Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients

IntroductionDespite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear.ObjectivesThis investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant.MethodsObservational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1 + HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1 + CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1 + CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis.ResultsCompared to the CI1 + HA, CI1 + CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio = 4.38, 95% confidence interval – 95% = 1.07–17.93, p = 0.04).ConclusionsThe children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.     

Production of consonants by prelinguistically deaf children with cochlear implants

Consonant production following the sensory restoration of audition was investigated in 22 prelinguistically deaf French children who received cochlear implants. Spontaneous speech productions were recorded at 6, 12, and 18 months post‐surgery and consonant inventories were derived from both glossable and non‐glossable phones using two acquisition criteria. The results showed that children initiated appropriate production of consonants after six months of implant use. Stops and labials were the most frequently produced speech sounds, whereas glides and palatals were still infrequent after 18 months. Speech accuracy also improved throughout the study. Consonant visibility appeared to influence the order of acquisition in the first months following the implantation and, as experience with auditory information increased, patterns of development tended to resemble those seen in children with normal hearing. Finally, a signed mode of communication and oral rehabilitation programs prior to implantation were better outcome predictors than age at implantation.     

Using fNIRS to examine occipital and temporal responses to stimulus repetition in young infants: Evidence of selective frontal cortex involvement

How does the developing brain respond to recent experience? Repetition suppression (RS) is a robust and well-characterized response of to recent experience found, predominantly, in the perceptual cortices of the adult brain. We use functional near-infrared spectroscopy (fNIRS) to investigate how perceptual (temporal and occipital) and frontal cortices in the infant brain respond to auditory and visual stimulus repetitions (spoken words and faces). In Experiment 1, we find strong evidence of repetition suppression in the frontal cortex but only for auditory stimuli. In perceptual cortices, we find only suggestive evidence of auditory RS in the temporal cortex and no evidence of visual RS in any ROI. In Experiments 2 and 3, we replicate and extend these findings. Overall, we provide the first evidence that infant and adult brains respond differently to stimulus repetition. We suggest that the frontal lobe may support the development of RS in perceptual cortices.     

Perception based method for the investigation of audiovisual integration of speech

Speech comprehension is significantly improved by visual input on the speaker's mouth movements. Audiovisual integration underlying this phenomenon is often studied in EEG experiments in which the event related brain potential (ERP) elicited by a bimodal stimulus is compared to the sum of ERPs triggered by auditory and visual signals of the same source. However, this method leads to spurious results in time ranges when ERP components common to all these stimulus types are present. A method that aims to filter out such common early anticipatory potentials is data high-pass filtering. In the present study, first, we demonstrated that subtle changes in filter cut-off frequency lead to remarkably different results on the interaction effect so that no reliable conclusion on the spatial distribution of the interaction could be drawn. Second, we suggested a different approach for the investigation of ERP correlates of audiovisual integration: bimodal syllables modified by light temporal asynchrony were presented to subjects and ERPs correlating with the fused and unfused perceptions were compared. We found that components corresponding to both auditory N1 and P2 waves were smaller in case of the fused perception, supporting the view that N1 and P2 generator activities are suppressed during multimodal speech perception. The N1 effect showed a clearly right hemisphere dominance while the effect around the P2 peak was most pronounced on centroparietal electrodes and dominated over the left hemisphere.     

Auditory stream segregation in children with Asperger syndrome

Individuals with Asperger syndrome (AS) often have difficulties in perceiving speech in noisy environments. The present study investigated whether this might be explained by deficient auditory stream segregation ability, that is, by a more basic difficulty in separating simultaneous sound sources from each other. To this end, auditory event-related brain potentials were recorded from a group of school-aged children with AS and a group of age-matched controls using a paradigm specifically developed for studying stream segregation. Differences in the amplitudes of ERP components were found between groups only in the stream segregation conditions and not for simple feature discrimination. The results indicated that children with AS have difficulties in segregating concurrent sound streams, which ultimately may contribute to the difficulties in speech-in-noise perception.     

