Long-Term Trajectories of the Development of Speech Sound Production in Pediatric Cochlear Implant Recipients

Abstract

Purpose This study characterized the development of speech sound production in prelingually deaf children with a minimum of 8 years of cochlear implant (CI) experience. Method Twenty-seven pediatric CI recipients' spontaneous speech samples from annual evaluation sessions were phonemically transcribed. Accuracy for these speech samples was evaluated in piecewise regression models. Results As a group, pediatric CI recipients showed steady improvement in speech sound production following implantation, but the improvement rate declined after 6 years of device experience. Piecewise regression models indicated that the slope estimating the participants' improvement rate was statistically greater than 0 during the first 6 years postimplantation, but not after 6 years. The group of pediatric CI recipients' accuracy of speech sound production after 4 years of device experience reasonably predicts their speech sound production after 5–10 years of device experience. Conclusions The development of speech sound production in prelingually deaf children stabilizes after 6 years of device experience, and typically approaches a plateau by 8 years of device use. Early growth in speech before 4 years of device experience did not predict later rates of growth or levels of achievement. However, good predictions could be made after 4 years of device use.

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

“…Nittrouer, Caldwell, Lowenstein, Tarr, and Holloman (2012) found that comprehension of spoken language was the best predictor, in children below 24 months of age, of their language/literacy skills in kindergarten. Tomblin et al (2008) found that accuracy of speech sound production at 4 years postimplant was a good predictor of speech skills after 5 to 10 years of use. Moeller et al (2007) studied speech sound development between 10 and 24 months of age in 33 children with and without hearing loss and found that early measures of syllable production predicted unique variance in later speech production and vocabulary outcomes.…”

“…Over the years, updates in CI technology have included redesigned internal equipment (i.e., electrode arrays and internal receiver stimulators), new speech processing strategies, and external device hardware (speech processors and microphones; Carlson, Driscoll, Gifford, & McMenomey, 2012;Wilson & Dorman, 2008). For example, early improvements in speech processing strategies resulted in significant improvements in speech perception for adults and children (Geers, Brenner, & Davidson, 1999;Skinner, Arndt, & Staller, 2002;Skinner et al, 1994;Tomblin, Peng, Spencer, & Lu, 2008;Wilson & Dorman, 2008). Improved front-end processing strategies and microphone and processor technology have combined to improve speech perception, especially for access to low-level speech inputs (Davidson, 2006;Dawson, Decker, & Psarros, 2004;Dawson, Vandali, Knight, & Heasman, 2007).…”

“…Phoneme production at both 3.5 and 4.5 years of age was assessed from phonetic transcription of language samples. Transcription of naturally occurring rather than elicited production has been used in other longitudinal studies of speech in children with CIs that extend to young ages (Tomblin et al, 2008). The first 100 different words produced by a child were transcribed by speech-language pathology graduate students using the International Phonetic Alphabet, following transcription protocols described by Shriberg and Kwiatkowski (1982).…”

Production of contrast between sibilant fricatives by children with cochlear implants

“…Most studies that have analyzed the speech of children with cochlear implants (CIs) have examined how intelligible these children are (e.g., Chin et al, 2003;Peng et al, 2004) or how accurately they produce phonemes (e.g., Blamey et al, 2001;Tobey et al, 2007;Tomblin et al, 2008). While these studies have generally observed that children with CIs have poorer speech production than is expected from their peers with normal hearing (NH), their conclusions are limited by the fact that accuracy and intelligibility are based solely on adult listeners' judgments.…”

Intelligibility of Speech Produced by Children with Hearing Loss: Conventional Amplification versus Nonlinear Frequency Compression in Hearing Aids

“…It has been shown that speech intelligibility of children with profound hearing loss improved after cochlear implantation [6][7][8][9][10], and improved with increased duration of implant use [11]. Younger age of implantation was also associated with higher levels of intelligibility for children with profound hearing loss [12].…”