language, and reading abilities, which carries important implications for multifaceted approaches to intervention.

Brain responses during auditory word recognition vary with reading ability in Chinese school-age children.

While the close relationship between the brain system for speech processing and reading development is well-documented in alphabetic languages, whether and how such a link exists in children in a language without systematic grapheme-phoneme correspondence has not been directly investigated. In the present study, we measured Chinese children's brain activation during an auditory lexical decision task with functional magnetic resonance imaging. The results showed that brain areas distributed across the temporal and frontal lobes activated during spoken word recognition. In addition, the left occipitotemporal cortex (OTC) was recruited, especially under the real word condition, thus confirming the involvement of this orthographic-related area in spoken language processing in Chinese children. Importantly, activation of the left temporoparietal cortex (TPC) in response to words and pseudowords was positively correlated with children's reading ability, thus supporting the salient role phonological processing plays in Chinese reading in the developing brain. Furthermore, children with higher reading scores also increasingly recruited the left anterior OTC to make decisions on the lexical status of pseudowords, indicating that higher-skill children tend to search abstract lexical representations more deeply than lower-skill children in deciding whether spoken syllables are real. In contrast, the precuneus was more related to trial-by-trial reaction time in lower-skill children, suggesting that effort-related neural systems differ among pupils with varying reading abilities. Taken together, these findings suggest a strong link between the neural correlates of speech processing and reading ability in Chinese children, thus supporting a universal basis underlying reading development across languages.

Speechreading in hearing children can be improved by training.

Visual information conveyed by a speaking face aids speech perception. In addition, children’s ability to comprehend visual-only speech (speechreading ability) is related to phonological awareness and reading skills in both deaf and hearing children. We tested whether training speechreading would improve speechreading, phoneme blending, and reading ability in hearing children. Ninety-two hearing 4- to 5-year-old children were randomised into two groups: business-as-usual controls, and an intervention group, who completed three weeks of computerised speechreading training. The intervention group showed greater improvements in speechreading than the control group at post-test both immediately after training and 3 months later. This was the case for both trained and untrained words. There were no group effects on the phonological awareness or single-word reading tasks, although those with the lowest phoneme blending scores did show greater improvements in blending as a result of training. The improvement in speechreading in hearing children following brief training is encouraging. The results are also important in suggesting a hypothesis for future investigation: that a focus on visual speech information may contribute to phonological skills, not only in deaf children but also in hearing children who are at risk of reading difficulties. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=bBdpliGkbkY.

Pre-operative Brain Imaging Using Functional Near-Infrared Spectroscopy Helps Predict Cochlear Implant Outcome in Deaf Adults

Currently, it is not possible to accurately predict how well a deaf individual will be able to understand speech when hearing is (re)introduced via a cochlear implant. Differences in brain organisation following deafness are thought to contribute to variability in speech understanding with a cochlear implant and may offer unique insights that could help to more reliably predict outcomes. An emerging optical neuroimaging technique, functional near-infrared spectroscopy (fNIRS), was used to determine whether a pre-operative measure of brain activation could explain variability in cochlear implant (CI) outcomes and offer additional prognostic value above that provided by known clinical characteristics. Cross-modal activation to visual speech was measured in bilateral superior temporal cortex of pre- and post-lingually deaf adults before cochlear implantation. Behavioural measures of auditory speech understanding were obtained in the same individuals following 6 months of cochlear implant use. The results showed that stronger pre-operative cross-modal activation of auditory brain regions by visual speech was predictive of poorer auditory speech understanding after implantation. Further investigation suggested that this relationship may have been driven primarily by the inclusion of, and group differences between, pre- and post-lingually deaf individuals. Nonetheless, pre-operative cortical imaging provided additional prognostic value above that of influential clinical characteristics, including the age-at-onset and duration of auditory deprivation, suggesting that objectively assessing the physiological status of the brain using fNIRS imaging pre-operatively may support more accurate prediction of individual CI outcomes. Whilst activation of auditory brain regions by visual speech prior to implantation was related to the CI user’s clinical history of deafness, activation to visual speech did not relate to the future ability of these brain regions to respond to auditory speech stimulation with a CI. Greater pre-operative activation of left superior temporal cortex by visual speech was associated with enhanced speechreading abilities, suggesting that visual speech processing may help to maintain left temporal lobe specialisation for language processing during periods of profound deafness.

Masked Speech Recognition and Reading Ability in School-Age Children: Is There a Relationship?

