Prelingually Deaf Children With Cochlear Implants Show Better Perception of Voice Cues and Speech in Competing Speech Than Postlingually Deaf Adults With Cochlear Implants.

OBJECTIVES: Postlingually deaf adults with cochlear implants (CIs) have difficulties with perceiving differences in speakers' voice characteristics and benefit little from voice differences for the perception of speech in competing speech. However, not much is known yet about the perception and use of voice characteristics in prelingually deaf implanted children with CIs. Unlike CI adults, most CI children became deaf during the acquisition of language. Extensive neuroplastic changes during childhood could make CI children better at using the available acoustic cues than CI adults, or the lack of exposure to a normal acoustic speech signal could make it more difficult for them to learn which acoustic cues they should attend to. This study aimed to examine to what degree CI children can perceive voice cues and benefit from voice differences for perceiving speech in competing speech, comparing their abilities to those of normal-hearing (NH) children and CI adults. DESIGN: CI children's voice cue discrimination (experiment 1), voice gender categorization (experiment 2), and benefit from target-masker voice differences for perceiving speech in competing speech (experiment 3) were examined in three experiments. The main focus was on the perception of mean fundamental frequency (F0) and vocal-tract length (VTL), the primary acoustic cues related to speakers' anatomy and perceived voice characteristics, such as voice gender. RESULTS: CI children's F0 and VTL discrimination thresholds indicated lower sensitivity to differences compared with their NH-age-equivalent peers, but their mean discrimination thresholds of 5.92 semitones (st) for F0 and 4.10 st for VTL indicated higher sensitivity than postlingually deaf CI adults with mean thresholds of 9.19 st for F0 and 7.19 st for VTL. Furthermore, CI children's perceptual weighting of F0 and VTL cues for voice gender categorization closely resembled that of their NH-age-equivalent peers, in contrast with CI adults. Finally, CI children had more difficulties in perceiving speech in competing speech than their NH-age-equivalent peers, but they performed better than CI adults. Unlike CI adults, CI children showed a benefit from target-masker voice differences in F0 and VTL, similar to NH children. CONCLUSION: Although CI children's F0 and VTL voice discrimination scores were overall lower than those of NH children, their weighting of F0 and VTL cues for voice gender categorization and their benefit from target-masker differences in F0 and VTL resembled that of NH children. Together, these results suggest that prelingually deaf implanted CI children can effectively utilize spectrotemporally degraded F0 and VTL cues for voice and speech perception, generally outperforming postlingually deaf CI adults in comparable tasks. These findings underscore the presence of F0 and VTL cues in the CI signal to a certain degree and suggest other factors contributing to the perception challenges faced by CI adults.

School-age children benefit from voice gender cue differences for the perception of speech in competing speech.

Differences in speakers' voice characteristics, such as mean fundamental frequency (F0) and vocal-tract length (VTL), that primarily define speakers' so-called perceived voice gender facilitate the perception of speech in competing speech. Perceiving speech in competing speech is particularly challenging for children, which may relate to their lower sensitivity to differences in voice characteristics than adults. This study investigated the development of the benefit from F0 and VTL differences in school-age children (4-12 years) for separating two competing speakers while tasked with comprehending one of them and also the relationship between this benefit and their corresponding voice discrimination thresholds. Children benefited from differences in F0, VTL, or both cues at all ages tested. This benefit proportionally remained the same across age, although overall accuracy continued to differ from that of adults. Additionally, children's benefit from F0 and VTL differences and their overall accuracy were not related to their discrimination thresholds. Hence, although children's voice discrimination thresholds and speech in competing speech perception abilities develop throughout the school-age years, children already show a benefit from voice gender cue differences early on. Factors other than children's discrimination thresholds seem to relate more closely to their developing speech in competing speech perception abilities.

Development of vocal emotion recognition in school-age children: The EmoHI test for hearing-impaired populations.

Traditionally, emotion recognition research has primarily used pictures and videos, while audio test materials are not always readily available or are not of good quality, which may be particularly important for studies with hearing-impaired listeners. Here we present a vocal emotion recognition test with pseudospeech productions from multiple speakers expressing three core emotions (happy, angry, and sad): the EmoHI test. The high sound quality recordings make the test suitable for use with populations of children and adults with normal or impaired hearing. Here we present normative data for vocal emotion recognition development in normal-hearing (NH) school-age children using the EmoHI test. Furthermore, we investigated cross-language effects by testing NH Dutch and English children, and the suitability of the EmoHI test for hearing-impaired populations, specifically for prelingually deaf Dutch children with cochlear implants (CIs). Our results show that NH children's performance improved significantly with age from the youngest age group onwards (4-6 years: 48.9%, on average). However, NH children's performance did not reach adult-like values (adults: 94.1%) even for the oldest age group tested (10-12 years: 81.1%). Additionally, the effect of age on NH children's development did not differ across languages. All except one CI child performed at or above chance-level showing the suitability of the EmoHI test. In addition, seven out of 14 CI children performed within the NH age-appropriate range, and nine out of 14 CI children did so when performance was adjusted for hearing age, measured from their age at CI implantation. However, CI children showed great variability in their performance, ranging from ceiling (97.2%) to below chance-level performance (27.8%), which could not be explained by chronological age alone. The strong and consistent development in performance with age, the lack of significant differences across the tested languages for NH children, and the above-chance performance of most CI children affirm the usability and versatility of the EmoHI test.

