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• W58903254 abstract "Speech perception is often considered specific to the auditory modality, despite convincing evidence that speech processing is bimodal. The theoretical and clinical roles of lipreading for speech perception, however, have received little attention in speech-language pathology. The aims of this study were to investigate how lipreading ability can be assessed to facilitate clinical decision making in speech and language intervention, to determine how lipreading affects speech development in a hearing impaired cohort and to assess the interaction of lipreading skills with other factors thought to give rise to variation in communication skills in hearing impaired children. Five pieces of evidence that support lipreading as an integral part of speech processing are reviewed in Chapter 1. Definitions of hearing loss and lipreading are also presented. Ways of assessing lipreading ability are essential for both research and clinical practice and a review of lipreading tests in Chapter 1 highlights the inadequacy of assessment tools in this area. Factors often cited in the literature as affecting lipreading skills in a hearing and /or hearing impaired cohort are also examined. These include gender, age, socioeconomic status, intelligence, degree of hearing loss and aetiology of hearing loss. Chapter 2 details a longitudinal study by Dodd, McIntosh, and Woodhouse (1992) which described the communication development of children with hearing impairment and investigated the associations between communication skills and other linguistic and non¬linguistic factors. Lipreading skills were assessed using the Speechreading Assessment for Children with Hearing Impairment (SPACHI), a test developed for the study, and this data is also discussed. An association was found between lipreading skills and speech development. Those children with good lipreading skills had better speech skills as measured quantitatively through their phonemic repertoire. They had fewer phonemes missing and a higher percent of correct consonants. As a whole group, receptive and expressive language skills were below age appropriate scores. Chapter 3 reports new analysis of unused data from the longitudinal study which indicated associations between memory skills and other speech and language parameters. The results show that lipreading skills were highly correlated with some parameters of speech and language skills. Children who had better lipreading skills at an early age had better speech skills as measured qualitatively in their phonological repertoire. They also had more developmental error patterns. Poor lipreaders had significantly more phonemes missing from their phonemic repertoires and made significantly more nondevelopmental speech errors than the good lipreaders. Good lipreaders had better visual memory skills. The longitudinal study was limited by a number of factors, including low participant numbers and the lack of adherence to current best assessment practice in the assessments used. It also became evident that the SPACHI was inadequate and needed revision. It did not clearly delineate the level at which a child’s lipreading skills were plateauing (i.e., word, phrase, sentence or conversational speech) and there was no contingency for test familiarity, therefore making the test unreliable if used too frequently. In order to assess lipreading for research purposes, it may be necessary to test the skill in isolation, as well as multimodally. There was no ability to accurately assess both visual and auditory visual modalities using the SPACHI and there were insufficient test items per section to clearly determine competence at specific levels of ability. Finally, no hearing children were assessed for validity and reliability measurements using the test. Chapter 4 describes the development and content of the Lipreading Assessment of Children with Hearing Impairment (LACHI), a revised and enhanced version of the SPACHI. The LACHI provides an assessment of children’s lipreading skills across the word, phrase, sentence, question and conversational levels. There are three interchangeable test forms (the Farm, the Beach and the Park) and they can be used to test auditorily, visually (lipreading) or auditory-visually, without test familiarity being an issue. Chapter 5 provides an overview of the use of the LACHI on a cohort of hearing children and children with impaired hearing, evaluating LACHI performance in terms of gender, age and socioeconomic status. On average, girls performed significantly better than boys, and older children performed better than younger children, although some younger children had excellent lipreading skills. Socioeconomic grouping affected the hearing group only, with those from a higher socioeconomic group performing better. Data on the internal structure of the LACHI was evaluated and indicated that the interchangeable forms are not significantly different, with test section five being the most difficult for both the hearing and hearing impaired cohorts. The communication development of children with hearing impairment is examined in more depth in Chapter 6. No past research has provided such an overview of lipreading in relation to other communication skills. The cross-sectional study examined speech skills using free speech analysis and the Diagnostic Evaluation of Articulation and Phonology (DEAP). Receptive and expressive language skills were also investigated as was visual and auditory memory. Lipreading skills were assessed using the LACHI. Results confirmed the association between good lipreading and better speech skills by the type of error patterns (more developmental) and Percent Consonants Correct, Percent Vowels Correct and Percent Phonemes Correct (all higher). Visual memory was better than auditory memory. Expressive and receptive language scores were age appropriate. Chapter 7 looks at the interplay of lipreading skills and other factors including intelligence, gender, age, socioeconomic status and degree of hearing loss in the hearing impaired cohort. Categories of good and poor lipreaders were established. Comparisons of the two groups’ speech, language and memory skills revealed that good lipreading skills were associated with degree of hearing loss, age and gender, as well as better expressive language, speech and supra-segmental characteristics. In contrast, receptive language, auditory and visual memory, intelligence and socioeconomic grouping did not discriminate between the groups. Some of these findings were surprising and were further explored in terms of the interplay of the skills with each other. In Chapter 8, the results of the study are discussed. Associations between lipreading skills and speech skills in a hearing impaired cohort are considered, as well as the relationship between memory, language and lipreading. A discussion on the effectiveness and potential use of the LACHI as an important assessment tool in clinical intervention with hearing and other disordered populations is presented. The overwhelming evidence from the data collected in this thesis indicates there is an association between good lipreading skills and better expressive speech skills in a hearing impaired cohort, with memory skills implicated in lipreading ability. This adds evidence to the theoretical discussions on multimodal speech processing and accessing the phonological code. Finally, the LACHI was found to be an efficient and effective measurement of lipreading skills in hearing children and children with hearing impairment." @default.
• W58903254 created "2016-06-24" @default.
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• W58903254 date "2007-12-01" @default.
• W58903254 modified "2023-09-27" @default.
• W58903254 title "Lipreading skills in children with hearing impairment" @default.
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