Typical Hearing Research Articles

Feasibility of Using Wearable Sensors to Measure Listening-Related Stress

Purpose: This study evaluated the feasibility of using wearable sensors to assess listening-related stress in varying listening difficulties. The results were compared to listening effort assessed using laboratory-grade physiological measures. We hypothesized that these wearable sensors could accurately measure listening-related stress and that the results would be in the same direction as those observed with laboratory-grade equipment. Method: A within-subject repeated-measures study was conducted on 16 young adults with typical hearing ability. Participants wore three commercially available sensors to record heart rate (HR), respiration rate (RR), and galvanic skin response (GSR). Participants' listening-related stress was assessed using self-report, wearable sensors, and laboratory-grade physiological measures while listening to sentences in noise. Listening conditions were manipulated in terms of signal-to-noise ratios (SNRs; −4, 0, +4, and +8 dB SNR), sentence predictability (high and low), and stress-inducing negative feedback (flash of light and monetary punishers). Results: On average, participants reported higher arousal and task load with decreasing SNR, for low predictability, and with negative feedback. Participants had significantly higher HR and RR in difficult listening conditions, when measured with wearable sensors. However, no significant differences were observed for skin conductance. There was a good agreement between the measures for HR but not for RR and GSR. Conclusions: Although wearable sensors have potential in reflecting changes in listening effort, the results were not consistent with laboratory-grade measures. Methodological choices in both measures and design appear to affect outcomes. Future studies should focus on crafting designs appropriate to wearable devices to reflect changes in listening-related stress.

Hearing What You Can't See: Influence of Face Masks on Speech Perception and Eye Movement by Adults With Hearing Loss.

The aim of the study was to analyze how face masks influence speech perception and time spent looking at the speaker's mouth and eyes by adults with and without hearing loss. Twenty participants with hearing loss and 20 without were asked to repeat Spanish words presented in various conditions, including different types of face masks (no mask, transparent window mask, and opaque mask FFP2) and presentation modes (audiovisual, video only, and audio only). Recognition accuracy and the percentage of time looking at the speaker's eyes and mouth (dwell time) were measured. In the audiovisual condition, participants with hearing loss had significantly better word recognition scores when the speaker wore no mask compared to when they wore an opaque face mask. However, there were no differences between the transparent mask and no mask conditions. For those with typical hearing, the type of face mask did not affect speech recognition. Audiovisual presentation consistently improved speech recognition for participants with hearing loss across all face mask conditions, but for those with typical hearing, it only improved compared to video-only mode. These participants demonstrated a ceiling effect in audiovisual and audio-only modes. Regarding eye movement patterns, participants spent less time looking at the speaker's mouth and more time at the eyes when the speaker wore an opaque mask compared to no mask or a transparent mask. The use of transparent face masks (ClearMask-type model) is recommended in contexts where face masks are still used (hospitals) to prevent the hindering effect of opaque masks (FFP2-type model) in speech perception among people with hearing loss, provided that any fogging of the window of the transparent mask is controlled by wiping it off as needed and the light is in front of the speaker to minimize shadows.

Perception of voice cues and speech-in-speech by children with prelingual single-sided deafness and a cochlear implant