Development of voice perception is dissociated across gender cues in school-age children.

Children's ability to distinguish speakers' voices continues to develop throughout childhood, yet it remains unclear how children's sensitivity to voice cues, such as differences in speakers' gender, develops over time. This so-called voice gender is primarily characterized by speakers' mean fundamental frequency (F0), related to glottal pulse rate, and vocal-tract length (VTL), related to speakers' size. Here we show that children's acquisition of adult-like performance for discrimination, a lower-order perceptual task, and categorization, a higher-order cognitive task, differs across voice gender cues. Children's discrimination was adult-like around the age of 8 for VTL but still differed from adults at the age of 12 for F0. Children's perceptual weight attributed to F0 for gender categorization was adult-like around the age of 6 but around the age of 10 for VTL. Children's discrimination and weighting of F0 and VTL were only correlated for 4- to 6-year-olds. Hence, children's development of discrimination and weighting of voice gender cues are dissociated, i.e., adult-like performance for F0 and VTL is acquired at different rates and does not seem to be closely related. The different developmental patterns for auditory discrimination and categorization highlight the complexity of the relationship between perceptual and cognitive mechanisms of voice perception.

Individual Differences in Lexical Access Among Cochlear Implant Users.

Purpose The current study investigates how individual differences in cochlear implant (CI) users' sensitivity to word-nonword differences, reflecting lexical uncertainty, relate to their reliance on sentential context for lexical access in processing continuous speech. Method Fifteen CI users and 14 normal-hearing (NH) controls participated in an auditory lexical decision task (Experiment 1) and a visual-world paradigm task (Experiment 2). Experiment 1 tested participants' reliance on lexical statistics, and Experiment 2 studied how sentential context affects the time course and patterns of lexical competition leading to lexical access. Results In Experiment 1, CI users had lower accuracy scores and longer reaction times than NH listeners, particularly for nonwords. In Experiment 2, CI users' lexical competition patterns were, on average, similar to those of NH listeners, but the patterns of individual CI users varied greatly. Individual CI users' word-nonword sensitivity (Experiment 1) explained differences in the reliance on sentential context to resolve lexical competition, whereas clinical speech perception scores explained competition with phonologically related words. Conclusions The general analysis of CI users' lexical competition patterns showed merely quantitative differences with NH listeners in the time course of lexical competition, but our additional analysis revealed more qualitative differences in CI users' strategies to process speech. Individuals' word-nonword sensitivity explained different parts of individual variability than clinical speech perception scores. These results stress, particularly for heterogeneous clinical populations such as CI users, the importance of investigating individual differences in addition to group averages, as they can be informative for clinical rehabilitation. Supplemental Material https://doi.org/10.23641/asha.11368106.

Individual Variations in Effort: Assessing Pupillometry for the Hearing Impaired.

Assessing effort in speech comprehension for hearing-impaired (HI) listeners is important, as effortful processing of speech can limit their hearing rehabilitation. We examined the measure of pupil dilation in its capacity to accommodate the heterogeneity that is present within clinical populations by studying lexical access in users with sensorineural hearing loss, who perceive speech via cochlear implants (CIs). We compared the pupillary responses of 15 experienced CI users and 14 age-matched normal-hearing (NH) controls during auditory lexical decision. A growth curve analysis was applied to compare the responses between the groups. NH listeners showed a coherent pattern of pupil dilation that reflects the task demands of the experimental manipulation and a homogenous time course of dilation. CI listeners showed more variability in the morphology of pupil dilation curves, potentially reflecting variable sources of effort across individuals. In follow-up analyses, we examined how speech perception, a task that relies on multiple stages of perceptual analyses, poses multiple sources of increased effort for HI listeners, wherefore we might not be measuring the same source of effort for HI as for NH listeners. We argue that interindividual variability among HI listeners can be clinically meaningful in attesting not only the magnitude but also the locus of increased effort. The understanding of individual variations in effort requires experimental paradigms that (a) differentiate the task demands during speech comprehension, (b) capture pupil dilation in its time course per individual listeners, and (c) investigate the range of individual variability present within clinical and NH populations.