Effects on Speech & Language

Question 1

How does hearing loss affect spoken language?

Answer 1

A. Acquisition of Spoken Language
B. Receptive and Expressive Forms
C. Maintenance of Quality

• Difficult to determine the effect because range of performance is so variable

Question 2

Major Factors affecting Spoken Language: List 3

Answer 2

1. Time of Onset
2. Degree of HL
3. Type of HL

Question 3

Time of Onset: Pre-lingual vs. Post-lingual

Answer 3

• Pre-lingual= development of language)

* Post-lingual= maintenance of language)

Question 4

Degree of Loss: 2 functional groups

Answer 4

1. Mild-Mod
2. Sev-Prof

Degree of hearing loss can impact spoken language but the audiogram alone cannot predict effects on spoken language
(Also Configuration)

Question 5

Type of HL:

Answer 5

•SNHL most affected because of:

• Potential for maximum loss of audibility
• Likely have distorted cochlear processing

•Purely Conductive hearing loss will have neither of the above

Question 6

For Deafened Adults, Loss of auditory feedback can cause

Answer 6

• Speech Conservation: Precision in articulation, rate and intonation of speech becomes monotonous, quality of voice is affected, speech control especially with loudness of the voice

Question 7

For Children, Hearing loss affects all aspects of speech and language, resulting in:

Answer 7

• Delay (mild to moderately severe hearing loss): progression that is the same as the general population (same error), just at a slower rate (same as normal but delayed
• Deviance (severe to profound hearing loss): difficulties considered ”odd” at any age

Question 8

Factors that may influence speech/language development

Answer 8

• Use amplification (HAs, CIs)
• Fit optimally: kids prefer louder sounds/ adults: less amplification
• Worn and maintained regularly: routine check
• Time of identification and intervention
• Ability to use incomplete information
• Parental motivation and effort
• Ability to understand speech
• Cognitive ability and speech discrimination ability
• Quality and availability of appropriate remediation therapy

Question 9

Effects of HI on Speech Production: Mild to Moderately Severe Impairment

Answer 9

• Misarticulations similar to normal hearing children (NHC)
• Develop and use speech sounds in same order as NHC but end up being delayed
• Articulation of vowels and voice quality is the same as NHC
• Should be able to develop speech spontaneously although will be delayed

Question 10

Commonly misarticulated phonemes: Mild to Mod

Answer 10

Fricatives
Affricates
initial glide

Question 11

Speech deviates from normal in 3 major respects: Mild to Mod

Answer 11

1) Omission of final consonants (tense, plural)
2) Infrequent production of voiceless fricatives (because not hearing them)
3) Rare use of voiced back lingual consonants, such as /g/, /dz/ and /ng/

Question 12

Effects of HI on Speech Production: Transition to Severe to Profound

Answer 12

Deviance
•Children with flat thresholds at 60-70 dBHL across frequencies:
- Cannot hear spoken language at conversational levels
- Would function as if they were deaf without intervention

• Appropriate amplification and therapeutic intervention may allow these children to receive enough acoustic information to acquire speech naturally
• They would exhibit errors consistent with the mild to moderate category

Question 13

Effects of HI on Speech Production: Severe to Profound Impairment (list 3)

Answer 13

1. Overall Intelligibility
2. articulation (segmentals)
3. suprasegmentals

Question 14

Effects of HI on Speech Production: Severe to Profound– OVERALL INTELLIGIBILITY

Answer 14

•Earlier studies: 15 to 25% intelligibility in 8-15 year old deaf kids

Question 15

Effects of HI on Speech Production: Severe to Profound– Articulation

Answer 15

Segmentals: indiv. sounds/ discrete units of speech (phonemes)

Vowels
•More vowel errors than typical: mild to moderate kids- less mistakes (easier to hear, lower freq)// profound kids make more vowel errors
•Errors occur between vowels situated close to each other in place of articulation (I vs i)
•Tongue assumes a neutral position “neutralization of vowels”