Clinical research with the prosody-voice screening profile

The Prosody-Voice Screening Profile (PVSP) is a clinical research instrument that quantifies a speaker's conversational speech status in seven suprasegmental domains: phrasing, rate, stress, loudness, pitch, laryngeal quality and resonance. The PVSP has been used to assess the prosody-voice characteristics of children and adult speakers with typical speech-language development and with a variety of speech-language disorders of known and unknown origin. PVSP coding requires a trained examiner to determine, on an utterance-by-utterance basis within each of the seven domains, whether a speaker's prosody-voice characteristics can be defined as appropriate based on a set of auditory-perceptual criteria. This report provides brief overviews of the development, administration, and psychometric features of this screening tool, and summarizes prosody-voice findings to date for several typically speaking and clinical populations.     

Affective reactivity of speech disturbances in schizotypy

Speech disturbances (SD) are a pernicious symptom of schizophrenia that increase when negative emotion is elicited. This increase is referred to as affective reactivity (AR). Although considerable research has examined SD in schizophrenia, few studies have investigated this symptom in individuals at risk for the disorder, who demonstrate schizophrenia-like, or schizotypic, traits. In the present study, we examined: (1) SD severity in schizotypy, (2) how SD varies as a function of stress reactivity in schizotypy, and (3) the relationship between SD/AR with Quality of Life (QOL). Individuals with psychometrically-defined schizotypy (n = 83) and controls (n = 22) completed a laboratory procedure in which they produced speech while viewing pleasant and stressful photographs. This speech was analyzed for subtle speech disorder using a well-validated measure. We found that the schizotypy group demonstrated significant increases in SD across both baseline and stressful conditions compared to the control group. AR was not significantly different between the groups. Within the schizotypy group, severity of disorganized schizotypy symptoms was associated with high levels of SD and AR while interpersonal schizotypy was associated with low levels of SD and AR. AR was also related to increased objective QOL in the schizotypy group. This study highlights the role of stress reactivity across the schizophrenia-spectrum. Moreover, the incongruous relationships between disorganized and interpersonal symptoms with SD underscore the marked heterogeneity in processes across schizotypy.     

Temporal modulations in speech and music

Speech and music have structured rhythms. Here we discuss a major acoustic correlate of spoken and musical rhythms, the slow (0.25–32 Hz) temporal modulations in sound intensity and compare the modulation properties of speech and music. We analyze these modulations using over 25 h of speech and over 39 h of recordings of Western music. We show that the speech modulation spectrum is highly consistent across 9 languages (including languages with typologically different rhythmic characteristics). A different, but similarly consistent modulation spectrum is observed for music, including classical music played by single instruments of different types, symphonic, jazz, and rock. The temporal modulations of speech and music show broad but well-separated peaks around 5 and 2 Hz, respectively. These acoustically dominant time scales may be intrinsic features of speech and music, a possibility which should be investigated using more culturally diverse samples in each domain. Distinct modulation timescales for speech and music could facilitate their perceptual analysis and its neural processing.     

腭裂病人一期术后的语音评估

目的 对腭裂病人一期术后的语音障碍进行评估和分析,寻求合理的治疗方法 .方法 因语音障碍在我院就诊的唇腭裂或腭裂术后病人共65例,其中单侧完全性腭裂28例,单侧不完全性腭裂19例,双侧完全性腭裂10例,不能判定腭裂类型者8例.对65例病人行语音评估及同期录音分析,分析共鸣方式和构音方法 ;并对47例病人行鼻咽纤维镜(NPS)检查,确定腭咽闭合不全率(Ratio).结果 语音评估结果 显示,共鸣方式为高鼻音52例(占80.0%),低鼻音13例(占20.0%);从音韵结构历程和病人构音位置等方面分析,声母省略47例(占72.3%),声母舌后置19例(占29.2%),声母舌前置16例(占24.6%),而喉头音和代偿性语音32例(占49.2%).NPS检查示,Ratio<0.3者12例,0.3～0.5者15例,0.6～0.7者11例,0.8～0.9者9例.结论 对腭裂病人一期术后语音评估有助于手术方式的评价,并为二期腭咽成形手术和语音治疗提供客观依据.