CSD 5400REHABILITATION

PROCEDURES FOR THE HARD OF HEARING

Visual Stimuli in CommunicationSpeechreading and Manual

Communication

Speechreading/Lipreading

How good do you think you are?

Video activity“I see what you say”

Salient FactorsAffecting Performance

1. Visibility of Speech SoundsVisibility of the

articulators needed to make the speech sound

Degree to which sounds are distinguishable from each other

Visibility

Most visible phonemes are made at the front of the mouth with maximum lip, jaw, and tongue movementsOnly 11-57% of English phonemes are

visible during production and distinguishable from one another

Distinguishability

Making phonemes different enough that when perceived, only one phoneme fits all the pieces of information perceivedWhen we perceive speech by auditory stimuli,

phonemes are distinguished on the basis of the different acoustic cues related to place of articulation, manner of articulation, and voicing

When we perceive speech visually, we can only “see” place of articulation

You can’t “see” voicing or manner

Several Classification Systems for English Visemes

Viseme groups are contrasting groups of homophemes that differ in terms of place of articulation

Homophemes are speech sounds that look the same (they share a similar place of articulation)

Visibility and ItsEffect on Speechreading

Visibility of a particular phoneme will contribute to its ability to be “read”Sentence familiarity and linguistic structure are

also factorsVisibility can change from words in isolation to words

in sentencesShort sentences are easier than longer onesFrequently occuring words are easier than strange

words

People show varying abilities to integrate visual and auditory information

2. Rate of SpeechAverage rate of speech

15 phonemes/sec

Consonant durations 30-300 ms

Speechreading is very taxing on the visual system and very fatiguingPassive speechreading is

impossible

Natural rates are best

3. Speaker Characteristics

How much do the articulators move?

How expressive is the speaker?

Gestures?Familiarity?Is the mouth visible?

4. Environmental Characteristics

Speaker-to-listener distancesOptimal distance is

about 5 feet

Lighting

5. Speechreader Characteristics

IQ and personality characteristics don’t correlate well with this abilityWillingness to

synthesize information

Willingness to guess

Age

Assessment of Speechreading

Standardized tests do existUtley, Barley, Keaster

Not used much at all1990 survey of ASHA certified clinically active

audiologists reported only 16% used any kind of speechreading assessment tool

Why?Problems with test validityProblems with test difficultyProblems with test, re-test reliabilityNo auditory cues allowed

Bisensory EvaluationSpeechreading is best

used as a supplement to auditory information

Table is consonant perception performance in a variety of auditory/visual combinationsLook at the gains

achieved when visual is added to auditory

Notice that visual alone is not effective

A Philosophical Approach to Speechreading…

Remember that the acoustic cues most affected and lost by the presence of HL are place of articulation cuesSpeechreading can give some additional

information regarding place of artic cues and only place cues

Manner of articulation and voicing cues are less likely to be affected by the presence of HL

Therefore, information of manner of articulation and voicing can be obtained auditorily and speechreading can help supplement the lost information related to place of articulation

Speechreading Training for Adults

Best handled in a discussion (group) format

Here’s an example of a handout you might develop to stimulate discussion of the speechreading process

Speechreading Training For Adults

Here’s another example of a way to direct a discussion of the process of speechreading

“Good communication involves observing”

Speechreading Training for Adults

Here’s an example of a handout you might generate to discuss the “rules” to follow when speechreading

Specific ways to improve receptive communication

SpeechreadingTraining for Adults

Here’s another illustration of a list of “basic rules” for speechreading

SpeechreadingTraining for Adults

It’s very helpful to get adults thinking about factors that affect performance, where these variables arise, and whether they are under the HI listener’s control

“Factors that influence understanding”

SpeechreadingTraining for Adults

It’s also necessary to help listeners be realistic about the overall effectiveness of speechreading

Discuss the relative visibility of individual speech sounds

SpeechreadingTraining for Adults

Don’t let your clients forget the importance of nonverbal cues/information

Help them make use of this information in improving their overall receptive communication

SpeechreadingTraining for Children

Very different from the informal adult approach

A major habilitation component for kids with cochlear implants

Speechreading Objectives

AnalyticThese training objectives are directed

toward developing vowel and consonant recognition skills

Underlying goal is to gradually increase the child’s reliance on the auditory signal for discriminating phonemic contrasts while they speechread

Vowel Analytic Training Objectives--Some Examples1. The student will discriminate words with /i/

and /u/n me from moo, geese from goose, she from shoe

2. The student will discriminate words with /i/ and /a/n heat from hot, keep from cop, seed from sock,

cheap from chop

3. The student will identify words with /i/, /u/, and /a/, using a four-item and then six-item response setn bean from bean, pot, pit, and pool

4. The student will identify words with /u/, /i/, and /a/ from an open set of familiar vocabulary

Consonant Analytic Training Objectives--Some Examples1. The student will discriminate consonant pairs that share

similar place of production but differ in manner and voicen pan from man

2. The student will discriminate consonant pairs that share place and manner and/or voice

n park from bark

3. The student will identify consonants from a 4 item response set that share manner of production

n tag from tag, bag, back, and gas

4. The student will identify consonants from a 4 item response set of voiced or voiceless consonants

n pop from pop, cop, cap, and top

5. The student will identify words from an open set of familiar vocabulary

Synthetic Speechreading Training Objectives--an

Example

The student will follow simple directions using a closed response set

The student will identify a sentence illustration from a set of four dissimilar pictures

The student will identify a sentence illustration from a set of four similar pictures

The student will listen to topic-related sentences and repeat/paraphrase them

The student will listen to two related sentences and draw a picture about them

The student will speechread a paragraph-long narrative and then answer questions about it

Summary Remarks about Speechreading..

Can speechreading skills be developed significantly through training?The jury is still outWhen improvements occur, they tend to be

modestSometimes we can’t objectively demonstrate

improvement, but the client feels their skills are better

Not much data available concerning children

Summary Remarks about Speechreading..

Speechreading training is almost never provided in the absence of other aural rehab servicesAmplification, effective communication

strategies training, auditory training, etc

Most beneficial to incorporate into the training ways the listener can minimize the difficulty of the speechreading taskManaging the environmentAppropriate communication behaviors of their

communication partners

Manual Forms of Communication

Fingerspelling Current uses

Manual Forms of Communication

Manually coded English Signed English Seeing Essential English (SEE I) Seeing Essential English II (SEE II)

CD ROM Ch08.02 An example of SEE II

American Sign Language (ASL)

The only recognized language of the Deaf culture

A History….

Thomas Hopkins Gallaudet Born in 1787 Hartford

Connecticut Alice Cogswell

A History… Braidwood Family Abbe Sicard was

the director of the French Institute for the Deaf of Paris

Laurent Clerc

A History…First American

school for the Deaf Established in

Hartford, CT in 1817

Now called the American School for the Deaf

Statue of Gallaudet teaching Cogswell “a”

A History…

A statue of Alice Cogswell at Gallaudet University

American Sign Language (ASL)

The only recognized language of the Deaf culture

Unique vocabulary and syntax French grammar Space as a linguistic element CD ROM Ch.08.03

Cued Speech

Developed as a speechreading supplement to spoken English Provides visual cues

CD ROM Ch.08.01