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Thesis (Ph.D.)--University of Western Sydney, 2007. / A thesis submitted to the University of Western Sydney, College of Arts, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliography.

Thesis (M.Ed.(Opvoedkundige Sielkunde))-Universiteit van Pretoria, 2007. / Includes bibliographical references.

The relationship between visual short term memory (as measured by the Memory for Designs Test) and speechreading ability (as measured by the Barley Speechreading Test) was investigated in a sample of twenty-seven hearing impaired geriatrics. Correlation analysis verified a statistically significant relationship between Memory for Designs Test scores and Barley Speechreading Test scores. Partial correlation revealed the relationship between speechreading scores and short term memory scores was rot influenced significantly by variance in chronological age or speech discrimination ability. Memory for Designs Test scores were shown to be accurate predictors of scores achieved on the Barley Speechreading Test. Results of this study suggest that development of different approaches (for evaluating speechreading ability of geriatrics) could prove more informative and useful than the speechreading tests currently in use. For example, development of a speechreading test, composed of several subtests (such as visual short term memory) which would evaluate specific factors related to speechreading ability, would optimize both clinical

In order for the hearing handicapped child to derive maximum benefit of language acquisition through maturation, a method of receptive communication is essential at the earliest age possible. It is felt that speechreading is this method. The need for a method of training speechreading cues to prelingual, aurally handicapped children is based on the fact that most visual speechreading methods require the use of language. If speechreading can be regarded as a learning process involving the discrimination of visual cues that maybe disassociated from language expression then training the child to discriminate various facial expressions may actually enhance speech-reading ability. If such a training method proved to be highly connected with speechreading learning, then it also might prove useful in helping the deaf pre-school child acquire the necessary attentive and discriminitive behaviors consistent with speechreading. Ten pre-school, normal hearing children participated in an oral-gestural training program which was carried out in three parts: 1) Administration of the revised Children's Speechreading Test, 2) Training for discrimination of oral-gestural pairs as "same" or "different" until a 100 percent correct response criterion had been obtained, 3) Evaluation of the oral-gestural training through readministration of the revised Children's Speechreading Test. A t-test of the difference between the baseline mean and post training speechreading mean revealed significance beyond the .05 level of confidence. This supported the original proposal that speechreading skills for propositional words can be acquired by means of visual discrimination training in oral-facial movements. It is thus proposed that such training will prove useful in helping the hearing handicapped preschool child acquire the necessary behaviors consistent with speechreadlng, namely attention and visual discrimination. This study involved normal hearing subjects in which language was already established. Since the Oral-Gestural Training program is designed for the hearing handicapped prelingual child, further investigation with such a population appears necessary to confirm the findings of this investigation. Other questions that arose during the study such as sex and age differences of a larger sample, and the significance of the number of oral-gestural training sessions as related to the post-training test score, are other related areas that need consideration before a final conclusion can be drawn. Although no formal data was obtained on attention span, it was observed subjectively that this capacity improved markedly among these subjects. This is a clinical observation and should be subjected to further investigation. In conclusion, it appears through the findings of this study, that such a training method may be highly related with speechreading training and may indeed prove useful in helping prelingual, aurally handicapped children acquire the necessary behaviors consistent with speechreading.

One of the main input devices to computerized systems is Voice Recognition Systems (VRS). VRS is best suited for applications where job functions require more than two hands to be performed. The performance of VRS is highly dependent on the environment's noise. The higher the noise level the lower the recognition capability. Automatic lip reading through vision systems have been utilized to improve the recognition capability in noisy environments. However, this approach is costly and time-consuming. The objective of this thesis was to investigate the utilization of an Infrared sensor for automatic lip reading to improve the recognition performance of VRS. The developed system is cheaper and faster than other automatic lip readers. The test results of fifty words and eleven digits indicated that the method has good repeatability, and good character recognition, while not dependent on or sensitive to the ambient light level. Although speaker independence was tested, the results are inconclusive. / Master of Science

This thesis visualizes the communication challenges both latent and obvious of my daily life as a hard of hearing individual. By focusing on a variety of experiences and examples I demonstrate the implications of a hard of hearing individual’s life. The prints, objects and videos that I have created for my visual thesis aim to enrich the understanding of a broader public on issues regularly faced by Deaf people. At the heart of my work my goal is to generate mutual empathy between the hearing and the Deaf.