Voice cues, such as fundamental frequency (F0) and vocal tract length (VTL), help listeners identify the speaker's gender, perceive the linguistic and emotional prosody, and segregate competing talkers. Postlingually implanted adult cochlear implant (CI) users seem to have difficulty in perceiving and making use of voice cues, especially of VTL. Early implanted child CI users, in contrast, perceive and make use of both voice cues better than CI adults, and in patterns similar to their peers with normal hearing (NH).In our study, we investigated the perception and use of voice cues in children with single-sided deafness (SSD) who received their CI at an early age (SSD+CI), in an attempt to bridge the gap between these two groups. The SSD+CI children have access to bilateral auditory information and often receive their CI at an early age, similar to CI children. They may also have dominant acoustic representations, similar to CI adults who acquired hearing loss at a later age. As such, the current study aimed to investigate the perception and use of voice cues by a group of nine early-implanted children with prelingual SSD. The study consisted of three experiments: F0 and VTL discrimination, voice gender categorization, and speech-in-speech perception. In each experiment, the results of the SSD group are compared to children and adults with CIs (for their CI ear) and with typical hearing (for their NH ear).Overall, the SSD+CI children had poorer VTL detection thresholds with their CI compared to their NH ear, while their F0 perception was similar across ears. Detection thresholds for both F0 and VTL with their CI ear was comparable to those of bilaterally implanted CI children, suggesting that SSD+CI children do not only rely on their NH ear, but actually make use of their CI. SSD+CI children relied more heavily on F0 cues than on VTL cues for voice gender categorization, with cue weighting patterns comparable to those of CI adults. In contrast to CI children, the SSD+CI children showed limited speech perception benefit based on F0 and VTL differences between the target and masker speaker, which again corresponded to the results of CI adults. Altogether, the SSD+CI children make good use of their CI, despite a good-hearing ear, however, the perceptual patterns seem to fall in-between those of CI children and CI adults. Perhaps a combination of childhood neuroplasticity, limited experience with relying only on the CI, and a dominant acoustic representation of voice gender explain these results.

Longitudinal follow-up of hearing, speech, and language skills in 6-year-old children with congenital moderate hearing loss

ObjectivesChildren born with moderate hearing loss present with speech and language outcomes at both ends of the spectrum. To explore reasons for this, the objective of this study was to follow up a group of children born with moderate sensorineural hearing loss at 6 years of age (n=7) by investigating their outcomes in hearing, speech, and language development from time point of hearing aid fitting at 6 months. Another objective was to investigate the relationship between earlier outcomes on precursing variables to the current status in auditory, speech and language development. MethodEarlier data from a project with the same participants of auditory variables, speech, and language development were compared to the current study outcomes at 6 years of age. Children in this study performed standardized tests of phonology (SVANTE), expressive vocabulary (BNT), and speech-in-noise test (Hagerman´s sentences). Parents reported on their child´s functional auditory performance in everyday life (PEACH), and demographics and general development (questionnaire). Etiology and frequency of speech and language-directed intervention from time point of diagnosis to 6 years of age were collected through medical journals. ResultsHearing levels were stable over time in all children but one, who had received bilateral cochlear implants. Performance on speech-in-noise testing varied in aided condition (-0.8 to 8, mean 2.65, SD 3.09) and unaided condition (7.2 dB to 21.2 dB, mean 12.06, SD 4.82). Scores on the PEACH indicated further review in four of the seven children. Mean group score on consonant proficiency had increased from 3 to 6 years of age and were within age norms. Vocabulary scores were below the norms of children with typical hearing. Outcomes on vocabulary measures at 2.5 years years showed strong correlations that were significant to scores on the BNT at 6 years of age (r = 0.87, p = 0.05). Correlations between hours of hearing aid use and vocabulary was not significant at 6 years of age. The frequency of intervention sessions in the first 6 years varied between participants (4 to 55, mean 19.1, SD 17.1). ConclusionDespite homogeneous hearing and other background variables in the participants from birth, large individual variations in speech and language outcomes at 6 years of age were found. Considering the many factors involved that impact the development of children with moderate hearing loss, the results suggest that monitoring early precursors in auditory, speech and language development may be helpful in setting commensurate goals for each child. Detecting additional conditions that may pose challenges in future speech and language as early as possible is important. There is ample room for improvement in terms of increasing the frequency of intervention for children with moderate hearing loss and their families.

A longitudinal study on moral emotions and psychosocial functioning among preschool children with and without hearing loss.

Moral emotions such as shame, guilt and pride are crucial to young children's social-emotional development. Due to the restrictions caused by hearing loss in accessing the social world, deaf and hard of hearing (DHH) children may encounter extra difficulties in their development of moral emotions. However, little research so far has investigated the development trajectory of moral emotions during preschool years in DHH children. The present study used a longitudinal design to explore the development trajectories of shame, guilt, and pride, in a sample of 259 Chinese DHH and typically hearing (TH) preschoolers aged 2 to 6 years old. The results indicated that according to parent reports, DHH children manifested lower levels of guilt and pride compared to their TH peers, yet the manifested levels of shame, guilt, and pride increased throughout the preschool time at a similar pace in all children. Moreover, whilst guilt and pride contributed to increasing levels of psychosocial functioning over the preschool years, shame contributed to lower social competence and more externalizing behaviors in DHH and TH preschoolers. The outcomes imply that early interventions and adjustment to hearing loss could be useful to safeguard the social development of children with severe hearing loss, and cultural variances shall be taken into consideration when studying moral emotions in a Chinese cultural background.

