The Effect of Cued-Speech (CS) Perception on Auditory Processing in Typically Hearing (TH) Individuals Who Are Either Naïve or Experienced CS Producers.

Cued Speech (CS) is a communication system that uses manual gestures to facilitate lipreading. In this study, we investigated how CS information interacts with natural speech using Event-Related Potential (ERP) analyses in French-speaking, typically hearing adults (TH) who were either naïve or experienced CS producers. The audiovisual (AV) presentation of lipreading information elicited an amplitude attenuation of the entire N1 and P2 complex in both groups, accompanied by N1 latency facilitation in the group of CS producers. Adding CS gestures to lipread information increased the magnitude of effects observed at the N1 time window, but did not enhance P2 amplitude attenuation. Interestingly, presenting CS gestures without lipreading information yielded distinct response patterns depending on participants' experience with the system. In the group of CS producers, AV perception of CS gestures facilitated the early stage of speech processing, while in the group of naïve participants, it elicited a latency delay at the P2 time window. These results suggest that, for experienced CS users, the perception of gestures facilitates early stages of speech processing, but when people are not familiar with the system, the perception of gestures impacts the efficiency of phonological decoding.

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.

How is the McGurk effect modulated by Cued Speech in deaf and hearing adults?

Speech perception for both hearing and deaf people involves an integrative process between auditory and lip-reading information. In order to disambiguate information from lips, manual cues from Cued Speech may be added. Cued Speech (CS) is a system of manual aids developed to help deaf people to clearly and completely understand speech visually (Cornett, 1967). Within this system, both labial and manual information, as lone input sources, remain ambiguous. Perceivers, therefore, have to combine both types of information in order to get one coherent percept. In this study, we examined how audio-visual (AV) integration is affected by the presence of manual cues and on which form of information (auditory, labial or manual) the CS receptors primarily rely. To address this issue, we designed a unique experiment that implemented the use of AV McGurk stimuli (audio /pa/ and lip-reading /ka/) which were produced with or without manual cues. The manual cue was congruent with either auditory information, lip information or the expected fusion. Participants were asked to repeat the perceived syllable aloud. Their responses were then classified into four categories: audio (when the response was /pa/), lip-reading (when the response was /ka/), fusion (when the response was /ta/) and other (when the response was something other than /pa/, /ka/ or /ta/). Data were collected from hearing impaired individuals who were experts in CS (all of which had either cochlear implants or binaural hearing aids; N = 8), hearing-individuals who were experts in CS (N = 14) and hearing-individuals who were completely naïve of CS (N = 15). Results confirmed that, like hearing-people, deaf people can merge auditory and lip-reading information into a single unified percept. Without manual cues, McGurk stimuli induced the same percentage of fusion responses in both groups. Results also suggest that manual cues can modify the AV integration and that their impact differs between hearing and deaf people.

Atypical audio-visual speech perception and McGurk effects in children with specific language impairment.

Audiovisual speech perception of children with specific language impairment (SLI) and children with typical language development (TLD) was compared in two experiments using /aCa/ syllables presented in the context of a masking release paradigm. Children had to repeat syllables presented in auditory alone, visual alone (speechreading), audiovisual congruent and incongruent (McGurk) conditions. Stimuli were masked by either stationary (ST) or amplitude modulated (AM) noise. Although children with SLI were less accurate in auditory and audiovisual speech perception, they showed similar auditory masking release effect than children with TLD. Children with SLI also had less correct responses in speechreading than children with TLD, indicating impairment in phonemic processing of visual speech information. In response to McGurk stimuli, children with TLD showed more fusions in AM noise than in ST noise, a consequence of the auditory masking release effect and of the influence of visual information. Children with SLI did not show this effect systematically, suggesting they were less influenced by visual speech. However, when the visual cues were easily identified, the profile of responses to McGurk stimuli was similar in both groups, suggesting that children with SLI do not suffer from an impairment of audiovisual integration. An analysis of percent of information transmitted revealed a deficit in the children with SLI, particularly for the place of articulation feature. Taken together, the data support the hypothesis of an intact peripheral processing of auditory speech information, coupled with a supra modal deficit of phonemic categorization in children with SLI. Clinical implications are discussed.