The relationship between reading (decoding) skills, phonological processing abilities, and masked speech recognition in typically developing children was explored. This experiment was designed to evaluate the relationship between phonological processing and decoding abilities and 2 aspects of masked speech recognition in typically developing children: (a) the ability to benefit from temporal and spectral modulations within a noise masker and (b) the masking exerted by a speech masker. Forty-two typically developing 3rd- and 4th-grade children with normal hearing, ranging in age from 8;10 to 10;6 years (mean age = 9;2 years, SD = 0.5 months), completed sentence recognition testing in 4 different maskers: steady-state noise, temporally modulated noise, spectrally modulated noise, and two-talker speech. Children also underwent assessment of phonological processing abilities and assessments of single-word decoding. As a comparison group, 15 adults with normal hearing also completed speech-in-noise testing. Speech recognition thresholds varied between approximately 3 and 7 dB across children, depending on the masker condition. Compared to adults, performance in the 2-talker masker was relatively consistent across children. Furthermore, decreasing the signal-to-noise ratio had a more precipitously deleterious effect on children's speech recognition in the 2-talker masker than was observed for adults. For children, individual differences in speech recognition threshold were not predicted by phonological awareness or decoding ability in any masker condition. No relationship was found between phonological awareness and/or decoding ability and a child's ability to benefit from spectral or temporal modulations. In addition, phonological awareness and/or decoding ability was not related to speech recognition in a 2-talker masker. Last, these data suggest that the between-listeners variability often observed in 2-talker maskers for adults may be smaller for children. The reasons for this child-adult difference need to be further explored. https://doi.org/10.23641/asha.5913547.

Emotional recognition of dynamic facial expressions before and after cochlear implantation in adults with progressive deafness

Visual processing has been extensively explored in deaf subjects in the context of verbal communication, through the assessment of speech reading and sign language abilities. However, little is known about visual emotional processing in adult progressive deafness, and after cochlear implantation. The goal of our study was thus to assess the influence of acquired post-lingual progressive deafness on the recognition of dynamic facial emotions that were selected to express canonical fear, happiness, sadness, and anger. A total of 23 adults with post-lingual deafness separated into two groups; those assessed either before (n = 10) and those assessed after (n = 13) cochlear implantation (CI); and 13 normal hearing (NH) individuals participated in the current study. Participants were asked to rate the expression of the four cardinal emotions, and to evaluate both their emotional valence (unpleasant-pleasant) and arousal potential (relaxing-stimulating). We found that patients with deafness were impaired in the recognition of sad faces, and that patients equipped with a CI were additionally impaired in the recognition of happiness and fear (but not anger). Relative to controls, all patients with deafness showed a deficit in perceiving arousal expressed in faces, while valence ratings remained unaffected. The current results show for the first time that acquired and progressive deafness is associated with a reduction of emotional sensitivity to visual stimuli. This negative impact of progressive deafness on the perception of dynamic facial cues for emotion recognition contrasts with the proficiency of deaf subjects with and without CIs in processing visual speech cues (Rouger et al., 2007; Strelnikov et al., 2009; Lazard and Giraud, 2017). Altogether these results suggest there to be a trade-off between the processing of linguistic and non-linguistic visual stimuli.

Enhanced visual adaptation in cochlear implant users revealed by concurrent EEG-fNIRS

Previous studies have observed lower visual cortex activation for visual processing in cochlear implant (CI) users compared to normal hearing controls, while others reported enhanced visual speechreading abilities in CI users. The present work investigated whether lower visual cortical activation for visual processing can be explained by a more efficient visual sensory encoding in CI users. Specifically, we investigated whether CI users show enhanced stimulus-specific adaptation for visual stimuli compared to controls. Auditory sensory adaptation was also investigated to explore the sensory specificity of the predicted effect. Twenty post-lingually deafened adult CI users and twenty age-matched controls were presented with repeated visual and auditory stimuli during simultaneous acquisition of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). By integrating EEG and fNIRS signals we found significantly enhanced visual adaptation and lower visual cortex activation in CI users compared to controls. That is, responses to repeated visual stimuli decreased more prominently in CI users than in controls. The results suggest that CI users process visual stimuli more efficiently than controls.

