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The compensatory substitutional placements for phonemes produced by MoS speakers may detract from the intelligibility of speech. This is similar to the McGurk-MacDonald effect, whereby an illusory auditory signal is perceived when visual information from lip movements does not match the auditory information from speech. It also suggests that observers use contextual clues, more than the acoustic signal alone, to arrive at the accurate recognition of the message of the speakers with MoS. Therefore, speakers with MoS should be counseled in the top-down approach of auditory closure. When the speech signal is degraded, predictable messages are more easily understood than unpredictable ones. It is also important to confirm the speaking partner's understanding of the topic before proceeding.