Objective Analysis of Motor Speech Performance in Children with Cochlear Implants

Abstract

Objectives:

Objectively analyze speech and articulation in children with longstanding experience using unilateral cochlear implants.

Methods:

Cross-sectional study design at a tertiary pediatric hospital. Sixteen subjects (aged 8-17 years) using unilateral cochlear implants were studied. The subjects had a median of 7 years of cochlear implant experience, with excellent audiogram and speech perception scores. Speech was objectively assessed with the Motor Speech Profile (MSP) software and Computerized Speech Lab model 4500 (KayPentax, Lincoln NJ). Results were compared to previously published normative pediatric data.

Results:

Diadochokinetic rates were within normal limits for 69% of children with /pa/pa/pa/ and 73% of children with /pa/ta/ka/ spoken tasks. The magnitude and rate of the second formant transition were within normal limits for 56% and 83% of children, respectively. The variability in amplitude of intonation stimulability was within normal limits for 100% of children, but variability in frequency was within normal limits in 44% of children only. The syllabic rate and duration were both within normal limits for 88% of children. Overall, subjects demonstrated excellent articulation and timing but poor frequency intonation stimulability.

Conclusions:

Although the majority of the measured characteristics of speech were normalized after cochlear implantation, variability in frequency during intonation stimulability testing remained outside of the normal range in 56% of subjects even with long term cochlear implant use. This limitation may be perceived as a dampening of emotional expression during speech. Novel cochlear implant software programming and auditory verbal therapy strategies may be needed to address this finding.