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Lip Movements
“…it is important to realize that we move our articulators to produce acoustically distinct sounds and NOT visually contrastive movements.”– Mark Ross
Speechreading Factoid
Campbell et al, (1981) surveyed the literature and found 38-58% of individuals with HL have accompanying visual deficiencies
Johnson et al (1981) found 65% entering NTID demonstrated defective vision
Vision loss may be greater among individuals with HL
Individuals with HL need vision evaluation***
Auditory plus Vision
When BOTH auditory and visual information is available, individuals with hearing loss tend to do better on communication tasks
Example (Auditory plus Vision):– Speech Recognition Score = 50%– Speechreading Score = 20%– Combined Visual/Auditory Score = 90%
9:00 am Appointment
The waiting room is filled with several individuals to evaluate. Which patient will benefit from speechreading training?– Recent cochlear implant patient– Recent new user of digital hearing aid who has
had hearing loss for fifty years– Three year-old child with profound loss– Patient with recent sudden onset hearing loss
Traditional Lipreading Methods
Four lipreading methods were introduced into the U.S.:
Mueller-Walle introduced by Bruhn Nitchie introduced by Nitchie Kinzie introduced by Kinzie Jena introduced by Bunger
Speechreading Factoid
Three of the lipreading methods introduced into the U.S. were implemented by individuals with normal hearing until adulthood, at which time they acquired a significant hearing loss, and sought assistance.
They developed methods that bear their names: Bruhn, Kinzie, and Nitchie.
Bunger later wrote about the Jena method.
Analytic & Synthetic
Analytic approach– perceive each of the basic parts before the
whole can be identified• Syllable considered to be the basic unit• Bruhn & Jena methods
Synthetic approach– Perception of the whole is paramount to
perception of the basic parts• Sentence considered to be the basic unit• Nitchie and Kinzie methods
Mueller-Walle Method Originated in Germany Martha Emma Bruhn studied lipreading with
Julius Mueller-Walle in Hamburg, Germany and introduced method in the US
Hallmark: rapid syllable drill– emphasis on quickly identifying position and
movement of speech sounds produced– syllable rhythmic drills: she-ma-flea and she-may-free– Practiced recognizing homophenous words using
sentence cues to distinguish meaning
Nitchie Method Edward Nitchie became deaf during adolescence Eventually established his own school for the deaf
in NY Initially developed an analytic approach, altering
the approach to a synthetic approach (credited with developing synthetic approach to speechreading)
Speechreader studies articulatory movements by viewing meaningful monosyllabic words to develop eye training
Advocated use of sentences and stories to train mind to comprehend the general meaning connected discourse
Kinzie Method Cora acquired HL while medical student in PA Studied with Bruhn and then Nitchie
combining best methods from both approaches Unique feature: graded lessons for children
and adults with sentences as basis of instruction
They recommended all sentences be “definite, natural, interesting, pleasing, rhythmical, and dignified”
Jena Method Developed by Karl Brauckman in Jena,
Germany and promoted by Anna Bunger from Michigan
Emphasizes syllable drills, rhythm practice, and kinesthetic awareness
Material presented in rhythmic manner reinforcing fact that speech is rhythmic
Focused on mimetic (imitating movements) and kinesthetic (perception of movement, position, etc.) forms and sensations
Recent Speechreading Trends Decline of speechreading as sole element of
AR with advent of technology Technology (HA, CI, ALDs) is providing
opportunities for individuals to make increasing use of audible speech and other audible sounds
Newer lipreading approaches tend to be eclectic– Modification or combinations of earlier
synthetic and analytic approaches
Holistic Approach Increase the child’s knowledge of the speechreading
process Increase the child’s ability to generate strategies to
facilitate more successful communication Increase the child’s confidence in the efficacy of high
probability success Increase the child’s tolerance for communicative
situations that have a higher degree of frustration Increase the child’s ability to generate personal goals
for improving speechreading Increase the child’s motivation to improve
speechreading abilities
Efficacy of Speechreading Training
Studies are mixed regarding demonstrating improvement following treatment for adults
Little research regarding children– Children may have greater potential for benefit
from speechreading training than adults
Developing Speechreading Skills
First step is usually instructional and includes consideration for the process
Second step may require speechreaders to reflect on their on habits and skills
Third step may require speechreaders to identify difficult listening situations and formulate solutions
Fourth step is introduction of formal speechreading lessons
Analytic Speechreading Training Focus on vowel and consonant recognition Underlying logic this curricula is to gradually
increase reliance on auditory signal for discriminating phonemic contrasts while they are speechreading
Reliance on Audition
Rel
ianc
e on
Vis
ion
Analytic Vowel Training
Initial training highly contrastive features• i u a
– Differ in BOTH formant structure and on the mouth
– Back vs front vowels• I i e ae front vowels
• u U o back vowels
Analytic Training Objectives
Examples:
Will discriminate words with i and u Will discriminate words with i and a Will discriminate words with u and a Will identify words with i u and a
Discriminate Vowels with i and u
beet/boot see/soup she/shoe
beet/boot leap/loop peel/pool
heat/hoot jeep/jewel sheet/shoot
keep/coop knee/new geese/goose
leap/loop need/nude read/rude
Identify Vowels with u
beet/boot/bat soup/seat/sap lass/lease/loose
hat/heat/hoot team/tam/tomb gas/geese/goose
pool/pal/peel jeep/jab/jude teen/tool/tan
Analytical Consonant Training
Features – manner, place, voicing– Place – visible AND audible– Manner and voicing – NOT visible, but audible
Consonant Place of Productionbi
l abi
alla
biod
enta
ld e
n ta l
alve
olar pa
lata
l
vela
r
glot
tal
p b
mf
v th
t d n
s z
l
Sh
zh c
h jd
k g
ng
h
Analytic Consonant Objectives will discriminate consonant pairs that differ in
place of production and share either voice or manner
will discriminate consonant pairs that share similar place of production but differ in manner and voice
will discriminate consonant pairs that share place and manner and/or voice
will identify consonants that share manner of production, using a four-item response set
will identify consonants from a six-item response set of voiced or voiceless consonants
Discriminate Consonant Pairs that Differ in Place and Share Either Voice or Manner
meet/geese pill/chill top/chop
moose/goose pot/hot boat/coat
bit/knit dog/jog peal/heal
make/lake tear/chair pin/chin
Synthetic Speechreading Training Objectives
1. will follow simple directions using a closed set response
2. will identify a sentence illustration from a set of four dissimilar pictures
3. will identify a sentence illustration from a set of four similar pictures
4. will listen plus lipread to two related sentences, and then draw a picture about them or paraphrase them
5. will speechread a paragraph-long narrative and then answer questions about it
Example of Synthetic ApproachSentences concerning cooking:1. I added a cup of flour.2. The bread is in the oven.3. Will you hand me the measuring cup.4. I need the box of sugar.5. The mixer is in the cabinet.6. The oven is set to 300 degrees.7. Put the bowl in the sink, please8. The pan is filled with batter.9. I will beat the eggs.10. Please pour a cup of milk.
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