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
Introduction•Receptive language impairment is related
to:▫Audiometrically low hearing sensitivity ▫Audiometrically sensitive hearing it may be
due to: Non speech auditory perceptual deficit Linguistic problem.
Failure of phonology representation
Phonological awareness•Quality or
distinctiveness of phonemic representations in memory
Internal representation•Incorporate more
segmental information
•Representations of distinct phonemes
Expressive phonology or articulation errors•Bidirectional causal
relation between articulation and underlying phonemic representations
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
Children’s articulation accuracy
Preexisting differences in phonological
representations
Perceive, discriminate, manipulate
speech sounds
Production
Perception
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
Similarity and confusability of phonemes•The similarity between phonemes and
confusability in short-term memory influence:▫Speech errors ▫The strength of phonotactic constraints▫The 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
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.
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.
Methodology•Protocol of language disorders
▫Audiological evaluation▫Profile of Speech errors (Phonology test)(1)
▫Psychometry
•Phoneme Speech auditory Perception evaluation
1. Abou-Ras et al. 27th Alexandria International Combined ORL Congress, April 8-10,2009
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.
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
Vowel Identification
CVC syllables
Vowel Identification (monosyllabic words)
Discrimination of vowels
2) Consonant perception testing:
Low frequency phonemes
Low frequenc
y fricative
s
High frequen
cy fricative
s
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
اتا ابا
Results
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.
Group A: Cochlear Implanted discrimination of vowels
1 2 3 4 5 6 7 8 9 10 11 120%
10%20%30%40%50%60%70%80%90%
100%
Vowel Length1 2 3 4 5 6 7 8 9 10 11 12
0%10%20%30%40%50%60%70%80%90%
100%
Vowel Place
1 2 3 4 5 6 7 8 9 10 11 120%
10%20%30%40%50%60%70%80%90%
100%
Vowel Height
Group A: Cochlear Implanted Consonants Identification
0 2 4 6 8 10 12 140.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
StopsNasalsGlideslaterals
Group A: Cochlear Implanted Consonants Identification
0 2 4 6 8 10 12 140.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%Low frequency phonemes High Frequency Fricatives Low Frequency fricatives
Group A: Cochlear Implant Discrimination of consonants
1 2 3 4 5 6 7 8 9 10 110%
10%20%30%40%50%60%70%80%90%
100%
Voicing
1 2 3 4 5 6 7 8 9 10 11 120%
10%20%30%40%50%60%70%80%90%
100%
Place of articulation
1 2 3 4 5 6 7 8 9 10 110.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Manner of articulation
1 2 3 4 5 6 7 8 9 10 11 120%
10%20%30%40%50%60%70%80%90%
Emphatic
Group B:Hearing Impaired•Degree of hearing loss
▫6 Moderate severe▫2 Moderate
•Configuration of hearing loss:▫6 High frequency hearing loss (sloping)▫2 Flat configuration
Group B: Hearing Impaired•Common speech errors:
▫Difficulty of production of high frequency fricatives.
▫Substitution Stopping Devoicing
Group B: Hearing Impaired Discrimination of vowels
1 2 3 4 5 6 7 80%
10%20%30%40%50%60%70%80%90%
100%
Vowel Length1 2 3 4 5 6 7 8
0%10%20%30%40%50%60%70%80%90%
100%
Vowel Place
1 2 3 4 5 6 7 80%
10%20%30%40%50%60%70%80%90%
100%
Vowel Height
Group B: Hearing Impaired consonants identification
0 1 2 3 4 5 6 7 8 90.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
StopsNasalsGlideslaterals
Group B: Hearing Impaired consonants identification
0 1 2 3 4 5 6 7 8 90%
20%
40%
60%
80%
100%
120%Low frequency phonemes High Frequency Fricatives Low Frequency fricatives
Group B: Hearing Impaired Discrimination of consonants
1 2 3 4 5 6 7 80%
20%40%60%80%
100%
Voicing
1 2 3 4 5 6 7 80.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Manner of articulation
1 2 3 4 5 6 7 80%
10%20%30%40%50%60%70%80%90%
Place of articulation
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.
Comparison between Group A, B, C and D: Vowels
CI: Cochlear implant, HI: hearing Impaired, Ph: phonological errors
Comparison between Group A, B, C and D: Consonants low frequency phonemes identification
CI: Cochlear implant, HI: hearing impaired, Ph: phonological errors
Comparison between Group A,B,C and D : Consonants Identification
CI: cochlear implanted, HI: Hearing impaired, Ph: phonological errors
Comparison between Group A, B, C and D: Consonants Discrimination
CI: Cochlear implant, HI: hearing impaired, Ph: phonological errors
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)
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.
Recommendation for Further Research•Extension of the number of studied
subjects.•Study of influence of variable stimuli on
speech perception results.
Thank you for your attention