Speech Perception in Noise by Children With Cochlear Implants

Abstract

Purpose Common wisdom suggests that listening in noise poses disproportionately greater difficulty for listeners with cochlear implants (CIs) than for peers with normal hearing (NH). The purpose of this study was to examine phonological, language, and cognitive skills that might help explain speech-in-noise abilities for children with CIs. Method Three groups of kindergartners (NH, hearing aid wearers, and CI users) were tested on speech recognition in quiet and noise and on tasks thought to underlie the abilities that fit into the domains of phonological awareness, general language, and cognitive skills. These last measures were used as predictor variables in regression analyses with speech-in-noise scores as dependent variables. Results Compared to children with NH, children with CIs did not perform as well on speech recognition in noise or on most other measures, including recognition in quiet. Two surprising results were that (a) noise effects were consistent across groups and (b) scores on other measures did not explain any group differences in speech recognition. Conclusions Limitations of implant processing take their primary toll on recognition in quiet and account for poor speech recognition and language/phonological deficits in children with CIs. Implications are that teachers/clinicians need to teach language/phonology directly and maximize signal-to-noise levels in the classroom.

Initial Stop Voicing in Bilingual Children With Cochlear Implants and Their Typically Developing Peers With Normal Hearing

“…As Caldwell and Nittrouer (2013) note, voicing contrasts for consonants may be relatively more resistant to hearing loss than other phonemic distinctions, a fact that has likely contributed to the results we found regarding how well bilingual children with CIs were able to match their peers' productions when it came to initial stop voicing. Future studies on phonological acquisition in bilingual children with hearing loss who use CIs may focus on a wider range of phonological phenomena, some of which are easily accessible to children with CIs and others that may be more challenging for them (such as certain fricatives; cf.…”

“…We also posit the null hypothesis regarding group differences between bilingual children with CIs versus their peers with NH because as Caldwell and Nittrouer (2013) note, VOT can be conveyed well via the device, but as reviewed in previous paragraphs, children with CIs may display delay in some aspects of language relative to their peers with NH. Thus, it is not known whether bilingual children with CIs will produce stop voicing contrasts in a similar fashion to their peers with NH due to the perceptual salience of the contrast or whether there will be differences due to hearing loss.…”

“…The aspects of phonology and speech that develop more readily in children with CIs are at least partially dependent on what the device can transmit well. For example, Caldwell and Nittrouer (2013) note that CIs transmit temporal aspects of speech relatively well; consequently, voice onset time (VOT)-and by extension, stop voicingpresents an opportunity to test how well children with CIs can form phonemic categories. Giezen, Escudero, and Baker (2010) found that Dutch children with CIs differentiate stop voicing contrasts (/bu/ vs. /pu/) better than other phonemic contrasts (/fu/ vs. /su/).…”

A Multicenter Clinical Evaluation of Data Logging in Cochlear Implant Recipients Using Automated Scene Classification Technologies

“…In addition, previous research has clearly demonstrated the benefit of a good SNR for speech understanding in children [Caldwell and Nittrouer, 2013;Gifford et al, 2011;Meister et al, 2015;Plasmans et al, 2016]. The use of hearing assistance technology for CI patients is therefore essential to improve speech recognition in classrooms.…”

The Phonics Approach in Swedish Children using Cochlear Implants or Hearing Aids: Inspecting Phonological Gain

“…Fewer studies have sought to explore how these cognitive abilities relate to the development of PhPS [30]. Another aspect worth considering when studying DHH children's cognitive development is how reduced spectral resolution [31] and less cues of temporal fine structure [32,33] affect how they develop PhPS in different situations, i.e., speech recognition in noise [21,34], and in reaching fine-grained levels of phonological sensitivity [2]. Thus, as Nittrouer et al reasoned [2] finegrained levels of phonological processing might be difficult to acquire both due to the hearing loss itself, and due to the signal transmitted through their technical device.…”