Effects of Speech Production Ability on a Measure of Speech Perception Capacity in Young

119 Pages·2015·2.68 MB·English

University of South Florida
Scholar Commons
Graduate Theses and Dissertations Graduate School
January 2013
Effects of Speech Production Ability on a Measure
of Speech Perception Capacity in Young Children
with Cochlear Implants and their Articulation-
Matched Peers
Victoria Beatriz Gonzalez
University of South Florida, [email protected]
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Scholar Commons Citation
Gonzalez, Victoria Beatriz, "Effects of Speech Production Ability on a Measure of Speech Perception Capacity in Young Children with
Cochlear Implants and their Articulation-Matched Peers" (2013).Graduate Theses and Dissertations.
http://scholarcommons.usf.edu/etd/4896
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Effects of Speech Production Ability on a Measure of Speech Perception Capacity in

Young Children with Cochlear Implants and their Articulation-Matched Peers.

by

Victoria B. Gonzalez

A dissertation submitted in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
Department of Communication Sciences and Disorders
College of Behavioral and Community Sciences
University of South Florida

Major Professor: Theresa Hnath Chisolm, Ph.D.
Ruth H. Bahr, Ph.D.
Laurie S. Eisenberg, Ph.D.
Robert D. Frisina, Ph.D.

Date of Approval:
November 18, 2013

Keywords: pediatric hearing loss, auditory perceptual development, OlimSpac,
speech audiometry, imitation

Copyright © 2013, Victoria B. Gonzalez
Dedication

I dedicate this dissertation to my parents, Ana and Hector Gonzalez. This
compilation of chapters is evidence of their belief in my abilities, perseverance, and
strength. Their unconditional love, endless encouragement, and support both emotionally
and financially made this all possible.
I also dedicate this to myself as a testament of all the hard work, sacrifices made,
and obstacles that were overcome. The road may not have been easy, but the sense of
fulfillment and accomplishment outweighed every tear, sleepless night, or moment of
self-doubt. I will forever be proud of this grandiose achievement.
Acknowledgments

My journey to achieve a Ph.D. was long and winding. It took a great deal of inner
strength and self-discipline to ultimately see the finish line. But I was fortunate to have
the support and guidance of my family, friends, and colleagues along the way.
This dissertation could not have been accomplished without Dr. Theresa
Chisolm’s recognition of my passion for clinical research and her belief that I could carry
out the project. She assembled a team of experts, Drs. Ruth Bahr, Laurie Eisenberg, and
Robert Frisina, who graciously agreed to serve as committee members. I am forever
grateful for the time, patience, and constructive criticism they provided throughout the
whole process. I would like to thank my fellow Ph.D. students, both within and outside
the department, who helped build a support system to share ideas, empathize with
struggles, and encourage my efforts every step of the way. I cannot thank enough the
parents and children who went out of their way to participate in my study, the students
who helped with data collection and analysis, and the incredible professionals who
helped with recruitment. Also, thank you to Alex for loving me when times got tough,
reminding me of my strength when I need it the most, and listening to every idea and
struggle. Lastly, thank you to my parents for which without them none of this would be
possible. You raised me to be a strong independent woman, taught me that I had the
potential to achieve my academic goals (however big I made them), and supported me
unconditionally until I reached them.
Table of Contents

List of Tables ..................................................................................................................... iii

List of Figures ......................................................................................................................v

Abstract ............................................................................................................................. vii

Chapter One: Introduction ...................................................................................................1

Chapter Two: Literature Review .........................................................................................8
Speech Perception Development .............................................................................9
Level I – Sensory primitives ......................................................................10
Assessment of sensory primitives ..................................................10
Level II – Perceptual representations .........................................................11
Assessment of perceptual representations .....................................12
Level III – Cognitive/Linguistic representations .......................................12
Assessment of Cognitive/Linguistic representations .....................13
Influence of hearing loss on speech perception development ...................14
Speech Production Development ...........................................................................17
Level I – Production primitives .................................................................18
Level II – Production representations ........................................................19
Level III – Cognitive/Linguistic productions ............................................19
Influence of hearing loss on speech production development ...................20
Role of Cochlear Implants .....................................................................................24
Study Objectives ....................................................................................................33

Chapter Three: Methods ....................................................................................................35
Participants .............................................................................................................35
Cochlear implant group..............................................................................35
Normal hearing group ................................................................................37
Test Measures ........................................................................................................39
Measure of speech pattern contrast perception ..........................................39
OlimSpac procedure.......................................................................40
OlimSpac scoring ...........................................................................41
Measure of speech production ...................................................................41
GFTA-2 procedure .........................................................................42
GFTA-2 scoring .............................................................................42
Measure of receptive language ..................................................................43
PPVT-4 procedure .........................................................................44
i
PPVT-4 scoring ..............................................................................44
Instrumentation ......................................................................................................44
Audiological assessment/screening ...........................................................44
Speech pattern contrast perception ............................................................45
Speech production and receptive language ................................................46
Recordings .................................................................................................47
Procedures ........................................................................................................47
NH group ...................................................................................................47
CI group .....................................................................................................48
Matching Criteria ...................................................................................................50
Statistical Analysis .................................................................................................54

