Profile of Phoneme Auditory Perception Ability in Children with Hearing Impairment and - PowerPoint Presentation

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Profile of Phoneme Auditory Perception Ability in Children with Hearing Impairment and Phonological Disorders

ByManal Mohamed El-Banna (MD)Unit of Phoniatrics, Faculty of Medicine,Alexandria University

Cairo

8

/3/2012

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Introduction

Receptive language impairment is related to:Audiometrically low hearing sensitivity Audiometrically sensitive hearing it may be due to:Non speech auditory perceptual deficitLinguistic problem.

Failure of phonology representation

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The Relation between Perception and Production

Same linguistic representation systems. Unbalanced relationship.A synchronize development in early language acquisition.

1. Se´ne´chal M, Ouellette, G Young L: Testing the concurrent and predictive relations among articulation accuracy, speech perception, and phoneme awareness J. Experimental Child Psychology 89 (2004) 242–269 2.Warker JA, Xu Y, Dell GS, Fisher C. Speech errors reflect the phonotactic constraints in recently spoken syllables, but not in recently heard syllables.Cognition 112 (2009) 81–96

Production

Perception

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Speech Perception Phoneme Specific Tasks:

Attempt to measure implicit phonological representations.Provide a sensitive test of the association between variables.Confound speech perception ability with memory and vocabulary skills by involving word, pseudoword.(1)

1. Boada R., Pennington B.F.

Deficient implicit phonological representations in children with dyslexia

Journal of Experimental Child Psychology 95 (2006) 153–193

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Similarity and confusability of phonemes

The similarity between phonemes and confusability in short-term memory influence:Speech errors The strength of phonotactic constraintsThe overall similarity between whole words. Important for many psycholinguistic contexts.

Bailey MT, Hahn U. Phoneme similarity and confusabilityJournal of Memory and Language 52 (2005) 339–362

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Aim of the work

Study the phoneme auditory perceptual profile in children with hearing impairment and phonological errors.

Highlight the relation between the ability to interpret the acoustic characteristics of the phoneme as represented by phoneme auditory perception assessment results and the speech production errors.

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Subjects:

32 children, age range 6-12 years. Average intelligence.

Group A: 12 children Med-El cochlear implant.

Group B: 8 children moderate severe and moderate SNHL.

Group C: 6 children with phonological disorders.

Group D: 6 normally language developing children.

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Methodology

Protocol of language disordersAudiological evaluationProfile of Speech errors (Phonology test)(1)PsychometryPhoneme Speech auditory Perception evaluation

1. Abou-Ras et al.

27th Alexandria International Combined ORL Congress, April 8-10,2009

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General Testing Instructions:

•Room: Quiet room with minimal distractions.•Position : Behind and to the side.•Examination condition: life sound by use sound level meter at 60 dB.•Responses according to each task and level.•Reinforcement is providing at the beginning of each task.•Patient should understand the instructions first before proceeding.

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1) Vowel perception testing:

Recording of the number of correct response according to total number of stimuli & calculation of %.

Identify vowels using pictures of facial gestures representing/a/,/

i

/,/o/. (CVC)

Discrimination of pairs of monosyllabic words:

Vowel height

Vowel place

Vowel length

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Vowel Identification

CVC syllables

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Vowel Identification (monosyllabic words)

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Discrimination of vowels

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2) Consonant perception testing:

Low frequency phonemes

Low frequency fricatives

High frequency fricatives

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Consonant perception testing

Consonants are introduced

listwise

in syllabic form (VCV) with vowel stabilization.

Score of correct identification

:

Low

frquency

Fricatives

High frequency fricatives

Low frequency phonemes

Stops

Nasals

Glides

Laterals

Score of correct discrimination:

Voicing

Place of articulation

Manner of articulation

Emphatic

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ابا

اتا

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Results

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Group A: Cochlear Implant

Common speech production error:

Distorted vowels

Imprecision of consonants (manner and place of articulation)

Devoicing

Fricatives were easier to acquire than rest of consonants.

Difficulties to perceive voicing cues and vowels with close acoustic features.

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Group A: Cochlear Implanted discrimination of vowels

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Group A: Cochlear Implanted Consonants Identification

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Group A: Cochlear Implanted Consonants Identification

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Group A: Cochlear Implant Discrimination of consonants

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Group B:Hearing Impaired

Degree of hearing loss6 Moderate severe2 ModerateConfiguration of hearing loss:6 High frequency hearing loss (sloping)2 Flat configuration

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Group B: Hearing Impaired

Common speech errors:

Difficulty of production of high frequency fricatives.

Substitution

Stopping

Devoicing

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Group B: Hearing Impaired Discrimination of vowels

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Group B: Hearing Impaired consonants identification

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Group B: Hearing Impaired consonants identification

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Group B: Hearing Impaired Discrimination of consonants

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Group C: Phonological errors

Common speech production errors:

Substitution

6 (Devoicing)

2 (Fronting)

100% accuracy of vowel perception

100% accuracy of consonants perception

Difficulty encountered with discrimination tasks, were not consistently detected on repetition of testing.

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Comparison between Group A, B, C and D: Vowels

CI: Cochlear implant, HI: hearing Impaired, Ph: phonological errors

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Comparison between Group A, B, C and D: Consonants low frequency phonemes identification

CI: Cochlear implant, HI: hearing impaired, Ph: phonological errors

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Comparison between Group A,B,C and D : Consonants Identification

CI: cochlear implanted, HI: Hearing impaired, Ph: phonological errors

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Comparison between Group A, B, C and D: Consonants Discrimination

CI: Cochlear implant, HI: hearing impaired, Ph: phonological errors

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Conclusion

Cochlear implantees encounter perceptual difficulties in interpretation of temporal feature (vowel length, stops, voicing) that is not necessarily related to their production difficulty.

Hearing Impaired difficulty were more related to spectral nature of the sound (vowel advancement, high frequency fricatives, emphatic)

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Conclusion

Phonological errors encountered may not be related to error of acoustic interpretation of phoneme signals, but could relate to attention or central perceptual difficulty easily corrected by repetition.

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Recommendation for Further Research

Extension of the number of studied subjects.

Study of influence of variable stimuli on speech perception results.

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Thank you for your attention