Audiovisual & Speechreading Training Chapter 5

1. Audiovisual & Speechreading TrainingChapter 5 Perry C. Hanavan, Au.D.

2. Lip Movements • “…it is important to realize that we move our articulators to produce acoustically distinct sounds and NOT visually contrastive movements.” • Mark Ross

3. Speechreading Factoid • Campbell et al, (1981) surveyed the literature and found 38-58% of individuals with HL have accompanying visual deficiencies • Johnson et al (1981) found 65% entering NTID demonstrated defective vision • Vision loss may be greater among individuals with HL • Individuals with HL need vision evaluation***

5. Auditory plus Vision • When BOTH auditory and visual information is available, individuals with hearing loss tend to do better on communication tasks • Example (Auditory plus Vision): • Speech Recognition Score = 50% • Speechreading Score = 20% • Combined Visual/Auditory Score = 90%

6. WIPI • Word Intelligibility by Picture Identification (WIPI) • closed-set picture-pointing (six pictures per plate) • appropriate for children whose language age is between 5 and 10-11 • comprised of four 25-monosyllabic word lists • contains 26 color plates (one for practice), six pictures per page. (A, V, A-V)

8. Larsen Recorded Test • Auditory word discrimination test • Pairs of phonemes in words • few vs. chew • bill vs. mill • nice vs. vice • Lists represent an attempt to present the phone in the initial, medial and final position of a word • Limited choice—select one of two words by drawing line through printed word heard

10. Test of Child Speechreading • Child friendly • Computer based • Sentence and word recognition http://www.isca-speech.org/archive_open/avsp09/papers/av09_028.pdf

11. CAVET Children’s Audiovisual Enhancement Test • Assesses speechreading enhancement in children within the vocabulary level of 7-9 year olds with profound prelingual hearing loss • Designed to minimize ceiling and floor effects, eliminate syntactic factors, and minimize semantic factors • 3 lists of 20 words each with half of words easy to recognize in a vision-only condition and half are less likely to be recognized in each list but presented in random order • Each list is designated for auditory alone, visual alone, or auditory-visual only mode • Test available in CD-ROM and VHS format • (Tye-Murray & Geers, 2002)

12. Auditory Plus Vision • Tye-Murray • CAVET (children) • Audition plus vision • Vision only • Audition alone • Eber • Sent-Ident

13. Ling-6 • Phoneme level detection and recognition test • m, s, sh, e, a, u • Procedure • Detection and identification of phonemes

14. Craig Lipreading Test

15. Denver Quick Test

16. 9:00 am Appointment • The waiting room is filled with several individuals to evaluate. Which patient will benefit from speechreading training? • Recent cochlear implant patient • Recent new user of digital hearing aid who has had hearing loss for fifty years • Three year-old child with profound loss • Patient with recent sudden onset hearing loss

17. Traditional Lipreading Methods Four lipreading methods were introduced into the U.S.: • Mueller-Walle introduced by Bruhn • Nitchie introduced by Nitchie • Kinzie introduced by Kinzie • Jena introduced by Bunger

18. Speechreading Factoid • Three of the lipreading methods introduced into the U.S. were implemented by individuals with normal hearing until adulthood, at which time they acquired a significant hearing loss, and sought assistance. • They developed methods that bear their names: Bruhn, Kinzie, and Nitchie. • Bunger later wrote about the Jena method.

19. Analytic & Synthetic • Analytic approach (bottom-up) • perceive each of the basic parts before the whole can be identified • Syllable considered to be the basic unit • Bruhn & Jena methods • Synthetic approach (top-down) • Perception of the whole is paramount to perception of the basic parts • Sentence considered to be the basic unit • Nitchie and Kinzie methods

20. Mueller-Walle Method • Originated in Germany • Martha Emma Bruhn studied lipreading with Julius Mueller-Walle in Hamburg, Germany and introduced method in US • Hallmark: rapid syllable drill • emphasis on quickly identifying position and movement of speech sounds produced • rapid syllable rhythmic drills: she-ma-flea and she-may-free • practiced recognizing homophenous words using sentence cues to distinguish meaning • lessons based on sound movement or group movements

21. Nitchie Method • Edward Nitchie became deaf during adolescence • Eventually established his own school for the deaf in NY • Initially developed an analytic approach, altering the approach to a synthetic approach (credited with developing synthetic approach to speechreading) • Speechreader studies articulatory movements by viewing meaningful monosyllabic words to develop eye training • Advocated use of sentences and stories to train mind to comprehend the general meaning connected discourse • Mirror training

