Influence of communication mode on speech intelligibility and syntactic structure of sentences in profoundly hearing impaired French children implanted between 5 and 9 years of age.

OBJECTIVE: The purpose of this study was to examine the speech production in French profoundly hearing impaired children, focusing on word intelligibility, sentences syntax, and sentence pattern stages, by incorporating direct comparisons between speech production skills and communication modes in the same children. DESIGN: The design of the study incorporated a within-subject, repeated measures design for assessing speech production intelligibility and syntax. SETTING: Montpellier Pediatric Cochlear Implant Center. SUBJECTS: Twelve prelingually deafened French children who received a Nucleus multichannel cochlear implant (mean age at the time of implantation was 7 years 2 months) served as subjects for the speech production assessment. MAIN OUTCOME MEASURES: Speech production intelligibility, syntax, and sentence pattern stages were assessed at 1, 2 and 3 years postimplant. Speech production skills were related to the communication mode of the children (auditory-oral, four children; cued-speech, four children; sign-language, four children). RESULTS: Scores on word intelligibility steadily improved with increased experience with the implant, ranging from 18% before implantation to 54.5% at 36 months postimplantation in the overall population. The highest scores were found in the cued-speech group with an averaged score of 66.8% at 36 months postimplant. The number of syntactic elements increased over time with implant experience. Children receiving cued-speech education had higher scores by 3 years postimplantation than children receiving either auditory-oral or sign-language modes of communication. Language level (sentence pattern stages) also improved with increased experience with the device. By 3 years postimplantation, children receiving auditory-oral or cued-speech instruction were able to produce sentences; however, the sign-language children failed to do so at a rate comparable to the other children. Language level was significantly higher in the oralist or cued-speech educated children than in the sign-language group. CONCLUSIONS: Speech production skills improved with increased experience using a cochlear implant. Word intelligibility, syntactic structure of sentences, sentence pattern stages improved gradually over time. Production skills were greater in the cued-speech educated children group than in the auditory oral or sign-language groups. Statistically better sentence pattern stages were found in the auditory oral and sign-language groups.

Speech perception skills and speech production intelligibility in French children with prelingual deafness and cochlear implants.

OBJECTIVE: To examine speech perception and production intelligibility in French children with prelingual deafness who received multichannel cochlear implants. DESIGN: Within-subject, repeated-measures design for assessing speech perception and a cross-sectional design for assessing overall speech intelligibility. SETTING: A pediatric cochlear implant center. SUBJECTS: Sixty-four French children with prelingual deafness who received multichannel cochlear implants (mean age at time of implantation, 3 years 11 months) underwent assessment for speech perception. A subset of 16 children who received implants by 3 years of age underwent assessment for speech intelligibility. MAIN OUTCOME MEASURES: Speech perception skills were assessed using phoneme detection, closed-set word and sentence recognition, and modified open-set (MOS) recognition. Speech intelligibility was assessed by asking 50 listeners to identify recorded speech samples from the subjects. Dependent variables for the studies consisted of percent of correct items. RESULTS: After implantation, all children were able to detect phonemes by 3 months. Closed-set word and sentence identification reached 100% accuracy by 48 months (7 children with 4 years of implantation experience). Some children (8 of 48) demonstrated some MOS recognition after 1 year. Modified open-set recognition averaged 67.9% by 42 months (12 children available) and 80% by 48 months (7 children available). Overall speech intelligibility was 4.2% after 1 year, 30.7% after 2 years, 55.2% after 3 years, and 74.2% after 4 years. Within-subject comparison of MOS recognition and overall speech intelligibility scores revealed an insignificant trend for high perceptual performance to be associated with higher speech intelligibility scores (P = .17). There also was a tendency for higher performance to be associated with longer implantation experience. CONCLUSIONS: Speech perception scores appear to increase with increased experience using a cochlear implant. Overall speech intelligibility appears to steadily improve with increased experience and appears to be poorly related to perceptual performance on MOS recognition tasks.

Speech-perception performance in prelingually deafened French children using the nucleus multichannel cochlear implant.

PURPOSE: The speech-perception abilities of 36 French children, whose onset of deafness occurred before 2 years of age, was longitudinally examined after they received a Nucleus multichannel cochlear implant. METHODS: Speech perception was assessed in four areas: phoneme detection, closed-set word and sentence recognition; and modified open-set recognition. RESULTS: All children achieved phoneme detection by 3 months after implantation. Closed-set word and sentence recognition appeared initially less accurate in children with congenital deafness than in the prelingually deafened children; however, these differences disappeared by 18 months after implantation. Some modified open-set recognition was evident by 12 months after implantation and continued to improve 3 years after implantation. CONCLUSIONS: Data demonstrate significant improvements in speech perception with implant experience: 15 (60%) of 25 of the children identified sentences in closed sets, 22 (88%) of 25 identified words in closed sets after 12 months' experience, and 13 (81%) of 16 demonstrated open-set recognition after 24 months of implant use.