On the interplay between speech perception and production: insights from research and theories.

The study of spoken communication has long been entrenched in a debate surrounding the interdependence of speech production and perception. This mini review summarizes findings from prior studies to elucidate the reciprocal relationships between speech production and perception. We also discuss key theoretical perspectives relevant to speech perception-production loop, including hyper-articulation and hypo-articulation (H&H) theory, speech motor theory, direct realism theory, articulatory phonology, the Directions into Velocities of Articulators (DIVA) and Gradient Order DIVA (GODIVA) models, and predictive coding. Building on prior findings, we propose a revised auditory-motor integration model of speech and provide insights for future research in speech perception and production, focusing on the effects of impaired peripheral auditory systems.

A Modified Pediatric Ranked Order Speech Perception Score to Assess Speech Recognition Development in Children With Cochlear Implants.

PURPOSE: Characterizing and comparing speech recognition development in children with cochlear implants (CIs) is challenging because of variations in test type. This retrospective cohort study modified the Pediatric Ranked Order Speech Perception (PROSPER) scoring system to (a) longitudinally analyze the speech perception of children with CIs and (b) examine the role of age at CI activation, listening mode (i.e., unilateral or bilateral implantation), and interimplant interval. METHOD: Postimplantation speech recognition scores from 31 children with prelingual, severe-to-profound hearing loss who received CIs were analyzed (12 with unilateral CI [UniCI], 13 with sequential bilateral CIs [SEQ BiCIs], and six with simultaneous BiCIs). Data were extracted from the Massachusetts Eye and Ear Audiology database. A version of the PROSPER score was modified to integrate the varying test types by mapping raw scores from different tests into a single score. The PROSPER scores were used to construct speech recognition growth curves of the implanted ears, which were characterized by the slope of the growth phase, the time from activation to the plateau onset, and the score at the plateau. RESULTS: While speech recognition improved considerably for children following implantation, the growth rates and scores at the plateau were highly variable. In first implanted ears, later implantation was associated with poorer scores at the plateau (ß = -0.15, p = .01), but not growth rate. The first implanted ears of children with BiCIs had better scores at the plateau than those with UniCI (ß = 0.59, p = .02). Shorter interimplant intervals in children with SEQ BiCIs promoted faster speech recognition growth of the first implanted ears. CONCLUSION: The modified PROSPER score could be used clinically to track speech recognition development in children with CIs, to assess influencing factors, and to assist in developing and evaluating patient-specific intervention strategies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20113538.

Single-Channel Focused Thresholds Relate to Vowel Identification in Pediatric and Adult Cochlear Implant Listeners.

Speech recognition outcomes are highly variable among pediatric and adult cochlear implant (CI) listeners. Although there is some evidence that the quality of the electrode-neuron interface (ENI) contributes to this large variability in auditory perception, its relationship with speech outcomes is not well understood. Single-channel auditory detection thresholds measured in response to focused electrical fields (i.e., focused thresholds) are sensitive to properties of ENI quality, including electrode-neuron distance, intracochlear resistance, and neural health. In the present study, focused thresholds and speech perception abilities were assessed in 15 children and 21 adult CI listeners. Focused thresholds were measured for all active electrodes using a fast sweep procedure. Speech perception performance was evaluated by assessing listeners' ability to identify vowels presented in /h-vowel-d/ context. Consistent with prior literature, focused thresholds were lower for children than for adults, but vowel identification did not differ significantly across age groups. Higher across-array average focused thresholds, which may indicate a relatively poor ENI quality, were associated with poorer vowel identification scores in both children and adults. Adult CI listeners with longer durations of deafness had higher focused thresholds. Findings from this study demonstrate that poor-quality ENIs may contribute to reduced speech outcomes for pediatric and adult CI listeners. Estimates of ENI quality (e.g., focused thresholds) may assist in developing customized programming interventions that serve to improve the transmission of spectral cues that are important in vowel identification.

The Relationship Between Impedance, Programming and Word Recognition in a Large Clinical Dataset of Cochlear Implant Recipients.

Cochlear implant programming typically involves measuring electrode impedance, selecting a speech processing strategy and fitting the dynamic range of electrical stimulation. This study retrospectively analyzed a clinical dataset of adult cochlear implant recipients to understand how these variables relate to speech recognition. Data from 425 implanted post-lingually deafened ears with Advanced Bionics devices were analyzed. A linear mixed-effects model was used to infer how impedance, programming and patient factors were associated with monosyllabic word recognition scores measured in quiet. Additional analyses were conducted on subsets of data to examine the role of speech processing strategy on scores, and the time taken for the scores of unilaterally implanted patients to plateau. Variation in basal impedance was negatively associated with word score, suggesting importance in evaluating the profile of impedance. While there were small, negative bivariate correlations between programming level metrics and word scores, these relationships were not clearly supported by the model that accounted for other factors. Age at implantation was negatively associated with word score, and duration of implant experience was positively associated with word score, which could help to inform candidature and guide expectations. Electrode array type was also associated with word score. Word scores measured with traditional continuous interleaved sampling and current steering speech processing strategies were similar. The word scores of unilaterally implanted patients largely plateaued within 6-months of activation. However, there was individual variation which was not related to initially measured impedance and programming levels.

