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) 11dB 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. Cued Speech enhances noisy speech perception 3 Auditory speech perception for deaf or hard-of-hearing persons In recent years, a large number of deaf people (and in particular many congenitally deaf children) are fitted with a hearing aid (HA) or a cochlear implant (CI). With technological progress, CIs have become the most effective vehicle for helping profoundly deaf people to understand spoken language, to perceive environmental sounds, and, to some extent, to listen to music. The development of the early detection of deafness together with the trend for more and earlier implantation might decrease or minimize the interest for visual cues in oral communication. HAs and CIs immensely help deaf people by providing auditory access to speech. Yet, the auditory input they deliver remains degraded compared to the full auditory signal (

La perte auditive chez l'enfant peut entrainer un retard sur le développement du langage oral. L'Auditory Verbal Therapy (AVT) est une méthode uni-sensorielle qui se base principalement sur le canal auditif pour permettre aux enfants sourds implantés de développer de bonnes capacités auditives. La Langue française Parlée Complétée (LfPC) est un outil multimodal qui permet de désambiguïser la lecture labiale par l'ajout d'un geste manuel. Cette étude s'intéresse à l'apport de ces deux outils sur la perception de parole chez l'enfant porteur d'implant cochléaire, à partir d'une tâche de jugement de lexicalité. Les résultats suggèrent des performances similaires chez les enfants avec un bon niveau de LfPC, les enfants inscrits dans un programme AVT, et les enfants normoentendants, mais des performances plus faibles chez les enfants avec un faible niveau de LfPC. Ainsi, une prise en charge précoce et adaptée à l'enfant est nécessaire pour le développement phonologique.

IntroductionEarly exposure to a rich linguistic environment is essential as soon as the diagnosis of deafness is made. Cochlear implantation (CI) allows children to have access to speech perception in their early years. However, it provides only partial acoustic information, which can lead to difficulties in perceiving some phonetic contrasts. This study investigates the contribution of two spoken speech and language rehabilitation approaches to speech perception in children with CI using a lexicality judgment task from the EULALIES battery. Auditory Verbal Therapy (AVT) is an early intervention program that relies on auditory learning to enhance hearing skills in deaf children with CI. French Cued Speech, also called Cued French (CF), is a multisensory communication tool that disambiguates lip reading by adding a manual gesture.MethodsIn this study, 124 children aged from 60 to 140 months were included: 90 children with typical hearing skills (TH), 9 deaf children with CI who had participated in an AVT program (AVT), 6 deaf children with CI with high Cued French reading skills (CF+), and 19 deaf children with CI with low Cued French reading skills (CF-). Speech perception was assessed using sensitivity (d’) using both the hit and false alarm rates, as defined in signal-detection theory.ResultsThe results show that children with cochlear implants from the CF- and CF+ groups have significantly lower performance compared to children with typical hearing (TH) (p < 0.001 and p = 0.033, respectively). Additionally, children in the AVT group also tended to have lower scores compared to TH children (p = 0.07). However, exposition to AVT and CF seems to improve speech perception. The scores of the children in the AVT and CF+ groups are closer to typical scores than those of children in the CF- group, as evidenced by a distance measure.DiscussionOverall, the findings of this study provide evidence for the effectiveness of these two speech and language rehabilitation approaches, and highlight the importance of using a specific approach in addition to a cochlear implant to improve speech perception in children with cochlear implants.