Speechreading
The Difficulty of Lipreading cont.
-30-40% of sounds are visible -Thankfully the ones hardest to hear for HI are the easiest to see (presbycusis sounds affected = high frequencies) -Ones visible on the lips -Residual low frequency hearing to determine clusters *Voicing and nasality will help you determine differences -/p/ vs /m/ , /b/ vs /p/
Candidacy
-Adults who recently lost their hearing -Adults with long standing HL -Adults that receive a CI -Kids with CI -Kids utilizing total communication -Kids in oral/aural programs -Kids using cued speech -Everyone! *hook to get into AR *fun, sense of humor
So which should you use...
-All of them -Hull (2007) recommends tailoring speechreading to the individual consumers needs depending on their individual communication environment, specific communication partners, or specific communication situations -usually only speech reading by 10% -but concrete proof of change and more control
Age and Speechreading: Conclusions
-Although age apparent difficulties are well documented it is also important to note that they do benefit from AV cues -AR that centers on counseling and speechreading training that facilitate guessing are appropriate (Alpiner & McCarthy, 2005) -Every age group benefits -Rage around 50% is good lipreading -any benefit helps no matter what level
Visemes examples
-Are a group of sounds that appear identical on the lips /p,b,m/ -When produced voiceless they look the same Table 9-2 -look at distinct differences and context to get the rest of it -when you teach people, start with opposites and then get closer and closer
Age and Speechreading (SNR)
-As SNR decreases, reliance on visual cues increase (O'Neill, 1954;Erber, 1969) -As SNR decreases (signal getting more equal to background noise), older adults show age related decrements in the AV speech understanding but still benefit from visual cues (Ewertson and Nielson, 1971) -negative correlation with age and auditory processing/speechreading -processing speed can't keep up
Age and Speechreading-continuation
-Better performance for younger subjects than older subjects for visemes, CV, and sentences (Farrimond, 1959;Ewertsen and Nielson, 1971;Pelson and Prather, 1974;Shoop and Binnie, 1979;Kricos and Lesner, 1995) -Decreased in men per decade after age 30 (Farrimond, 1959) *processing effect earlier
Vision and Speechreading
-Campbell et al (1981) surveyed the literature and found 38-58% of the individuals with HL have accompanying visual deficiencies -Johnson et al ( 1981) found 65% entering NTID demonstrated defective vision -Vision loss might be higher among individuals with HL -Must check vision (before we start)
Common Lipreading Tests
-Craig Lipreading Inventory -Jacob's Everyday Sentences -Utley Lipreading Test -Denver Quick Test of Lipreading
Pragmatic Approach
-Creates ideal environment and context for the person with HL in dialogue, employing communication strategies -Aim is for the individual to concentrate on interaction more than the repetition of the specific cues or sounds, work on modifying message, communication strategies an situation information (Lind, 2009) -bringing in 4 factors
Tadoma Method
-Deafblind -Place thumb on the speaker's lips and their fingers along the jaw line during communication -https://www.youtube.com/watch?v=U_QMS-hzRMs&feature=youtu.be *uses articulators *they feel how the person is articulating the sounds *lip reads using hand
Holistic/Eclectic Approach
-Decline of speechreading as sole element of AR with advent of technology -Technology (HA, CI, ALDs) is providing opportunities for individuals to make increasing use of audible speech and other audible sounds *encompassing all three *emphasizing communication devices *people are getting better auditory input *newest approach *audition with speech reading on top
Analytic Speechreading Training Objectives
-Develop vowel and consonant recognition skills -Tries to gradually increase the patient's reliance on the auditory signal for discriminating phonemic contrast while they speechread -consonant easier for manner
Talker
-Familiarity -Face to face or no > than 45 degrees° (straight on) -Too slow makes it harder (overenunicating) -Use of body gestures optimal -Gender *Female speechreading more recognizable (more gestures) *Female harder for HI to hear (presbycusis) *Male talkers may have facial hair (beards, etc.), less movement of upper lip
Vowel Speechreading Training Objectives
-If the person has rudimentary speech recognition skills, initial speechreading should start on /i, u, a/ because they differ in formant structure and most importantly how they look on the mouth.
Holistic/Eclectic Approach cont.