Variability in Quantity and Quality of Early Linguistic Experience in Children With Cochlear Implants: Evidence from Analysis of Natural Auditory Environments.

OBJECTIVES: Understanding how quantity and quality of language input vary across children with cochlear implants (CIs) is important for explaining sources of large individual differences in language outcomes of this at-risk pediatric population. Studies have mostly focused either on intervention-related, device-related, and/or patient-related factors, or relied on data from parental reports and laboratory-based speech corpus to unravel factors explaining individual differences in language outcomes among children with CIs. However, little is known about the extent to which children with CIs differ in quantity and quality of language input they experience in their natural linguistic environments. To address this knowledge gap, the present study analyzed the quantity and quality of language input to early-implanted children (age of implantation <23 mo) during the first year after implantation. DESIGN: Day-long Language ENvironment Analysis (LENA) recordings, derived from home environments of 14 early-implanted children, were analyzed to estimate numbers of words per day, type-token ratio (TTR), and mean length of utterance in morphemes (MLUm) in adults' speech. Properties of language input were analyzed across these three dimensions to examine how input in home environments varied across children with CIs in quantity, defined as number of words, and quality, defined as whether speech was child-directed or overheard. RESULTS: Our per-day estimates demonstrated that children with CIs were highly variable in the number of total words (mean ± SD = 25,134 ± 9,267 words) and high-quality child-directed words (mean ± SD = 10,817 ± 7,187 words) they experienced in a day in their home environments during the first year after implantation. The results also showed that the patterns of variability across children in quantity and quality of language input changes depending on whether the speech was child-directed or overheard. Children also experienced highly different environments in terms of lexical diversity (as measured by TTR) and morphosyntactic complexity (as measured by MLUm) of language input. The results demonstrated that children with CIs varied substantially in the quantity and quality of language input experienced in their home environments. More importantly, individual children experienced highly variable amounts of high-quality, child-directed speech, which may drive variability in language outcomes across children with CIs. CONCLUSIONS: Analyzing early language input in natural, linguistic environments of children with CIs showed that the quantity and quality of early linguistic input vary substantially across individual children with CIs. This substantial individual variability suggests that the quantity and quality of early linguistic input are potential sources of individual differences in outcomes of children with CIs and warrant further investigation to determine the effects of this variability on outcomes.

Circumspection in using automated measures: Talker gender and addressee affect error rates for adult speech detection in the Language ENvironment Analysis (LENA) system.

Automatic speech processing devices have become popular for quantifying amounts of ambient language input to children in their home environments. We assessed error rates for language input estimates for the Language ENvironment Analysis (LENA) audio processing system, asking whether error rates differed as a function of adult talkers' gender and whether they were speaking to children or adults. Audio was sampled from within LENA recordings from 23 families with children aged 4-34 months. Human coders identified vocalizations by adults and children, counted intelligible words, and determined whether adults' speech was addressed to children or adults. LENA's classification accuracy was assessed by parceling audio into 100-ms frames and comparing, for each frame, human and LENA classifications. LENA correctly classified adult speech 67% of the time across families (average false negative rate: 33%). LENA's adult word count showed a mean +47% error relative to human counts. Classification and Adult Word Count error rates were significantly affected by talkers' gender and whether speech was addressed to a child or an adult. The largest systematic errors occurred when adult females addressed children. Results show LENA's classifications and Adult Word Count entailed random - and sometimes large - errors across recordings, as well as systematic errors as a function of talker gender and addressee. Due to systematic and sometimes high error in estimates of amount of adult language input, relying on this metric alone may lead to invalid clinical and/or research conclusions. Further validation studies and circumspect usage of LENA are warranted.

Individual Differences in Mothers' Spontaneous Infant-Directed Speech Predict Language Attainment in Children With Cochlear Implants.

Purpose Differences across language environments of prelingually deaf children who receive cochlear implants (CIs) may affect language acquisition; yet, whether mothers show individual differences in how they modify infant-directed (ID) compared with adult-directed (AD) speech has seldom been studied. This study assessed individual differences in how mothers realized speech modifications in ID register and whether these predicted differences in language outcomes for children with CIs. Method Participants were 36 dyads of mothers and their children aged 0;8-2;5 (years;months) at the time of CI implantation. Mothers' spontaneous speech was recorded in a lab setting in ID or AD conditions before ~15 months postimplantation. Mothers' speech samples were characterized for acoustic-phonetic and lexical properties established as canonical indices of ID speech to typically hearing infants, such as vowel space area differences, fundamental frequency variability, and speech rate. Children with CIs completed longitudinal administrations of one or more standardized language assessment instruments at variable intervals from 6 months to 9.5 years postimplantation. Standardized scores on assessments administered longitudinally were used to calculate linear regressions, which gave rise to predicted language scores for children at 2 years postimplantation and language growth over 2-year intervals. Results Mothers showed individual differences in how they modified speech in ID versus AD registers. Crucially, these individual differences significantly predicted differences in estimated language outcomes at 2 years postimplantation in children with CIs. Maternal speech variation in lexical quantity and vowel space area differences across ID and AD registers most frequently predicted estimates of language attainment in children with CIs, whereas prosodic differences played a minor role. Conclusion Results support that caregiver language behaviors play a substantial role in explaining variability in language attainment in children receiving CIs. Supplemental Material https://doi.org/10.23641/asha.12560147.