22. Kinzie Method • Cora acquired HL while medical student in PA • Studied with Bruhn and then Nitchie combining best methods from both approaches • Unique feature: graded lessons for children and adults with sentences as basis of instruction • They recommended all sentences be “definite, natural, interesting, pleasing, rhythmical, and dignified”

23. Questions What is meant by imitating movements of speaker • Kinesthetic • Mimetic • Auditory • Visual • All the above

24. Jena Method • Developed by Karl Brauckman in Jena, Germany and promoted by Anna Bunger from Michigan • Emphasizes syllable drills, rhythm practice, and kinesthetic awareness • Material presented in rhythmic manner reinforcing fact that speech is rhythmic • Focused on mimetic (imitating movements of speaker) and kinesthetic (perception of movement, position, etc.) forms and sensations

25. Question More recent methods of teaching speechreading tend to be: • Analytic • Synthetic • Eclectic • None of the above

26. Recent Speechreading Trends • Decline of speechreading as sole element of AR with advent of technology • Technology (HA, CI, ALDs) is providing opportunities for individuals to make increasing use of audible speech and other audible sounds • Newer lipreading approaches tend to be eclectic • Modification or combinations of earlier synthetic and analytic approaches

27. Holistic Approach • Increase the child’s knowledge of the speechreading process • Increase the child’s ability to generate strategies to facilitate more successful communication • Increase the child’s confidence in the efficacy of high probability success • Increase the child’s tolerance for communicative situations that have a higher degree of frustration • Increase the child’s ability to generate personal goals for improving speechreading • Increase the child’s motivation to improve speechreading abilities

28. Efficacy of Speechreading Training • Studies are mixed regarding demonstrating improvement following treatment for adults • Little research regarding children • Children may have greater potential for benefit from speechreading training than adults

29. Developing Speechreading Skills • First step is usually instructional and includes consideration for the process • Second step may require speechreaders to reflect on their on habits and skills • Third step may require speechreaders to identify difficult listening situations and formulate solutions • Fourth step is introduction of formal speechreading lessons

30. Analytic Speechreading Training • Focus on vowel and consonant recognition • Underlying logic this curricula is to gradually increase reliance on auditory signal for discriminating phonemic contrasts while they are speechreading Reliance on Vision Reliance on Audition

31. Analytic Vowel Training • Initial training of highly contrastive features • i u a • Differ in BOTH formant structure and on the mouth • Back vs front vowels • I i e ae front vowels • u U o back vowels

32. Acoustic vs Tongue Position

33. Analytic Training Objectives Examples: • Will discriminate words with i and u • Front vs. back vowels • Will discriminate words with i and a • High vs. low vowels • Will discriminate words with u and a • Will identify words with i u and a

34. Books, CD, DVDs, etc. • Speechreading • Seeing and Hearing Speech

35. Discriminate Vowels with i and u

36. Identify Vowels with u

37. Analytical Consonant Training • Features – manner, place, voicing • Place – visible AND audible • Manner and voicing – NOT visible, but audible

38. Consonant Place of Production k g ng velar palatal Sh zh ch jd alveolar dental p b m th t d n s z l bilabial labiodental f v glottal h

39. Analytic Consonant Objectives • will discriminate consonant pairs that differ in place of production and share either voice or manner • will discriminate consonant pairs that share similar place of production but differ in manner and voice • will discriminate consonant pairs that share place and manner and/or voice • will identify consonants that share manner of production, using a four-item response set • will identify consonants from a six-item response set of voiced or voiceless consonants

40. Discriminate Consonant Pairs that Differ in Place and Share Either Voice or Manner

41. Synthetic Speechreading Training Objectives • will follow simple directions using a closed set response • will identify a sentence illustration from a set of four dissimilar pictures • will identify a sentence illustration from a set of four similar pictures • will listen plus lipread to two related sentences, and then draw a picture about them or paraphrase them • will speechread a paragraph-long narrative and then answer questions about it

42. Example of Synthetic Approach Sentences concerning cooking: • I added a cup of flour. • The bread is in the oven. • Will you hand me the measuring cup. • I need the box of sugar. • The mixer is in the cabinet. • The oven is set to 300 degrees. • Put the bowl in the sink, please • The pan is filled with batter. • I will beat the eggs. • Please pour a cup of milk.

43. Resources • Online resources • Gallaudet • Read My Lips • Movie • Lipreading Laboratory