-Incorporates analytic, synthetic and pragmatic -Objectives: *Eval and mgmt of overall communication skills *Psychosocial aspects of hearing loss, *The education of significant others *Hearing aid orientation *Emphasis on improving interactive skills *Uses of HATs -sounds familiar to aural rehab in general
Speechreader
-Innate ability -Hearing acuity -Emotional and physical state (e..g, tired)
Age and Speechreading
-Older adults that acquired a HL in childhood did better than elderly with acquired HL in adulthood (Thorn and Thorn, 1989) -On the Lip-reading Discrimination Test (LDT) older adults were adversely affected by the competing story (Sapp, 1997)
Administration of Lipreading Tests
-Same for both live and video testing (pre and post test) -Distance (3 to 6 feet) -Lighting -Angle
Components most supported by evidence cont.
-Skills from the Pragmatic Approach *communication strategies, *changing the environment or lighting conditions *assertiveness training, *repair strategies, *and the use of communication based training in groups or one-on-one for practice. -The inclusion of spouses or key family members
Components most supported by evidence
-Some Analytic instruction to help speechreaders interpret ambiguous sounds -Some Synthetic training that focuses on the overall meaning of the message and make use of contextual cues as an additional skill to "fill in the blanks" when visemes are not visible,
Components most supported by evidence cont. 2
-Stress reduction techniques *speech reading is hard *circular breathing -A focus on bimodal communication that is flexible for the speechreaders level of hearing loss -Training using Amplification and HATs better -Allied professionals: ENT, SLP, audiologist, psychologist etc. *incorporate everyone to ensure best outcomes -MORE data!!!! Subjective and Objective
Message
-Structure *Length, complexity, content etc. -Frequency of usage -Lexical neighborhoods *sounds that start with same letter *how many words/ *smaller = easier *bigger = hearder -Context *i.e. "set the _________"vs "buy the ___________" *table vs. blueberries
Factors affecting Speechreading Process
-Talker -Message -Environment and communication situation -Speechreader *4 factors
Coarticulation and Stress Effects
-Third factor that causes difficulty with lip-reading -Co articulation makes the sound look different when put in linguistic context *E.g /b/ in "beet vs boot" -Stress can also affect the appearance of a word -Example: "Whadya do today?" *"What did you do today?" -look differently on lips -or if you are not used to dialect
Synthetic Approach
-Top down approach *Perception of the whole, or the overall meaning of the message is emphasized more so than concentrating on smaller parts. -Goal is for the speechreader to use context and any known information to allow for educated guessing, knowing the topic *whole rather than parts *jist
Analytic (drill)
-Traditional approach -Bottom up *Analyze the incoming visual signal into its basic component before assembling those components into words or sentences ( Kaplan, et all, 1985) -Defined as approach that focuses on smallest unit of speech to understand spoken communication *breaking down basic elements of a word
Purpose of Lipreading tests
-Useful measurement of basic lipreading ability -Used to measure effects of lipreading training -Determine placement of individuals in lipreading program -Diagnostic purposes to categorize acoustically handicapped; excellent, average, poor lipreaders -Determine whether analytic or synthetic methods are better. *we need data to show change
Environment and Communication Situation
-Viewing angle -Distance *3ft optimal *every 3 ft you go back, harder and harder -Room conditions (i.e. lighting, barriers etc.) *sun directed at person who is talking *see the person -Noise *auditory and visual connected
Visibility of Sounds: Vowels
-Vowels tend not be as visible despite some differences in lip spreading and rounding -Vowels are relatively salient even with higher degrees of HL
Communication as a whole
-Watch lips, tongue or jaw movements -Observe facial expression + -Use residual hearing with Amplification if possible -Follow rhythm and stress + -Use the mind to put 2 and 2 together -Assess situation & be aware of context -Use knowledge of the subject -Recognize the structure & use of language
Rapidity of Speech
-We speak about 180-220 syllables per minute -15 phonemes/sec -The eye can only register 9-10 mouth movement/sec -Therefore: *Little time to process the identity of the word *Might not see the important mouth movement *speech reading in addition to what we are hearing because of rapidity
What happens when you lipread?