Effect of Speechreading Telepractice Intervention using Smartphone on Speechreading Ability of Young Deaf Adults

연구목적: 스마트폰을 이용한 원격 독화 중재가 청년층 청각장애인의 독화 능력에 미치는 영향 및 대상일반화, 반응일반화, 유지 효과를 살펴보고자 하였다. 연구방법: 이 연구에는 고도에서 최고도의 감각신경성 난청을 가진 청년층 청각장애인 5명이 참여하였다. 연구설계는 대상자간 중다간헐기초선설계를 적용하였다. 평가는 기초선, 중재, 일반화, 유지 단계에서 문장과 단어 독화 검사를 이용하여 매 회기 5분씩 이루어졌으며, 기초선과 동일한 조건을 적용하여 실시하였다. 독화 중재는 주 5회, 총 4주 동안 실시되었고, 음절 변별 과제, 단어 변별과제, 문장 이해 과제, 문단 이해 과제를 순서대로 진행하였다. 모든 평가와 중재는 온라인상에서 이루어졌으며, 대상자들은 스마트폰을 이용하여 장소나 시간에 관계없이 연구에 사용되는 사이트에 접속하여 훈련에 참여하였다. 연구결과: 첫째, 대상자 모두 문장 독화 능력이 향상된 것으로 나타났지만, 단어 수준에서는 대상자 모두 중재 효과 크기가 작거나 거의 없는 것으로 나타났다. 둘째, 문장 수준에서는 대상일반화와 반응일반화에서 대상자 모두 효과가 있는 것으로 나타났으나, 단어수준에서는 대상자의 일부만 대상일반화와 반응일반화를 보인 것으로 나타났다. 셋째, 문장 수준에서는 모두 독화 능력이 유지되었지만, 단어 수준에서는 대상자 중 4명만이 유지 효과를 보인 것으로 나타났다. 결론: 전통적인 독화 지도나 컴퓨터 혹은 비디오를 이용한 독화 지도에 관한 선행 연구와 마찬가지로 스마트폰을 이용한 원격 독화 중재 또한 청각장애인의 독화 능력 향상에 효과적이었다. 따라서 스마트폰은 독화 중재의 효과성을 극대화시키는 도구로서 의미가 있으며, 스마트폰을 이용한 원격 중재에서의 언어치료사의 역할 또한 대상자들의 독화 능력을 향상시키는데 필수적인 것으로 나타났다.

Reducing viseme confusion in speech-reading

Speech-reading is an invaluable technique for people with hearing loss or those in adverse listening conditions (e.g., in a noisy restaurant, near children playing loudly). However, speech-reading is often difficult because identical mouth shapes (visemes) can produce several speech sounds (phonemes); there is a one-to-many mapping from visemes to phonemes. This decreases comprehension, causing confusion and frustration during conversation. My doctoral research aims to design and evaluate a visualisation technique that displays textual representations of a speaker's phonemes to a speech-reader. By combining my visualisation with their pre-existing speech-reading ability, speech-readers should be able to disambiguate confusing viseme-to-phoneme mappings without shifting their focus from the speaker's face. This will result in an improved level of comprehension, supporting natural conversation.

Hearing aid validation based on 40 Hz auditory steady-state response thresholds

Background and aimAided thresholds can be used for prediction of success of hearing aids and to choose between hearing aids and cochlear implants. This study aimed to compare characteristics of aided and unaided auditory steady-state responses (ASSRs). MethodsA total of 30 moderate to profoundly hearing-impaired subjects participated in this study. The subjects underwent acoustic immittance, behavioral audiometry, and ASSR with the modulation rate of 40 Hz, first without a hearing aid and then with a hearing aid. Sixteen people with normal hearing and 17 people with severe hearing loss were included in biological calibration of the sound field. ResultsThere was a significant difference between unaided behavioral and ASSR thresholds in all test frequencies (mean difference of unaided behavioral ASSR thresholds: 6.19 dB; P = 0.02 at 500 Hz, P < 0.001 at 1000 and 2000 Hz, and P = 0.02 for 4000 Hz). There was also a significant difference between aided behavioral and ASSR thresholds at 1000 and 2000 Hz (P < 0.001) but not at 500 (P = 0.14) and 4000 (P = 0.23) Hz (mean difference of behavioral ASSR thresholds was 4.33 dB). Despite observing any unaided responses, aided thresholds could be recorded in some severe to profoundly hearing-impaired subjects. The number of recordable thresholds was directly related to speech clarity and speech-reading ability. Multi-frequency stimulation elevated the ASSR threshold, especially for the higher frequencies and in the aided condition. ConclusionFunctional and ASSR gains show less difference than threshold data. Therefore, comparing gains instead of thresholds is more accurate for validation of hearing aids. The probability of success of hearing aids appears to be poor if ASSRs (especially aided ones) cannot be recorded. If special care is taken in the fitting of hearing aids and the testing conditions, aided ASSR testing could be a useful tool for validation of hearing aids and the cochlear implant decision-making process.This article is part of a Special Issue entitled <IEB Kyoto>.

The Effects of Audiovisual Stimulation on the Acceptance of Background Noise.

