The relationship between the speech perception and the degree of satisfaction among adult users of cochlear implants

Introduction: In recent years, the benefits associated with the use of cochlear implants (CIs), especially with regard to speech perception, have proven to surpass those produced by the use of hearing aids, making CIs a highly efficient resource for patients with severe/profound hearing loss. However, few studies so far have assessed the satisfaction of adult users of CIs. Objective: To analyze the relationship between the level of speech perception and degree of satisfaction of adult users of CI. Method: This was a prospective cross-sectional study conducted in the Audiological Research Center (CPA) of the Hospital of Craniofacial Anomalies, University of São Paulo (HRAC/USP), in Bauru, São Paulo, Brazil. A total of 12 users of CIs with pre-lingual or post-lingual hearing loss participated in this study. The following tools were used in the assessment: a questionnaire, "Satisfaction with Amplification in Daily Life" (SADL), culturally adapted to Brazilian Portuguese, as well as its relationship with the speech perception results; a speech perception test under quiet conditions; and the Hearing in Noise Test (HINT)Brazil under free field conditions. Results: The participants in the study were on the whole satisfied with their devices, and the degree of satisfaction correlated positively with the ability to perceive monosyllabic words under quiet conditions. The satisfaction did not correlate with the level of speech perception in noisy environments. Conclusion: Assessments of satisfaction may help professionals to predict what other factors, in addition to speech perception, may contribute to the satisfaction of CI users in order to reorganize the intervention process to improve the users' quality of life.

Assessment of speech perception and communication skills in adolescents with cochlear implants for pre- and peri-lingual deafness

This study aimed to assess speech perception and communication skills in adolescents between ages 8 and 18 that received cochlear implants for pre- and peri-lingual deafness.

Speech perception benefits of internet versus conventional telephony for hearing-impaired individuals

Telephone communication is a challenge for many hearing-impaired individuals. One important technical reason for this difficulty is the restricted frequency range (0.3-3.4 kHz) of conventional landline telephones. Internet telephony (voice over Internet protocol [VoIP]) is transmitted with a larger frequency range (0.1-8 kHz) and therefore includes more frequencies relevant to speech perception. According to a recently published, laboratory-based study, the theoretical advantage of ideal VoIP conditions over conventional telephone quality has translated into improved speech perception by hearing-impaired individuals. However, the speech perception benefits of nonideal VoIP network conditions, which may occur in daily life, have not been explored. VoIP use cannot be recommended to hearing-impaired individuals before its potential under more realistic conditions has been examined.

Internet video telephony allows speech reading by deaf individuals and improves speech perception by cochlear implant users

OBJECTIVE To analyze speech reading through Internet video calls by profoundly hearing-impaired individuals and cochlear implant (CI) users. METHODS Speech reading skills of 14 deaf adults and 21 CI users were assessed using the Hochmair Schulz Moser (HSM) sentence test. We presented video simulations using different video resolutions (1280 × 720, 640 × 480, 320 × 240, 160 × 120 px), frame rates (30, 20, 10, 7, 5 frames per second (fps)), speech velocities (three different speakers), webcameras (Logitech Pro9000, C600 and C500) and image/sound delays (0-500 ms). All video simulations were presented with and without sound and in two screen sizes. Additionally, scores for live Skype™ video connection and live face-to-face communication were assessed. RESULTS Higher frame rate (>7 fps), higher camera resolution (>640 × 480 px) and shorter picture/sound delay (<100 ms) were associated with increased speech perception scores. Scores were strongly dependent on the speaker but were not influenced by physical properties of the camera optics or the full screen mode. There is a significant median gain of +8.5%pts (p = 0.009) in speech perception for all 21 CI-users if visual cues are additionally shown. CI users with poor open set speech perception scores (n = 11) showed the greatest benefit under combined audio-visual presentation (median speech perception +11.8%pts, p = 0.032). CONCLUSION Webcameras have the potential to improve telecommunication of hearing-impaired individuals.

