Peng Shu-Chen, Tomblin J Bruce, Turner Christopher W
Department of Speech Pathology and Audiology, University of Iowa, Iowa City, IA, USA.
Ear Hear. 2008 Jun;29(3):336-51. doi: 10.1097/AUD.0b013e318168d94d.
Current cochlear implant (CI) devices are limited in providing voice pitch information that is critical for listeners' recognition of prosodic contrasts of speech (e.g., intonation and lexical tones). As a result, mastery of the production and perception of such speech contrasts can be very challenging for prelingually deafened individuals who received a CI in their childhood (i.e., pediatric CI recipients). The purpose of this study was to investigate (a) pediatric CI recipients' mastery of the production and perception of speech intonation contrasts, in comparison with their age-matched peers with normal hearing (NH), and (b) the relationships between intonation production and perception in CI and NH individuals.
Twenty-six pediatric CI recipients aged from 7.44 to 20.74 yrs and 17 age-matched individuals with NH participated. All CI users were prelingually deafened, and each of them received a CI between 1.48 and 6.34 yrs of age. Each participant performed an intonation production task and an intonation perception task. In the production task, 10 questions and 10 statements that were syntactically matched (e.g., "The girl is on the playground." versus "The girl is on the playground?") were elicited from each participant using interactive discourse involving pictures. These utterances were judged by a panel of eight adult listeners with NH in terms of utterance type accuracy (question versus statement) and contour appropriateness (on a five-point scale). In the perception task, each participant identified the speech intonation contrasts of natural utterances in a two-alternative forced-choice task.
The results from the production task indicated that CI participants' scores for both utterance type accuracy and contour appropriateness were significantly lower than the scores of NH participants (both p < 0.001). The results from the perception task indicated that CI participants' identification accuracy was significantly lower than that of their NH peers (CI, 70.13% versus NH, 97.11%, p < 0.001). The Pearson correlation coefficients (r) between CI participants' performance levels in the production and perception tasks were approximately 0.65 (p = 0.001).
As a group, pediatric CI recipients do not show mastery of speech intonation in their production or perception to the same extent as their NH peers. Pediatric CI recipients' performance levels in the production and perception of speech intonation contrasts are moderately correlated. Intersubject variability exists in pediatric CI recipients' mastery levels in the production and perception of speech intonation contrasts. These findings suggest the importance of addressing both aspects (production and perception) of speech intonation in the aural rehabilitation and speech intervention programs for prelingually deafened children and young adults who use a CI.
当前的人工耳蜗（CI）设备在提供对听众识别语音韵律对比（如语调及词汇声调）至关重要的音高信息方面存在局限。因此，对于童年时期接受人工耳蜗植入的语前聋个体（即小儿人工耳蜗接受者）而言，掌握此类语音对比的产生与感知极具挑战性。本研究的目的在于探究：（a）与年龄匹配的听力正常（NH）同龄人相比，小儿人工耳蜗接受者对语音语调对比的产生与感知的掌握情况；（b）人工耳蜗使用者和听力正常个体在语调产生与感知之间的关系。
26名年龄在7.44至20.74岁的小儿人工耳蜗接受者以及17名年龄匹配的听力正常个体参与了研究。所有人工耳蜗使用者均为语前聋，且他们在1.48至6.34岁之间接受了人工耳蜗植入。每位参与者都完成了一项语调产生任务和一项语调感知任务。在产生任务中，通过涉及图片的互动话语，从每位参与者那里引出10个句法匹配的问题和10个陈述句（例如，“女孩在操场上。”与“女孩在操场上？”）。由8名听力正常的成年听众组成的评判小组根据话语类型准确性（问题与陈述句）和轮廓适宜性（采用五点量表）对这些话语进行评判。在感知任务中，每位参与者在二选一的强制选择任务中识别自然话语的语音语调对比。
产生任务的结果表明，人工耳蜗使用者在话语类型准确性和轮廓适宜性方面的得分均显著低于听力正常参与者（p均<0.001）。感知任务的结果表明，人工耳蜗使用者的识别准确率显著低于其听力正常的同龄人（人工耳蜗使用者为70.13%，听力正常者为97.11%，p<0.001）。人工耳蜗使用者在产生任务和感知任务中的表现水平之间的皮尔逊相关系数（r）约为0.65（p = 0.001）。
总体而言，小儿人工耳蜗接受者在语音语调的产生或感知方面，并未展现出与其听力正常的同龄人相同程度的掌握情况。小儿人工耳蜗接受者在语音语调对比的产生和感知方面的表现水平存在中度相关性。小儿人工耳蜗接受者在语音语调对比的产生和感知的掌握水平上存在个体间差异。这些发现表明，在针对使用人工耳蜗的语前聋儿童和青少年的听觉康复及言语干预项目中，兼顾语音语调的产生和感知这两个方面至关重要。