The general aim of this thesis was to test the effects of paralinguistic (emotional) and prior contextual (topical) cues on perception of poorly specified visual, auditory, and audiovisual speech. The specific purposes were to (1) examine if facially displayed emotions can facilitate speechreading performance; (2) to study the mechanism for such facilitation; (3) to map information-processing factors that are involved in processing of poorly specified speech; and (4) to present a comprehensive conceptual framework for speech perception, with specification of the signal being considered. Experi¬mental and correlational designs were used, and 399 normal-hearing adults participated in seven experiments. The main conclusions are summarised as follows. (a) Speechreading can be facilitated by paralinguistic information as constituted by facial displayed emotions. (b) The facilitatory effect of emitted emotional cues is mediated by their degree of specification in transmission and ambiguity as percepts; and by how distinct the perceived emotions combined with topical cues are as cues for lexical access. (c) The facially displayed emotions affect speech perception by conveying semantic cues; no effect via enhanced articulatory distinctiveness, nor of emotion-related state in the perceiver is needed for facilitation. (d) The combined findings suggest that emotional and topical cues provide constraints for activation spreading in the lexicon. (e) Both bottom-up and top-down factors are associated with perception of poorly specified speech, indicating that variation in information-processing abilities is a crucial factor for perception if there is paucity in sensory input. A conceptual framework for speech perception, comprising specification of the linguistic and paralinguistic information, as well as distinctiveness of primes, is presented. Generalisations of the findings to other forms of paralanguage and language processing are discussed.

Introdução: A presença de perdas auditivas de origem neural no adulto que já desenvolveu linguagem pode acarretar alteração de compreensão da fala com dificuldade na discriminação auditiva dos sons e entendimento completo da mensagem. Entre as causas de perdas auditivas neurais está o distúrbio do espectro da neuropatia auditiva (DENA). A maioria das publicações sobre o DENA descrevem o padrão do diagnóstico auditivo, entretanto as consequências dessa alteração auditiva para a comunicação do indivíduo e as implicações dessas para o tratamento fonoaudiólogico são escassas. Faz-se necessária a identificação das especificidades linguísticas a serem avaliadas nos neuropatas, por meio de um protocolo de avaliação direcionado, para permitir a elaboração de diretrizes terapêuticas bem delineadas. Objetivo: Este estudo teve como objetivo descrever as manifestações linguísticas em adultos com o Distúrbio do espectro da neuropatia auditiva (DENA). Métodos: Foram incluídos neste estudo pacientes adultos identificados com o diagnóstico de DENA, alfabetizados, sem alterações neurológicas e cognitivas, no período entre 2007 e 2009 no setor de Fonoaudiologia do Ambulatório de Otorrinolaringologia do HCFMUSP. Doze pacientes foram selecionados, sendo 8 do sexo masculino (66,7%), com idades entre 18 e 50 anos. Foi elaborado um protocolo de anamnese incluindo dados sobre escolaridade, uso de amplificação sonora individual (AASI) e queixas auditivas específicas. O protocolo de avaliação constou de provas que abordaram a avaliação da recepção auditiva e da emissão de fala (identificação fonêmica; inteligibilidade; leitura e compreensão de texto e consciência fonológica) e da expressão (fala e elaboração). Os estímulos foram dados por via somente auditiva e no modo auditivo e visual (com leitura orofacial - LOF). Resultados: As principais características observadas nestes pacientes: sexo masculino, ensino fundamental incompleto, uso de AASI menor que três meses em ambas as orelhas, dificuldade de ouvir em ambientes ruidosos e diálogo foram as situações comunicativas que geraram maior dificuldade na expressão. Observou-se que em todas as provas com apoio da LOF, houve melhora significativa da percepção da fala do ponto de vista clínico. Conclusões: As especificidades linguísticas dos pacientes adultos com DENA encontradas foram: baixa escolaridade, velocidade de fala alterada, dificuldade de compreensão de texto tanto pela via auditiva como pela leitura, dificuldade de consciência fonológica, melhora da repetição de palavras e frases com o uso da LOF. / Introduction: Post linguistic neural hearing loss in adults can lead to speech alterations and difficulties in auditory discrimination of sounds and comprehension of the message. Auditory neuropathy spectrum disorder (ANSD) is among the causes of neural hearing loss. Most studies on ANSD describe the standard for auditory diagnosis. However, the consequences of such hearing impairment in communication and its implication on speech therapy are scarce. Thus, it is necessary to identify the specific language aspects to be assessed in neurologically impaired individuals through a directed assessment protocol to allow the development of outlined treatment guidelines. Objective: This study aimed to describe the linguistic manifestations in adults with ANSD. Methods: The study included adults diagnosed with ANSD, who were literate and had no neurological or cognitive alterations. Data collection was carried out between 2007 and 2009 at the Speech, Language and Hearing service of the Clinic of Otorhinolaryngology of HCFMUSP. Twelve patients, eight males (66,7%) with ages ranging from 18 and 50 years of age were selected. An anamnesis protocol was designed. This protocol included data on education, use of hearing aids (HA) and specific hearing complaints. The assessment protocol consisted on tests of auditory reception and production of speech (phonemic identification; intelligibility; reading and text comprehension; and phonological awareness) and expression (speech and elaboration). The stimuli input were given in auditory only and in auditory plus visual mode (with lip reading). Results: The main characteristics observed in all participants were: male gender; incomplete primary school; use of hearing aids for less than three months in both ears; difficulty hearing in noisy environments; and dialogue, were the communicative situations that led to greater difficulty in expression. A significant improvement in speech perception was observed in all tests with lip reading. Conclusions: The language specificities of individuals with ANSD were: low educational level; speech rate alterations; difficulty in reading comprehension both by hearing and by reading; difficulty in phonological awareness; improvement of words and phrases repetition using LR.