The Neural Substrates of Multisensory Speech Perception

Comprehending speech is one of the most important human behaviors, but we are only beginning to understand how the brain accomplishes this difficult task. One key to speech perception seems to be that the brain integrates the independent sources of information available in the auditory and visual modalities in a process known as multisensory integration. This allows speech perception to be accurate, even in environments in which one modality or the other is ambiguous in the context of noise. Previous electrophysiological and functional magnetic resonance imaging (fMRI) experiments have implicated the posterior superior temporal sulcus (STS) in auditory-visual integration of both speech and non-speech stimuli. While evidence from prior imaging studies have found increases in STS activity for audiovisual speech compared with unisensory auditory or visual speech, these studies do not provide a clear mechanism as to how the STS communicates with early sensory areas to integrate the two streams of information into a coherent audiovisual percept. Furthermore, it is currently unknown if the activity within the STS is directly correlated with strength of audiovisual perception. In order to better understand the cortical mechanisms that underlie audiovisual speech perception, we first studied the STS activity and connectivity during the perception of speech with auditory and visual components of varying intelligibility. By studying fMRI activity during these noisy audiovisual speech stimuli, we found that STS connectivity with auditory and visual cortical areas mirrored perception; when the information from one modality is unreliable and noisy, the STS interacts less with the cortex processing that modality and more with the cortex processing the reliable information. We next characterized the role of STS activity during a striking audiovisual speech illusion, the McGurk effect, to determine if activity within the STS predicts how strongly a person integrates auditory and visual speech information. Subjects with greater susceptibility to the McGurk effect exhibited stronger fMRI activation of the STS during perception of McGurk syllables, implying a direct correlation between strength of audiovisual integration of speech and activity within an the multisensory STS.

Effects of the rate of formant-frequency variation on the grouping of formants in speech perception

How speech is separated perceptually from other speech remains poorly understood. Recent research suggests that the ability of an extraneous formant to impair intelligibility depends on the modulation of its frequency, but not its amplitude, contour. This study further examined the effect of formant-frequency variation on intelligibility by manipulating the rate of formant-frequency change. Target sentences were synthetic three-formant (F1?+?F2?+?F3) analogues of natural utterances. Perceptual organization was probed by presenting stimuli dichotically (F1?+?F2C?+?F3C; F2?+?F3), where F2C?+?F3C constitute a competitor for F2 and F3 that listeners must reject to optimize recognition. Competitors were derived using formant-frequency contours extracted from extended passages spoken by the same talker and processed to alter the rate of formant-frequency variation, such that rate scale factors relative to the target sentences were 0, 0.25, 0.5, 1, 2, and 4 (0?=?constant frequencies). Competitor amplitude contours were either constant, or time-reversed and rate-adjusted in parallel with the frequency contour. Adding a competitor typically reduced intelligibility; this reduction increased with competitor rate until the rate was at least twice that of the target sentences. Similarity in the results for the two amplitude conditions confirmed that formant amplitude contours do not influence across-formant grouping. The findings indicate that competitor efficacy is not tuned to the rate of the target sentences; most probably, it depends primarily on the overall rate of frequency variation in the competitor formants. This suggests that, when segregating the speech of concurrent talkers, differences in speech rate may not be a significant cue for across-frequency grouping of formants.

Effects of differences in fundamental frequency on across-formant grouping in speech perception