Benefits of speech recognition in noise using remote microphones for people with typical hearing

IntroductionRemote microphone (RM) systems are designed to enhance speech recognition in noisy environments by improving the signal-to-noise ratio (SNR) for individuals with typical hearing (TH) and hearing impairment (HI). The aim of this investigation was to evaluate the advantages of speech recognition in noise for individuals with TH in a simulated group setting using two different remote microphones. MethodsA quasi-experimental, repeated-measures design was employed, involving ten participants with TH, ages 20 to 63 years. Each were fit with Roger Focus receivers bilaterally to listen to three RM conditions: Roger Select, Roger Pen, and no technology. Participants were instructed to transcribe sentences that were presented randomly at varying signal-to-noise ratios (SNRs: 0, -5, and -10 dB) from five speakers positioned equidistant around a circular table to simulate a group dining scenario. ResultsSignificant main effects of the technology condition and noise level (p < .05) were found. Participants exhibited superior performance with Roger Select compared to Roger Pen. As expected, recognition rates decreased with lower SNRs across all three technology conditions. ConclusionsTo enhance speech recognition in group settings for individuals with TH, the utilization of the Roger Select microphone in conjunction with bilateral Roger Focus receivers is recommended over the Roger Pen

Speech production skills of bilingual children using cochlear implants

Abstract Evidence is lacking on the impact of bilingualism on the speech skills of children with cochlear implants (CIs). This study described the speech production of children with CIs acquiring French and one or more additional spoken languages. Four groups of children aged 4–11 were included: bilinguals (n = 15) and monolinguals (n = 14) with CIs and bilinguals (n = 14) and monolinguals (n = 20) with typical hearing. Data were collected about the percentage of consonant correct (PCC) and vowel correct (PVC) produced in French and intelligibility in all languages they spoke. Bilingual and monolingual children with CIs had comparable speech accuracy in French, but the pattern differed, impacting PCC for bilinguals and PVC for monolinguals. Most children with CIs had accurate and intelligible speech in French, but few bilingual children with CIs were highly intelligible in their home language. Therefore, bilingualism did not impede the speech production outcomes of bilingual children with CIs in the language of the wider community.

Cortical mechanisms of across-ear speech integration investigated using functional near-infrared spectroscopy (fNIRS).

This study aimed to investigate integration of alternating speech, a stimulus which classically produces a V-shaped speech intelligibility function with minimum at 2-6 Hz in typical-hearing (TH) listeners. We further studied how degraded speech impacts intelligibility across alternating rates (2, 4, 8, and 32 Hz) using vocoded speech, either in the right ear or bilaterally, to simulate single-sided deafness with a cochlear implant (SSD-CI) and bilateral CIs (BiCI), respectively. To assess potential cortical signatures of across-ear integration, we recorded activity in the bilateral auditory cortices (AC) and dorsolateral prefrontal cortices (DLPFC) during the task using functional near-infrared spectroscopy (fNIRS). For speech intelligibility, the V-shaped function was reproduced only in the BiCI condition; TH (with ceiling scores) and SSD-CI conditions had significantly higher scores across all alternating rates compared to the BiCI condition. For fNIRS, the AC and DLPFC exhibited significantly different activity across alternating rates in the TH condition, with altered activity patterns in both regions in the SSD-CI and BiCI conditions. Our results suggest that degraded speech inputs in one or both ears impact across-ear integration and that different listening strategies were employed for speech integration manifested as differences in cortical activity across conditions.