Consonants (hard for mild to moderate too)
•Produce fewer consonants and later than NHC
•More errors with middle place consonants b/c more of them and require greater precision to produce
•Voice/voiceless cognate confusion (/b/ vs. /p/): same lip position/can’t hear
•Production often accompanied by hypernasality and/or audible nasal emission of air

Question 16

Effects of HI on Speech Production: Severe to Profound– Suprasegmentals

Answer 16

Melodic Components of Speech
•Duration: Duration and prosody or rhythm is the most deviant aspects of deaf speech. Smooth flow and timing control are critical for intelligibility

•Stress: Abnormal variation in stressed and unstressed vowels can obliterate speech patterns

•Voice quality or Phonation: Serious error for deaf speakers. Insufficient intensity and failure to coordinate breathing and speaking – Children must be taught to associate breath stream with speaking
Pitch: Often falsetto// Dull, monotonous, hoarse, nasal, breathy

Question 17

Role of Audition in Language

Answer 17

•Language learning is at a slower rate
•Primarily an auditory event
•Segmentals (units of language) grouped into patterns and combined with suprasegmental features that provide subtle cues to vary the meaning
Ex. “They gave her baby food”-Stress and timing

Question 18

Deaf individuals may seem very direct and blunt; Why?

Answer 18

Lang. is learned, not taught. It is dependent on quality and quantity of exposure.

Trying to speak loud and clear, short and to the point to simplify language, if they use sign they are very physically expressive

Question 19

Effects of HI on Language: Receptive Language

Answer 19

1) Reduced or distorted cues 2) Reduced amount and type of early parent-child intervention
- Early intervention that involves families is ideal

Question 20

Effects of HI on Language: Expressive Language

Answer 20

• Lack of intact auditory feedback loop: not hearing themselves
• Children speak what they hear, children speak how they hear

Question 21

3 Aspects of Lang.- list

Answer 21

1. Form: syntax, morphology
2. Content: semantics, vocab
3. Use: pragmatics

Question 22

1) Form: syntax, morphology

Answer 22

Syntax: Rules for word order
- use of only simple structures
- acquisition in order but at a slower rate
- reading ability
•Receptive: “The cat was bitten by the dog” interpreted “the cat bit the dog”
•Expressive: “the cat that dog bit” (order off)

Morphology: Rules which govern similar parts of words
- Delay or absence of markers for plurality, tense, possessive. - Absence or inconsistent production of: articles, prepositions, indefinite pronouns, present progressive “ing”

Question 23

2) Content: Semantics, vocabulary

Answer 23

Semantics- word meaning (understanding and expressing) and rules to govern meaning

•Limited range of semantic categories (related words)
[Semantic categories- Agent (animate objects like people or animals), objects, action (words that suggest motion, actions: kick, bite, run) location (words that suggest notion of place: garden house)]
•Difficulties in figurative, abstract material such as idioms, metaphors, slang, subtlety: “it’s raining cats and dogs outside”

Vocabulary- lexicon (# of words comprehended)
•reading abilities/performance
•Limited growth of vocabulary, thus, a large gap from normal

Limited vocab makes it hard to fully express yourself and emotions-very frustrating

Question 24

3) Use: pragmatics

Answer 24

Rules governing use of language in social environment; including rules for conversation

• Using language for different purposes (informing, demanding, requesting)
• Changing language according to needs of listener (baby, work voice vs. home voice)
• Following conversation rules (turn taking, staying on topic, nonverbal cues, how close to stand)

•Pragmatics tends to be better than the others, however, conversation skills can be poor

Question 25

Summary: Consequences of HL on Speech and Language

Answer 25

• All areas likely affected
• If mild to moderate, expect delay
• If severe to profound, expect deviance
• Errors will tend toward simplifications
• Errors will be based on what a child actually hears

Question 26

What about Unilateral Hearing Loss– Is it something to really worry about?

Answer 26

Yes- a concern.

• Speech in noise
• Localization
• Hearing consonants when someone is speaking on your “bad side”
• 10 times more likely to have academic problems
• 1/3 of unilateral loss children repeated a grade and/or required resource assistance

[potential delay; significant academic