In an isolated syllable, a formant will tend to be segregated perceptually if its fundamental frequency (F0) differs from that of the other formants. This study explored whether similar results are found for sentences, and specifically whether differences in F0 (?F0) also influence across-formant grouping in circumstances where the exclusion or inclusion of the manipulated formant critically determines speech intelligibility. Three-formant (F1 + F2 + F3) analogues of almost continuously voiced natural sentences were synthesized using a monotonous glottal source (F0 = 150 Hz). Perceptual organization was probed by presenting stimuli dichotically (F1 + F2C + F3; F2), where F2C is a competitor for F2 that listeners must resist to optimize recognition. Competitors were created using time-reversed frequency and amplitude contours of F2, and F0 was manipulated (?F0 = ±8, ±2, or 0 semitones relative to the other formants). Adding F2C typically reduced intelligibility, and this reduction was greatest when ?F0 = 0. There was an additional effect of absolute F0 for F2C, such that competitor efficacy was greater for higher F0s. However, competitor efficacy was not due to energetic masking of F3 by F2C. The results are consistent with the proposal that a grouping “primitive” based on common F0 influences the fusion and segregation of concurrent formants in sentence perception.

Formant-frequency variation and its effects on across-formant grouping in speech perception

How speech is separated perceptually from other speech remains poorly understood. In a series of experiments, perceptual organisation was probed by presenting three-formant (F1+F2+F3) analogues of target sentences dichotically, together with a competitor for F2 (F2C), or for F2+F3, which listeners must reject to optimise recognition. To control for energetic masking, the competitor was always presented in the opposite ear to the corresponding target formant(s). Sine-wave speech was used initially, and different versions of F2C were derived from F2 using separate manipulations of its amplitude and frequency contours. F2Cs with time-varying frequency contours were highly effective competitors, whatever their amplitude characteristics, whereas constant-frequency F2Cs were ineffective. Subsequent studies used synthetic-formant speech to explore the effects of manipulating the rate and depth of formant-frequency change in the competitor. Competitor efficacy was not tuned to the rate of formant-frequency variation in the target sentences; rather, the reduction in intelligibility increased with competitor rate relative to the rate for the target sentences. Therefore, differences in speech rate may not be a useful cue for separating the speech of concurrent talkers. Effects of competitors whose depth of formant-frequency variation was scaled by a range of factors were explored using competitors derived either by inverting the frequency contour of F2 about its geometric mean (plausibly speech-like pattern) or by using a regular and arbitrary frequency contour (triangle wave, not plausibly speech-like) matched to the average rate and depth of variation for the inverted F2C. Competitor efficacy depended on the overall depth of frequency variation, not depth relative to that for the other formants. Furthermore, the triangle-wave competitors were as effective as their more speech-like counterparts. Overall, the results suggest that formant-frequency variation is critical for the across-frequency grouping of formants but that this grouping does not depend on speech-specific constraints.

Formant-frequency variation and its effects on across-formant grouping in speech perception

How speech is separated perceptually from other speech remains poorly understood. In a series of experiments, perceptual organisation was probed by presenting three-formant (F1+F2+F3) analogues of target sentences dichotically, together with a competitor for F2 (F2C), or for F2+F3, which listeners must reject to optimise recognition. To control for energetic masking, the competitor was always presented in the opposite ear to the corresponding target formant(s). Sine-wave speech was used initially, and different versions of F2C were derived from F2 using separate manipulations of its amplitude and frequency contours. F2Cs with time-varying frequency contours were highly effective competitors, whatever their amplitude characteristics, whereas constant-frequency F2Cs were ineffective. Subsequent studies used synthetic-formant speech to explore the effects of manipulating the rate and depth of formant-frequency change in the competitor. Competitor efficacy was not tuned to the rate of formant-frequency variation in the target sentences; rather, the reduction in intelligibility increased with competitor rate relative to the rate for the target sentences. Therefore, differences in speech rate may not be a useful cue for separating the speech of concurrent talkers. Effects of competitors whose depth of formant-frequency variation was scaled by a range of factors were explored using competitors derived either by inverting the frequency contour of F2 about its geometric mean (plausibly speech-like pattern) or by using a regular and arbitrary frequency contour (triangle wave, not plausibly speech-like) matched to the average rate and depth of variation for the inverted F2C. Competitor efficacy depended on the overall depth of frequency variation, not depth relative to that for the other formants. Furthermore, the triangle-wave competitors were as effective as their more speech-like counterparts. Overall, the results suggest that formant-frequency variation is critical for the across-frequency grouping of formants but that this grouping does not depend on speech-specific constraints. © Springer Science+Business Media New York 2013.

