Exposure to Canadian French Cued Speech Improves Consonant Articulation in Children With Cochlear Implants: Acoustic and Articulatory Data.

PURPOSE: One of the strategies that can be used to support speech communication in deaf children is cued speech, a visual code in which manual gestures are used as additional phonological information to supplement the acoustic and labial speech information. Cued speech has been shown to improve speech perception and phonological skills. This exploratory study aims to assess whether and how cued speech reading proficiency may also have a beneficial effect on the acoustic and articulatory correlates of consonant production in children. METHOD: Eight children with cochlear implants (from 5 to 11 years of age) and with different receptive proficiency in Canadian French Cued Speech (three children with low receptive proficiency vs. five children with high receptive proficiency) are compared to 10 children with typical hearing (from 4 to 11 years of age) on their production of stop and fricative consonants. Articulation was assessed with ultrasound measurements. RESULTS: The preliminary results reveal that cued speech proficiency seems to sustain the development of speech production in children with cochlear implants and to improve their articulatory gestures, particularly for the place contrast in stops as well as fricatives. CONCLUSION: This work highlights the importance of studying objective data and comparing acoustic and articulatory measurements to better characterize speech production in children.

Speech rehabilitation in children with cochlear implants using a multisensory (French Cued Speech) or a hearing-focused (Auditory Verbal Therapy) approach.

Introduction: Early exposure to a rich linguistic environment is essential as soon as the diagnosis of deafness is made. Cochlear implantation (CI) allows children to have access to speech perception in their early years. However, it provides only partial acoustic information, which can lead to difficulties in perceiving some phonetic contrasts. This study investigates the contribution of two spoken speech and language rehabilitation approaches to speech perception in children with CI using a lexicality judgment task from the EULALIES battery. Auditory Verbal Therapy (AVT) is an early intervention program that relies on auditory learning to enhance hearing skills in deaf children with CI. French Cued Speech, also called Cued French (CF), is a multisensory communication tool that disambiguates lip reading by adding a manual gesture. Methods: In this study, 124 children aged from 60 to 140 months were included: 90 children with typical hearing skills (TH), 9 deaf children with CI who had participated in an AVT program (AVT), 6 deaf children with CI with high Cued French reading skills (CF+), and 19 deaf children with CI with low Cued French reading skills (CF-). Speech perception was assessed using sensitivity (d') using both the hit and false alarm rates, as defined in signal-detection theory. Results: The results show that children with cochlear implants from the CF- and CF+ groups have significantly lower performance compared to children with typical hearing (TH) (p < 0.001 and p = 0.033, respectively). Additionally, children in the AVT group also tended to have lower scores compared to TH children (p = 0.07). However, exposition to AVT and CF seems to improve speech perception. The scores of the children in the AVT and CF+ groups are closer to typical scores than those of children in the CF- group, as evidenced by a distance measure. Discussion: Overall, the findings of this study provide evidence for the effectiveness of these two speech and language rehabilitation approaches, and highlight the importance of using a specific approach in addition to a cochlear implant to improve speech perception in children with cochlear implants.

Cued Speech Enhances Speech-in-Noise Perception.

Speech perception in noise remains challenging for Deaf/Hard of Hearing people (D/HH), even fitted with hearing aids or cochlear implants. The perception of sentences in noise by 20 implanted or aided D/HH subjects mastering Cued Speech (CS), a system of hand gestures complementing lip movements, was compared with the perception of 15 typically hearing (TH) controls in three conditions: audio only, audiovisual, and audiovisual + CS. Similar audiovisual scores were obtained for signal-to-noise ratios (SNRs) 11 dB higher in D/HH participants compared with TH ones. Adding CS information enabled D/HH participants to reach a mean score of 83% in the audiovisual + CS condition at a mean SNR of 0 dB, similar to the usual audio score for TH participants at this SNR. This confirms that the combination of lipreading and Cued Speech system remains extremely important for persons with hearing loss, particularly in adverse hearing conditions.