CSD 5400 REHABILITATION PROCEDURES FOR THE HARD OF HEARING

1. CSD 5400REHABILITATION PROCEDURES FOR THE HARD OF HEARING Visual Stimuli in Communication Speechreading and Manual Communication

2. Speechreading/Lipreading How good do you think you are? Video activity “I see what you say”

3. Salient FactorsAffecting Performance 1. Visibility of Speech Sounds Visibility of the articulators needed to make the speech sound Degree to which sounds are distinguishable from each other

4. Visibility Most visible phonemes are made at the front of the mouth with maximum lip, jaw, and tongue movements Only 11-57% of English phonemes are visible during production and distinguishable from one another

5. Distinguishability Making phonemes different enough that when perceived, only one phoneme fits all the pieces of information perceived When 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

6. 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)

7. 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 factors Visibility can change from words in isolation to words in sentences Short sentences are easier than longer ones Frequently occuring words are easier than strange words People show varying abilities to integrate visual and auditory information

8. 2. Rate of Speech Average rate of speech 15 phonemes/sec Consonant durations 30-300 ms Speechreading is very taxing on the visual system and very fatiguing Passive speechreading is impossible Natural rates are best

9. 3. Speaker Characteristics How much do the articulators move? How expressive is the speaker? Gestures? Familiarity? Is the mouth visible?

10. Environmental Characteristics Speaker-to-listener distances Optimal distance is about 5 feet Lighting

11. 5. Speechreader Characteristics IQ and personality characteristics don’t correlate well with this ability Willingness to synthesize information Willingness to guess Age

12. Assessment of Speechreading Standardized tests do exist Utley, Barley, Keaster Not used much at all 1990 survey of ASHA certified clinically active audiologists reported only 16% used any kind of speechreading assessment tool Why? Problems with test validity Problems with test difficulty Problems with test, re-test reliability No auditory cues allowed

13. Bisensory Evaluation Speechreading is best used as a supplement to auditory information Table is consonant perception performance in a variety of auditory/visual combinations Look at the gains achieved when visual is added to auditory Notice that visual alone is not effective

14. A Philosophical Approach to Speechreading… Remember that the acoustic cues most affected and lost by the presence of HL are place of articulation cues Speechreading 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

15. 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

16. Speechreading Training For Adults Here’s another example of a way to direct a discussion of the process of speechreading “Good communication involves observing”

17. 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

18. SpeechreadingTraining for Adults Here’s another illustration of a list of “basic rules” for speechreading

19. 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”

20. 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

21. 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

22. SpeechreadingTraining for Children Very different from the informal adult approach A major habilitation component for kids with cochlear implants

23. Speechreading Objectives Analytic These 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

24. Vowel Analytic Training Objectives--Some Examples • The student will discriminate words with /i/ and /u/ • me from moo, geese from goose, she from shoe • The student will discriminate words with /i/ and /a/ • heat from hot, keep from cop, seed from sock, cheap from chop • The student will identify words with /i/, /u/, and /a/, using a four-item and then six-item response set • bean from bean, pot, pit, and pool • The student will identify words with /u/, /i/, and /a/ from an open set of familiar vocabulary

25. Consonant Analytic Training Objectives--Some Examples • The student will discriminate consonant pairs that share similar place of production but differ in manner and voice • pan from man • The student will discriminate consonant pairs that share place and manner and/or voice • park from bark • The student will identify consonants from a 4 item response set that share manner of production • tag from tag, bag, back, and gas • The student will identify consonants from a 4 item response set of voiced or voiceless consonants • pop from pop, cop, cap, and top • The student will identify words from an open set of familiar vocabulary

26. 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

27. Summary Remarks about Speechreading.. Can speechreading skills be developed significantly through training? The jury is still out When improvements occur, they tend to be modest Sometimes we can’t objectively demonstrate improvement, but the client feels their skills are better Not much data available concerning children

28. Summary Remarks about Speechreading.. Speechreading training is almost never provided in the absence of other aural rehab services Amplification, effective communication strategies training, auditory training, etc Most beneficial to incorporate into the training ways the listener can minimize the difficulty of the speechreading task Managing the environment Appropriate communication behaviors of their communication partners

29. Manual Forms of Communication Fingerspelling • Current uses

30. 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

31. American Sign Language (ASL) The only recognized language of the Deaf culture

32. A History…. Thomas Hopkins Gallaudet • Born in 1787 • Hartford Connecticut • Alice Cogswell

33. A History… • Braidwood Family • Abbe Sicard was the director of the French Institute for the Deaf of Paris • Laurent Clerc

34. 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”

35. A History… A statue of Alice Cogswell at Gallaudet University

36. 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

37. Cued Speech Developed as a speechreading supplement to spoken English • Provides visual cues CD ROM Ch.08.01