Cognitive and Visual Speech Contributions to Speech Perception in Challenging Listening Conditions

Speech perception routinely takes place in noisy or degraded listening environments, leading to ambiguity in the identity of the speech token. Here, I present one review paper and two experimental papers that highlight cognitive and visual speech contributions to the listening process, particularly in challenging listening environments. First, I survey the literature linking audiometric age-related hearing loss and cognitive decline and review the four proposed causal mechanisms underlying this link. I argue that future research in this area requires greater consideration of the functional overlap between hearing and cognition. I also present an alternative framework for understanding causal relationships between age-related declines in hearing and cognition, with emphasis on the interconnected nature of hearing and cognition and likely contributions from multiple causal mechanisms. I also provide a number of testable hypotheses to examine how impairments in one domain may affect the other. In my first experimental study, I examine the direct contribution of working memory (through a cognitive training manipulation) on speech in noise comprehension in older adults. My results challenge the efficacy of cognitive training more generally, and also provide support for the contribution of sentence context in reducing working memory load. My findings also challenge the ubiquitous use of the Reading Span test as a pure test of working memory. In a second experimental (fMRI) study, I examine the role of attention in audiovisual speech integration, particularly when the acoustic signal is degraded. I demonstrate that attentional processes support audiovisual speech integration in the middle and superior temporal gyri, as well as the fusiform gyrus. My results also suggest that the superior temporal sulcus is sensitive to intelligibility enhancement, regardless of how this benefit is obtained (i.e., whether it is obtained through visual speech information or speech clarity). In addition, I also demonstrate that both the cingulo-opercular network and motor speech areas are recruited in difficult listening conditions. Taken together, these findings augment our understanding of cognitive contributions to the listening process and demonstrate that memory, working memory, and executive control networks may flexibly be recruited in order to meet listening demands in challenging environments.

The Perception of Natural, Cell Phone, and Computer-Synthesized Speech During The Performance Of Simultaneous Visual-Motor Tasks

This study investigated the influence of top-down and bottom-up information on speech perception in complex listening environments. Specifically, the effects of listening to different types of processed speech were examined on intelligibility and on simultaneous visual-motor performance. The goal was to extend the generalizability of results in speech perception to environments outside of the laboratory. The effect of bottom-up information was evaluated with natural, cell phone and synthetic speech. The effect of simultaneous tasks was evaluated with concurrent visual-motor and memory tasks. Earlier works on the perception of speech during simultaneous visual-motor tasks have shown inconsistent results (Choi, 2004; Strayer & Johnston, 2001). In the present experiments, two dual-task paradigms were constructed in order to mimic non-laboratory listening environments. In the first two experiments, an auditory word repetition task was the primary task and a visual-motor task was the secondary task. Participants were presented with different kinds of speech in a background of multi-speaker babble and were asked to repeat the last word of every sentence while doing the simultaneous tracking task. Word accuracy and visual-motor task performance were measured. Taken together, the results of Experiments 1 and 2 showed that the intelligibility of natural speech was better than synthetic speech and that synthetic speech was better perceived than cell phone speech. The visual-motor methodology was found to demonstrate independent and supplemental information and provided a better understanding of the entire speech perception process. Experiment 3 was conducted to determine whether the automaticity of the tasks (Schneider & Shiffrin, 1977) helped to explain the results of the first two experiments. It was found that cell phone speech allowed better simultaneous pursuit rotor performance only at low intelligibility levels when participants ignored the listening task. Also, simultaneous task performance improved dramatically for natural speech when intelligibility was good. Overall, it could be concluded that knowledge of intelligibility alone is insufficient to characterize processing of different speech sources. Additional measures such as attentional demands and performance of simultaneous tasks were also important in characterizing the perception of different kinds of speech in complex listening environments.