Retrieval practice and word learning in children who are hard of hearing

Purpose Many children who are deaf and hard of hearing (DHH) show poorer auditory word-learning skills than children with typical hearing (TH). The goal of this study was to test the effect of retrieval practice on word learning in children who are hard of hearing (HH). Method Twenty-six TH children and 16 children who are HH completed a speech perception and a vocabulary test, and a rapid word-learning game to learn new words under no retrieval, immediate retrieval, and spaced retrieval conditions. Result Linear mixed-effect models revealed that learning condition and time predicted 48% of the variance in word recognition, and age predicted 15% of word recall variance. We observed no differences in word recognition and recall between TH children and children who are HH. Children learned and remembered more words in the immediate and spaced retrieval practice conditions than in the no retrieval condition. Conclusion Retrieval practice is more effective for word learning and retention than passive exposure (no retrieval). Clinical and educational practices for children who are DHH could combine explicit instruction using targeted exposures and retrieval of new words with naturalistic approaches. Future studies should assess retrieval practice in real-life interventions to inform clinical and educational practices.

Vocal and early speech development in Korean-acquiring children with hearing loss and typical hearing

ABSTRACT This study investigated the vocal and early speech development of Korean-acquiring children with hearing loss (HL) who underwent early auditory amplification compared to their typical hearing (TH) counterparts. The research focused on phonological characteristics of child vocalisation based on samples collected from naturalistic home environments. One-day home recordings using a Language ENvironment Analysis (LENA) recorder were obtained from 6 children with HL and 12 children with TH who ranged from 17 to 23 months of age in Korean monolingual environments. Child volubility, canonical babbling ratio (CBR), consonant distributions, and utterance structures of vocalisations were evaluated through qualitative and quantitative analyses of vocalisation samples collected from LENA recordings. The findings revealed that children with HL displayed comparable vocalisation levels to children with TH, with no significant differences in volubility and CBR. In consonant and utterance shape inventories, noticeable quantitative and qualitative differences were observed between children with HL and those with TH. The study also suggested both universal and language-specific production patterns, revealing the early effects of ambient language on consonant distributions and utterance structures within their vocalisation repertoire. This study emphasised the role of auditory input and the importance of early auditory amplification to support speech development in children with HL.

Neurocognitive outcomes in young adults with cochlear implants: The role of early language access and crossmodal plasticity

Many children with profound hearing loss have received cochlear implants (CI) to help restore some sense of hearing. There is, however, limited research on long-term neurocognitive outcomes in young adults who have grown up hearing through a CI. This study compared the cognitive outcomes of early-implanted (n = 20) and late-implanted (n = 21) young adult CI users, and typically hearing (TH) controls (n=56), all of whom were enrolled in college. Cognitive fluidity, nonverbal intelligence, and American Sign Language (ASL) comprehension were assessed, revealing no significant differences in cognition and nonverbal intelligence between the early and late-implanted groups. However, there was a difference in ASL comprehension, with the late-implanted group having significantly higher ASL comprehension. Although young adult CI users showed significantly lower scores in a working memory and processing speed task than TH age-matched controls, there were no significant differences in tasks involving executive function shifting, inhibitory control, and episodic memory between young adult CI and young adult TH participants. In an exploratory analysis of a subset of CI participants (n = 17) in whom we were able to examine crossmodal plasticity, we saw greater evidence of crossmodal recruitment from the visual system in late-implanted compared with early-implanted CI young adults. However, cortical visual evoked potential latency biomarkers of crossmodal plasticity were not correlated with cognitive measures or ASL comprehension. The results suggest that in the late-implanted CI users, early access to sign language may have served as a scaffold for appropriate cognitive development, while in the early-implanted group early access to oral language benefited cognitive development. Furthermore, our results suggest that the persistence of crossmodal neuroplasticity into adulthood does not necessarily impact cognitive development. In conclusion, early access to language – spoken or signed – may be important for cognitive development, with no observable effect of crossmodal plasticity on cognitive outcomes.

Difficulties in implicit emotion regulation of the deaf college students: An ERP study

BackgroundDeaf college students have been found to experience more difficulties in emotion regulation due to their hearing loss. However, few studies have used neurological measures to assess the characteristics of implicit emotion regulation among deaf college students. Methods30 typical hearing college students and 27 deaf college students completed the implicit emotion regulation task while recording ERP data. ResultsThe behavioral results indicated that deaf college students exhibited higher emotional experience intensity compared to typical hearing control. The ERP results showed that deaf college students had lower LPP amplitudes when using reappraisal and suppression strategies. Furthermore, the LPP of cognitive reappraisal was associated with an increase in depression scores among deaf students. ConclusionsDeaf college students may have deficits in implicit emotion regulation, which can effectively predict depression.