-When you lip-read, your eyes scan the talker's face looking for both phonetic and prosodic cues as to what is being said -For prosodic cues look at the upper face -For phonetic look at lower face -Eyes look at the talker's eyes at the end of a sentence *speech = whole body *When done an utterances and their turn = we check eyes
Homophenes
-Words that look identical on the mouth -Often not related to phonetics -E.g. -Which are homophenes: grade and yes (yes) boon and doom (yes)
A good video to start with
-know the topic -light -spell names for you -pay attention and relax
Visibility of Sounds; consonant production as a function of tongue and lip activity
-where placement of sounds -f,v: 4000 and 6000 hz (weak = 35-45dB)
Four General Speechreading approaches
1. Analytic 2. Synthetic 3. Pragmatic 4. Holistic/Eclectic
Developing Speechreading Skills;Class Discussion Material
1. Lipreading 2. Facial expression 3. Gesture, posture and movement 4. Situational cues 5. Knowing the topic 6. Knowledge of language 7. Keeping informed 8. Emotional factors 9. Use your hearing
Analytic Speechreading Training
1. Recognition of visemes 2. Recognition of words 3. Recognition of phrases 4. Recognition of sentences 5.Recognition of continuous discourse -bottom up -smallest first
Basic Rules for Speechreading
1. Use good communication strategies 2. Watch total expression, don't concentrate solely on speaker's lips 3. Seat yourself so you can see the speaker's face 4. Determine as soon as possible the topic 5. Look for ideas rather than isolated words 6. Relax
Speech Reading Rules
1. Watch the talker's lips 2. Provide information to the talker about how to communicate w/ you 3. Try to ensure that the room is well lit and that your position in the room allows for optimal speechreading performance 4. Try to minimize BGN 5. Know the topic of conversation 6. Pay attention to context cues 7. Keep a positive attitude and laugh -tell someone you are learning -group speech reading classes are great
Analytic consonant speechreading training (Adults)
1. Will discriminate consonant pairs that differ in place of production and share either voice or manner, e.g. tag vs. bag. 2. Will discriminate consonant pairs that share similar place of production but differ in manner and voice, e.g.. Pan vs. man 3. Will discriminate consonant pairs that share place and manner or voice, e.g. park vs. bark 4. Will identify consonants that share manner of production, using a 4-item and then a 6-item response set; e.g. tag from the response et of : tag, bag, back, gas.
Vowel Speechreading Training Objectives cont'd
1. Will identify words with /u/, /i/, and /a/ from an open set of familiar vocabulary 2. Can then add vowels training into consonant training.
Basic Rules for Speechreading-cont'd more
12. Don't mouth words or sounds you see. 13. Monitor your own speech 14. Remember it take time to learn speechreading 15. Practice, Practice, Practice
Analytic consonant speechreading training (Adults cont)
5. Will identify consonants from a 4-item and then a 6 item response set of voiced or voiceless consonants; for example pop from the response set of : pop, cop, cap, top. 6. Will identify consonants that share place of production, using a 4-item and then a 6-item response set, e.g. pan form the response set of pan, man, bat and mat. 7. Will identify words form an open set of familiar vocabulary
Basic Rules for Speechreading-cont'd
7. Keep up on current events 8. Keep informed of friend's new developments and interests 9. Tell people that you are a speechreader (in training) and ask them to help 10. Repeat back what you did get from the conversation for confirmation 11. Don't worry about staring at people
Talker Effects
Accents and dialects can make the same word look different
Efficacy of Speechreading Training
Adults -with HI show only a 10-15% improvement in their ability to recognize speech stimuli (Alcantra et al.,1990; Gagné, Dinon, & Parsons, 1991;Wladron et al., 1981) -Subjectively feel they improve (sense of control in world they lost control in) -The visual advantage of speechreading has been estimated to be equivalent to increasing the auditory signal by around 15 dB (significant) Children -If auditory visual score is 15+% better than audio only than recommend using it -limited research yet -shouldn't rely on it if they don't get 15 plus or better -we always should have technology
Computerized Instruction Advantages
Advantages to Computerized Training -Many items can be presented in a short amt of time -Computer keeps track of performance -Can be practiced at home or at the clinic -Training is interactive -Instruction is self paced -Training can occur at the student's convenience
Computerized Instruction
Dynamic Audio Visions Interactive Device (DAVID) developed by NTID -Sentences around everyday topics -The patient types in what they read -Has 3 levels of difficulty -Measure progress by how long it takes in secs to get one sentence correct Conversation Made Easy- purchase thru CID -3 different versions: adults and teenagers, high and low language kids -Three kinds of exercises, analytic, synthetic
Analytical Consonant Training
Features - manner, place, voicing Place - visible AND audible Manner and voicing - NOT visible, but audible
Visemes
Groups of speech sounds that appear identical on the lips (e.g /p,b,m/)
Online programs
Lipreading.org http://www.lipreadingpractice.co.uk/Lip-Reading-Exercises/ http://www.read-my-lips.org.uk/ -ideas about what to do with client -activities
What happens when you speechread?