Introdução: A presença de perdas auditivas de origem neural no adulto que já desenvolveu linguagem pode acarretar alteração de compreensão da fala com dificuldade na discriminação auditiva dos sons e entendimento completo da mensagem. Entre as causas de perdas auditivas neurais está o distúrbio do espectro da neuropatia auditiva (DENA). A maioria das publicações sobre o DENA descrevem o padrão do diagnóstico auditivo, entretanto as consequências dessa alteração auditiva para a comunicação do indivíduo e as implicações dessas para o tratamento fonoaudiólogico são escassas. Faz-se necessária a identificação das especificidades linguísticas a serem avaliadas nos neuropatas, por meio de um protocolo de avaliação direcionado, para permitir a elaboração de diretrizes terapêuticas bem delineadas. Objetivo: Este estudo teve como objetivo descrever as manifestações linguísticas em adultos com o Distúrbio do espectro da neuropatia auditiva (DENA). Métodos: Foram incluídos neste estudo pacientes adultos identificados com o diagnóstico de DENA, alfabetizados, sem alterações neurológicas e cognitivas, no período entre 2007 e 2009 no setor de Fonoaudiologia do Ambulatório de Otorrinolaringologia do HCFMUSP. Doze pacientes foram selecionados, sendo 8 do sexo masculino (66,7%), com idades entre 18 e 50 anos. Foi elaborado um protocolo de anamnese incluindo dados sobre escolaridade, uso de amplificação sonora individual (AASI) e queixas auditivas específicas. O protocolo de avaliação constou de provas que abordaram a avaliação da recepção auditiva e da emissão de fala (identificação fonêmica; inteligibilidade; leitura e compreensão de texto e consciência fonológica) e da expressão (fala e elaboração). Os estímulos foram dados por via somente auditiva e no modo auditivo e visual (com leitura orofacial - LOF). Resultados: As principais características observadas nestes pacientes: sexo masculino, ensino fundamental incompleto, uso de AASI menor que três meses em ambas as orelhas, dificuldade de ouvir em ambientes ruidosos e diálogo foram as situações comunicativas que geraram maior dificuldade na expressão. Observou-se que em todas as provas com apoio da LOF, houve melhora significativa da percepção da fala do ponto de vista clínico. Conclusões: As especificidades linguísticas dos pacientes adultos com DENA encontradas foram: baixa escolaridade, velocidade de fala alterada, dificuldade de compreensão de texto tanto pela via auditiva como pela leitura, dificuldade de consciência fonológica, melhora da repetição de palavras e frases com o uso da LOF. / Introduction: Post linguistic neural hearing loss in adults can lead to speech alterations and difficulties in auditory discrimination of sounds and comprehension of the message. Auditory neuropathy spectrum disorder (ANSD) is among the causes of neural hearing loss. Most studies on ANSD describe the standard for auditory diagnosis. However, the consequences of such hearing impairment in communication and its implication on speech therapy are scarce. Thus, it is necessary to identify the specific language aspects to be assessed in neurologically impaired individuals through a directed assessment protocol to allow the development of outlined treatment guidelines. Objective: This study aimed to describe the linguistic manifestations in adults with ANSD. Methods: The study included adults diagnosed with ANSD, who were literate and had no neurological or cognitive alterations. Data collection was carried out between 2007 and 2009 at the Speech, Language and Hearing service of the Clinic of Otorhinolaryngology of HCFMUSP. Twelve patients, eight males (66,7%) with ages ranging from 18 and 50 years of age were selected. An anamnesis protocol was designed. This protocol included data on education, use of hearing aids (HA) and specific hearing complaints. The assessment protocol consisted on tests of auditory reception and production of speech (phonemic identification; intelligibility; reading and text comprehension; and phonological awareness) and expression (speech and elaboration). The stimuli input were given in auditory only and in auditory plus visual mode (with lip reading). Results: The main characteristics observed in all participants were: male gender; incomplete primary school; use of hearing aids for less than three months in both ears; difficulty hearing in noisy environments; and dialogue, were the communicative situations that led to greater difficulty in expression. A significant improvement in speech perception was observed in all tests with lip reading. Conclusions: The language specificities of individuals with ANSD were: low educational level; speech rate alterations; difficulty in reading comprehension both by hearing and by reading; difficulty in phonological awareness; improvement of words and phrases repetition using LR.