Effects on Speech & Language Flashcards
How does hearing loss affect spoken language?
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
Major Factors affecting Spoken Language: List 3
- Time of Onset
- Degree of HL
- Type of HL
Time of Onset: Pre-lingual vs. Post-lingual
- Pre-lingual= development of language)
* Post-lingual= maintenance of language)
Degree of Loss: 2 functional groups
- Mild-Mod
- Sev-Prof
Degree of hearing loss can impact spoken language but the audiogram alone cannot predict effects on spoken language
(Also Configuration)
Type of HL:
•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
For Deafened Adults, Loss of auditory feedback can cause
- 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
For Children, Hearing loss affects all aspects of speech and language, resulting in:
- 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
Factors that may influence speech/language development
- 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
Effects of HI on Speech Production: Mild to Moderately Severe Impairment
- 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
Commonly misarticulated phonemes: Mild to Mod
Fricatives
Affricates
initial glide
Speech deviates from normal in 3 major respects: Mild to Mod
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/
Effects of HI on Speech Production: Transition to Severe to Profound
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
Effects of HI on Speech Production: Severe to Profound Impairment (list 3)
- Overall Intelligibility
- articulation (segmentals)
- suprasegmentals
Effects of HI on Speech Production: Severe to Profound– OVERALL INTELLIGIBILITY
•Earlier studies: 15 to 25% intelligibility in 8-15 year old deaf kids
Effects of HI on Speech Production: Severe to Profound– Articulation
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
Effects of HI on Speech Production: Severe to Profound– Suprasegmentals
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
Role of Audition in Language
•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
Deaf individuals may seem very direct and blunt; Why?
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
Effects of HI on Language: Receptive Language
1) Reduced or distorted cues 2) Reduced amount and type of early parent-child intervention
- Early intervention that involves families is ideal
Effects of HI on Language: Expressive Language
- Lack of intact auditory feedback loop: not hearing themselves
- Children speak what they hear, children speak how they hear
3 Aspects of Lang.- list
- Form: syntax, morphology
- Content: semantics, vocab
- Use: pragmatics
1) Form: syntax, morphology
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”
2) Content: Semantics, vocabulary
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
3) Use: pragmatics
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
Summary: Consequences of HL on Speech and Language
- 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
What about Unilateral Hearing Loss– Is it something to really worry about?
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