Awareness, knowledge, and practice among regular primary school teachers about hearing impairment

Abstract Purpose: Children will develop communication, cognitive, language, and social skills, and early academic achievement more effectively like their other typical hearing children if they are identified and intervened early. This study aimed to investigate the awareness, knowledge, and practices of regular school teachers regarding hearing impairment and its influencing factors. With the evolution of education for hearing-impaired children toward inclusive practices, teachers play a pivotal role in identifying and supporting students with hearing loss. Methods: Employing a questionnaire-based cross-sectional design with convenient sampling, 270 participants were recruited. The self-administered questionnaire investigates teachers’ awareness, knowledge, and practices concerning various aspects of hearing impairment. These aspects included etiology, effects, identification, management, audiology, communication methods/modifications, teacher support, noise, and prevention. Results: The study revealed a limited understanding among regular school teachers regarding the causes of hearing loss and the working and benefits of amplification devices. While the overall knowledge level regarding hearing impairment was deemed fair, notable gaps were identified. However, overall good awareness and practice were observed. Conclusion: From the above study, it can be concluded that teachers with special training (prior training related to education to hearing impaired children through seminar and online mode) were substantial better on awareness and knowledge skills compared to nontrained teachers.

Characteristics of Joint Attention and Maternal Cues in Mother-Child Interactions for Toddlers with Cochlear Implants

Objectives: This study aimed to identify the differences in the establishment of joint attention between the cochlear implant (CI) group and the typical hearing (TH) group during mother-child interactions and to explore the relationship between the joint attention variables and language development abilities in young children with CIs. Methods: Thirteen pairs of hearing mothers and children with CIs and seventeen pairs of mothers and children with TH participated in this study. Their interactions during a 20-minute free-play task were recorded using digital cameras. Results: The frequency of joint attention attempts in the CI group was significantly higher than in the TH group. There was no significant difference between the two groups in the success rate of joint attention; however, there was a considerable difference in the time ratio of joint attention and joint attention span. Children’s language scores were significantly correlated with the success rate of joint attention, the time ratio of joint attention, and joint attention span in the CI group. Conclusion: We observed the mothers’ efforts to establish joint attention with their children with CIs. These results suggest that children with CIs are more likely to have less time for joint attention during parent-child interactions. These findings can inform the development of parent-coaching programs in early auditory intervention for children with CIs.

Listening Effort Measured With Pupillometry in Cochlear Implant Users Depends on Sound Level, But Not on the Signal to Noise Ratio When Using the Matrix Test.

We investigated whether listening effort is dependent on task difficulty for cochlear implant (CI) users when using the Matrix speech-in-noise test. To this end, we measured peak pupil dilation (PPD) at a wide range of signal to noise ratios (SNR) by systematically changing the noise level at a constant speech level, and vice versa. A group of mostly elderly CI users performed the Dutch/Flemish Matrix test in quiet and in multitalker babble at different SNRs. SNRs were set relative to the speech-recognition threshold (SRT), namely at SRT, and 5 and 10 dB above SRT (0 dB, +5 dB, and +10 dB re SRT). The latter 2 conditions were obtained by either varying speech level (at a fixed noise level of 60 dBA) or by varying noise level (with a fixed speech level). We compared these PPDs with those of a group of typical hearing (TH) listeners. In addition, listening effort was assessed with subjective ratings on a Likert scale. PPD for the CI group did not significantly depend on SNR, whereas SNR significantly affected PPDs for TH listeners. Subjective effort ratings depended significantly on SNR for both groups. For CI users, PPDs were significantly larger, and effort was rated higher when speech was varied, and noise was fixed for CI users. By contrast, for TH listeners effort ratings were significantly higher and performance scores lower when noise was varied, and speech was fixed. The lack of a significant effect of varying SNR on PPD suggests that the Matrix test may not be a feasible speech test for measuring listening effort with pupillometric measures for CI users. A rating test appeared more promising in this population, corroborating earlier reports that subjective measures may reflect different dimensions of listening effort than pupil dilation. Establishing the SNR by varying speech or noise level can have subtle, but significant effects on measures of listening effort, and these effects can differ between TH listeners and CI users.