Previous examinations of noise acceptance have been conducted using an auditory stimulus only; however, the effect of visual speech supplementation of the auditory stimulus on acceptance of noise remains limited. The purpose of the present study was to determine the effect of audiovisual stimulation on the acceptance of noise in listeners with normal and impaired hearing. A repeated measures design was utilized. A total of 92 adult participants were recruited for this experiment. Of these participants, 54 were listeners with normal hearing and 38 were listeners with sensorineural hearing impairment. Most comfortable levels and acceptable noise levels (ANL) were obtained using auditory and auditory-visual stimulation modes for the unaided listening condition for each participant and for the aided listening condition for 35 of the participants with impaired hearing that owned hearing aids. Speech reading ability was assessed using the Utley test for each participant. The addition of visual input did not impact the most comfortable level values for listeners in either group; however, visual input improved unaided ANL values for listeners with normal hearing and aided ANL values in listeners with impaired hearing. ANL benefit received from visual speech input was related to the auditory ANL in listeners in each group; however, it was not related to speech reading ability for either listener group in any experimental condition. Visual speech input can significantly impact measures of noise acceptance. The current ANL measure may not accurately reflect acceptance of noise values when in more realistic environments, where the signal of interest is both audible and visible to the listener.

Comparison of informational vs. energetic masking effects on speechreading performance.

The effects of two types of auditory distracters (steady-state noise vs. four-talker babble) on visual-only speechreading accuracy were tested against a baseline (silence) in 23 participants with above-average speechreading ability. Their task was to speechread high frequency Swedish words. They were asked to rate their own performance and effort, and report how distracting each type of auditory distracter was. Only four-talker babble impeded speechreading accuracy. This suggests competition for phonological processing, since the four-talker babble demands phonological processing, which is also required for the speechreading task. Better accuracy was associated with lower self-rated effort in silence; no other correlations were found.

Longitudinal Speech Perception and Language Performance in Pediatric Cochlear Implant Users

Few studies have examined the long-term effect of age at implantation on outcomes using multiple data points in children with cochlear implants. The goal of this study was to determine whether age at implantation has a significant, lasting impact on speech perception, language, and reading performance for children with prelingual hearing loss. A linear mixed-model framework was used to determine the effect of age at implantation on speech perception, language, and reading abilities in 83 children with prelingual hearing loss who received cochlear implants by the age of 4 years. The children were divided into two groups based on their age at implantation: (1) under 2 years of age and (2) between 2 and 3.9 years of age. Differences in model-specified mean scores between groups were compared at annual intervals from 5 to 13 years of age for speech perception, and 7 to 11 years of age for language and reading. After controlling for communication mode, device configuration, and preoperative pure-tone average, there was no significant effect of age at implantation for receptive language by 8 years of age, expressive language by 10 years of age, reading by 7 years of age. In terms of speech-perception outcomes, significance varied between 7 and 13 years of age, with no significant difference in speech-perception scores between groups at ages 7, 11, and 13 years. Children who used oral communication (OC) demonstrated significantly higher speech-perception scores than children who used total communication (TC). OC users tended to have higher expressive language scores than TC users, although this did not reach significance. There was no significant difference between OC and TC users for receptive language or reading scores. Speech perception, language, and reading performance continue to improve over time for children implanted before 4 years of age. The present results indicate that the effect of age at implantation diminishes with time, particularly for higher-order skills such as language and reading. Some children who receive cochlear implants after the age of 2 years have the capacity to approximate the language and reading skills of their earlier-implanted peers, suggesting that additional factors may moderate the influence of age at implantation on outcomes over time.

Speechreading Development in Deaf and Hearing Children: Introducing the Test of Child Speechreading

In this article, the authors describe the development of a new instrument, the Test of Child Speechreading (ToCS), which was specifically designed for use with deaf and hearing children. Speechreading is a skill that is required for deaf children to access the language of the hearing community. ToCS is a deaf-friendly, computer-based test that measures child speechreading (silent lipreading) at 3 psycholinguistic levels: (a) Words, (b) Sentences, and (c) Short Stories. The aims of the study were to standardize the ToCS with deaf and hearing children and to investigate the effects of hearing status, age, and linguistic complexity on speechreading ability. Eighty-six severely and profoundly deaf children and 91 hearing children participated. All children were between the ages of 5 and 14 years. The deaf children were from a range of language and communication backgrounds, and their preferred mode of communication varied. Speechreading skills significantly improved with age for both groups of children. There was no effect of hearing status on speechreading ability, and children from both groups showed similar performance across all subtests of the ToCS. The ToCS is a valid and reliable assessment of speechreading ability in school-age children that can be used to measure individual differences in performance in speechreading ability.