Chapter Four: Results ........................................................................................................55
Matched Pairs ........................................................................................................56
Speech production abilities ........................................................................56
Demographic variables ..............................................................................57
Chronological age at testing...........................................................58
Parent education .............................................................................60
Receptive language skills ...............................................................62
Primary Objective ..................................................................................................63
Speech perception performance .................................................................63
Individual data for the auditory-only OlimSpac data ................................66
Secondary Objective ..............................................................................................70
Effect of presentation modality ..................................................................70
NH group .......................................................................................72
CI group .........................................................................................72

Chapter Five: Discussion ...................................................................................................76
Primary Objective ..................................................................................................78
Secondary Objective ..............................................................................................82
Limitations .............................................................................................................86
Future Directions ...................................................................................................87
Clinical Implications ..............................................................................................88
Conclusions ........................................................................................................90

References ..........................................................................................................................92

Appendix A: Parental Questionnaire for Normal Hearing Participants ...........................102

Appendix B: Parental Questionnaire for Cochlear Implant Participants .........................104

Appendix C: List of OlimSpac Vowel-Consonant-Vowel (VCV) Utterances ................106

ii
List of Tables

Table 3.1. Demographic data for participants in the CI Group .........................................38

Table 3.2. Demographic data for participants in the NH Group ........................................39

Table 3.3. Aided thresholds obtained from children in the CI Group. ..............................50

Table 3.4. Individual speech production results for participants in the NH group
and CI group. ...................................................................................................52

Table 3.5. Demographic characteristics and word-level articulation performance
of matched pairs of participants. ......................................................................53

Table 4.1. Demographic and performance characteristics of children with cochlear
implants and their articulation-matched normal hearing peers ........................59

Table 4.2. Individual speech perception results for matched pairs of participants. ...........64

Table 4.3. Two-Related Samples Analysis Results for Composite Scores for the
A-V and A-O Conditions of the OlimSpac. .....................................................67

Table 4.4a. Individual speech perception results for participants with normal
hearing..............................................................................................................71

Table 4.4b. Individual speech perception results for participants with cochlear
implants. ...........................................................................................................71

Table 4.5. Descriptive statistics and within-group differences in presentation
modality on OlimSpac single speech contrasts and composite scores
for children in the NH Group. ..........................................................................74
iii
Table 4.6. Descriptive statistics and within-group differences in presentation
modality on OlimSpac single speech contrasts and composite scores
for children in the CI Group.............................................................................75

iv
List of Figures

Figure 3.1. Graphic and numeric display of a generated OlimSpac score .........................42

Figure 3.2. Block diagram of OlimSpac test set-up ...........................................................46

Figure 3.3. Flow diagram of the administration order of study procedures for
children in the NH group (a) and children in the CI group (b) ........................49

Figure 4.1. Standard scores on the GFTA-2 Sounds-In-Words subtest between
matched pairs of participants with cochlear implants and normal
hearing..............................................................................................................57

Figure 4.2. Test age equivalence, in months, on the GFTA-2 Sounds-In-Words
subtest between matched pairs of participants with cochlear implants
and normal hearing ..........................................................................................58

Figure 4.3. Chronological age at testing between matched pairs of participants
with cochlear implants and normal hearing .....................................................60

Figure 4.4. Proportion of participants at each educational level in the CI and
articulation-matched NH group with highest degree earned by mothers
(a) and fathers (b) .............................................................................................61

Figure 4.5. Standard scores on the PPVT-4 between matched pairs of participants
with cochlear implants and normal hearing .....................................................62

Figure 4.6. OlimSpac composite scores in the A-V condition between matched
pairs of participants with cochlear implants and normal hearing ....................65

Figure 4.7. OlimSpac composite scores in the A-O condition between matched
pairs of participants with cochlear implants and normal hearing ....................66
v
Figure 4.8. Mean speech perception performance between the CI and articulation-
matched NH groups in the A-V and A-O conditions of the OlimSpac ...........68

Figure 4.9. The individual auditory-only results of children in the CI group and
the matched children in the NH group for six speech contrasts as a
function of standard scores (based on hearing age) of the GFTA-2
Sounds-In-Words subtest and speech contrast .................................................69

Figure 4.10. Mean speech perception performance in the A-V and A-O conditions
of the OlimSpac for the NH and CI group .......................................................70

Figure 4.11. Average number of correct responses obtained by children in the NH
group for each of the six single speech contrasts .............................................73

Figure 4.12. Average number of correct responses obtained by children in the CI
group for each of the six single speech contrasts .............................................74

vi