The Effort of Repairing a Misperceived Word Can Impair Perception of Following Words, Especially for Listeners With Cochlear Implants.

In clinical and laboratory settings, speech recognition is typically assessed in a way that cannot distinguish accurate auditory perception from misperception that was mentally repaired or inferred from context. Previous work showed that the process of repairing misperceptions elicits greater listening effort, and that this elevated effort lingers well after the sentence is heard. That result suggests that cognitive repair strategies might appear successful when testing a single utterance but fail for everyday continuous conversational speech. The present study tested the hypothesis that the effort of repairing misperceptions has the consequence of carrying over to interfere with perception of later words after the sentence. Stimuli were open-set coherent sentences that were presented intact or with a word early in the sentence replaced with noise, forcing the listener to use later context to mentally repair the missing word. Sentences were immediately followed by digit triplets, which served to probe carryover effort from the sentence. Control conditions allowed for the comparison to intact sentences that did not demand mental repair, as well as to listening conditions that removed the need to attend to the post-sentence stimuli, or removed the post-sentence digits altogether. Intelligibility scores for the sentences and digits were accompanied by time-series measurements of pupil dilation to assess cognitive load during the task, as well as subjective rating of effort. Participants included adults with cochlear implants (CIs), as well as an age-matched group and a younger group of listeners with typical hearing for comparison. For the CI group, needing to repair a missing word during a sentence resulted in more errors on the digits after the sentence, especially when the repair process did not result in a coherent sensible perception. Sentences that needed repair also contained more errors on the words that were unmasked. All groups showed substantial increase of pupil dilation when sentences required repair, even when the repair was successful. Younger typical hearing listeners showed clear differences in moment-to-moment allocation of effort in the different conditions, while the other groups did not. For CI listeners, the effort of needing to repair misperceptions in a sentence can last long enough to interfere with words that follow the sentence. This pattern could pose a serious problem for regular communication but would go overlooked in typical testing with single utterances, where a listener has a chance to repair misperceptions before responding. Carryover effort was not predictable by basic intelligibility scores, but can be revealed in behavioral data when sentences are followed immediately by extra probe words such as digits.

Greater working memory in cochlear implant users is related to higher subjective quality of life

IntroductionA common concern for individuals with moderate-to-profound hearing loss who have received a cochlear implants (CIs) is difficulty following conversations in noisy environments. A possible reason is the increased use of cognitive resources (attention and working memory) to disambiguate the speech stimuli potentially causing detriments in functional aspects of life. However, this relationship is not well-documented. The overall arching goal of this study was to quantify the relationships between Patient-Reported Outcome Measures (PROMs) and cognitive ability through working memory and speech perception measures.MethodsIn the current study, 31 adult CI users and typical hearing (TH) age-matched controls were recruited. CI users completed PROMs including Speech, Spatial and Quality of hearing survey (SSQ) and versions of a quality of life (QOL) for CI users (CIQOL) and Nijmegen Cochlear Implant Questionnaire (NCIQ). Measures of cognition were assessed using internet-based tools. Outcomes were compared between groups and PROMs and were related to the cognitive tasks.ResultsReduced auditory working memory and speech perception in noise were observed in CI users compared to TH controls. Correlation analyses revealed significant domain-specific PROM relationships with cognitive tasks in CI users, but not in TH controls. The SSQ had more significant relationships compared to the other PROMS.ConclusionThese results suggest that internet-based metrics of cognitive ability are associated with the functional hearing aspects of life in CI users and that SSQ is more sensitive to investigate the cognitive related effects of QOL compared to other commonly used PROMs.