McGurk effect when we recognize speech, we integrate auditory and visual info (cortices) as we decode the signal and thus integration is obligatory -In other words, what we see affects what we hear and visa versa *study with ba and ga mouthed *speakers they were playing ba or ga *knew what to look at
Vowel Speechreading Training Objectives percentages
Obj #1: The student will discriminate words with /i/ and /u/. With 80% accuracy. Beet/boot she/shoe Heat/hoot geese/goose Obj #2: The student will discriminate words with /i/ and /a/ with 80% accuracy. Heat/hot cheap/chop Team/topjeep/job Obj #3: The student will discriminate words with /u/ and /a/ with 80% accuracy. two/top goose/got Juice/jobclue/clock
Synthetic Speechreading Objectives notes
Obj. 1 -follow simple directions on closed sets, start with small sets, as they improve increase the sets Ex: Color the circle blue, Color the sky blue Obj 2 & 3- identify a sentence illustration for ma set of pictures, several sentences can be developed for each picture Obj 4 recognize topic related sentences which have a common, the HI is expected to repeat or paraphrase them Ex: I added a cup of flour The bread is in the oven The last obj- speechread paragraphs, can provide a picture, they must speechread exactly or paraphrase one syntactic at a time spoken by the clinician
Visibility of Sounds-Homophenes
Rise/rice Perch/merge Marry/bury Mat/man Bind/Mind Mite/Bite Aunt/Hand Van/Fat Pass/ban Down/bout -Words that look identical on the mouth -40-60% of speech sounds are not visible on the mouth or can not be seen readily Table 9-3
Example of Synthetic Approach
Sentences concerning cooking: -I added a cup of flour. -The bread is in the oven. -Will you hand me the measuring cup. -I need the box of sugar. -The mixer is in the cabinet. -The oven is set to 300 degrees. -Put the bowl in the sink, please -The pan is filled with batter. -I will beat the eggs. -Please pour a cup of milk. -we know topic (helps) -work on sentences -get jist of sentences
Importance of Residual Hearing
Severe to profound hearing impairment -Hear only the low frequencies even w/ HAs (vowels) -Only get info on voice pitch changes -Even with this their ability to speechread is enhanced -still use audition!
Synthetic Speechreading Objectives
The student will: 1. Follow simple directions using a closed response set 2. Identify a sentence illustration from a set of four dissimilar pictures 3. Identify a sentence illustration from a set of 4 similar pictures. 4. Listen to a topic -related sentences and repeat or paraphrase them. 5. Will listen to 2 related sentences, and then draw a picture abut them or paraphrase them. 6. Will speech read a paragraph long narrative and then answer questions about it.
Vowel Speechreading Training Objectives cont.
The student: 1. Will discriminate words with i/ and /u/; e.g. me from moo 2. Will discriminate words with/i/ and /a/; e.g. keep from cop 3. Will discriminate words with /u/ and /a/; e.g. coop from cop 4. Will identify words with/i/,/u/, and/a/, using a 4 item and then a 6 item response set; e.g. bean from the response set of: bean, pot, pit and pool. The vowels in the response set may include vowels other than /I,u,a/.
Characteristics of a good lipreader (cont.)
Variables that appear to have predictive power. Variables that have been shown to predict performance: -Cognitive skills -Age -Visual acuity > 20/80 -Type of hearing loss (prelingual or adventitious) -Jeffers and Barley (1971) cite: *ability to capitalize on contextual cues *Willingness to guess *Mental agility *Willingness to revise and try previous interpretations *rapidly
The Difficulty of Lipreading
Visibility of sounds -Many sounds are not associated with visible mouth movements Rapidity of speech -Often, sounds occur in sequence faster than the eye can resolve them Co-articulation and stress effects -The appearance of words vary as a function of how they are spoken Visemes and homophemes -Many sounds and words appear alike on the face Talker effects -Talkers speak sounds and words with different mouth movements
Auditory plus vision
When both auditory and visual information is available, HoH individuals do better -hardest way first: auditory only
Computerized Training programs
https://seeingspeech.com/ -can do it on their own
Viseme quiz
https://www.proprofs.com/quiz-school/story.php?title=discrimination-test-consonant-visemes