Spelling Errors in Children With Mild to Moderate Hearing Loss: Relations to Linguistic and Audiologic Factors

The purpose of this study was to evaluate the types of spelling errors made by children with mild to moderate hearing loss (CMMHL) compared with children with typical hearing (TH) and to determine if types of spelling errors were related to linguistic or audiologic factors. CMMHL and TH completed measures of spelling, spoken language, speech production, and reading. Children's spellings were coded for linguistic-based spelling errors using the Multilinguistic Coding System. The relation of types of linguistic spelling errors and children's performance on standardized language assessments, as well as audiologic factors, was evaluated. CMMHL did not make more spelling errors than TH; however, they exhibited a higher proportion of phonological awareness errors and a lower proportion of mental grapheme representation errors in their spellings. Phonological awareness errors and mental grapheme representation errors were related to relevant linguistic performance. Better-ear pure-tone average was related to total frequency of spelling errors and phonological awareness spelling errors, and better-ear Speech Intelligibility Index (SII) was related to semantic knowledge spelling errors. This study supports the use of linguistic spelling error analysis with CMMHL and provides evidence of the relation of types of linguistic spelling errors to linguistic knowledge and audiologic factors.

Comparative analysis of microstructures of narrative abilities in language-age-matched Tamil-speaking children with cochlear implants and typical hearing

In a unique exploration of narrative development among Tamil-speaking children, this study delves into the intricacies of linguistic expression, explicitly comparing the microstructure of narratives in two distinct groups: those with hearing differences (HD) and those with normal hearing. A total of 30 children were included in the study, with 15 children in each group, matched for language age between 3-5 years on standard language tests. The children were asked to retell a story they had listened to, and the obtained samples were transcribed verbatim and analyzed for various microstructural elements, including the mean length of utterances, total number of words, number of utterances, and number of different word types. The results revealed that children with hearing loss used fewer words and simpler sentences during retelling despite having the same language age as their peers. This highlights the importance of incorporating narrative assessment in standard language evaluations. Furthermore, the findings emphasise integrating narrative intervention into language intervention programs to enhance language productivity. Overall, this study provides valuable insights into the narrative abilities of Tamil-speaking children with cochlear implants and underscores the significance of addressing narrative skills in language intervention approaches.

Mandarin-speaking Children With Cochlear Implants Face Challenges in Using F0 Expansion to Express Contrastive Focus.

Children with cochlear implants (CIs) face challenges in perceiving fundamental frequency (F0) information because CIs do not transmit F0 effectively. In Mandarin, F0 can contrast meanings at the word level, that is, via lexical tones with distinct F0 contours, and signal contrastive relations between words at the utterance-level, that is, via contrastive focus with expanded F0 range and longer duration. Mandarin-speaking children with CIs have been reported to face challenges in producing distinct F0 contours across tones, but early implantation facilitates tonal acquisition. However, it is still unclear if utterance-level prosody, such as contrastive focus, is also challenging for these children, and if early implantation also offers benefits for focus production. Therefore, this study asked how accurately children with CIs can produce contrastive focus, and if early implantation leads to more accurate focus production, with acoustic patterns approaching that of children with typical hearing (TH). Participants included 55 Mandarin-speaking children (3 to 7 years) with CIs and 55 age-matched children with TH. Children produced noun phrases with and without contrastive focus, such as RED-COLORED cat versus red-colored cat. Three adult native listeners perceptually scored the productions as correct or incorrect. The "correct" productions were then acoustically analyzed in terms of F0 range and duration. Based on the perceptual scores, children with CIs produced focus with significantly lower accuracy (38%) than their TH peers (84%). The acoustic analysis on their "correct" productions showed that children with TH used both F0 and duration to mark focus, producing focal syllables with an expanded F0 range and long duration, and postfocal syllables with a reduced F0 range and short duration. However, children with CIs differed from children with TH in that they produced focal syllables with long duration but not an expanded F0 range, although they produced postfocal syllables with a reduced F0 range and short duration like their TH peers. In addition, early implantation correlated with the percept of more accurate focus productions and better use of F0 range in focal marking. This study finds that Mandarin-speaking children with CIs are still learning to apply appropriate acoustic cues to contrastive focus. The challenge appears to lie in the use of an expanded F0 range to mark focus, probably related to the limited transmission of F0 information through the CI devices. These findings thus have implications for parents and those working with children with CIs, showing that utterance-level prosody also requires speech remediation, and underscores the critical role of identifying problems early in the acquisition of F0 functions in Mandarin, not only at the word level but also at the utterance-level.