Speechreading TrainingChapter 6

Perry C. Hanavan, Au.D.

Lip Movements

“…it is important to realize that we move our articulators to produce acoustically distinct sounds and NOT visually contrastive movements.”– Mark Ross

Speechreading Factoid

Campbell et al, (1981) surveyed the literature and found 38-58% of individuals with HL have accompanying visual deficiencies

Johnson et al (1981) found 65% entering NTID demonstrated defective vision

Vision loss may be greater among individuals with HL

Individuals with HL need vision evaluation***

Auditory plus Vision

When BOTH auditory and visual information is available, individuals with hearing loss tend to do better on communication tasks

Example (Auditory plus Vision):– Speech Recognition Score = 50%– Speechreading Score = 20%– Combined Visual/Auditory Score = 90%

9:00 am Appointment

The waiting room is filled with several individuals to evaluate. Which patient will benefit from speechreading training?– Recent cochlear implant patient– Recent new user of digital hearing aid who has

had hearing loss for fifty years– Three year-old child with profound loss– Patient with recent sudden onset hearing loss

Traditional Lipreading Methods

Four lipreading methods were introduced into the U.S.:

Mueller-Walle introduced by Bruhn Nitchie introduced by Nitchie Kinzie introduced by Kinzie Jena introduced by Bunger

Speechreading Factoid

Three of the lipreading methods introduced into the U.S. were implemented by individuals with normal hearing until adulthood, at which time they acquired a significant hearing loss, and sought assistance.

They developed methods that bear their names: Bruhn, Kinzie, and Nitchie.

Bunger later wrote about the Jena method.

Analytic & Synthetic

Analytic approach– perceive each of the basic parts before the

whole can be identified• Syllable considered to be the basic unit• Bruhn & Jena methods

Synthetic approach– Perception of the whole is paramount to

perception of the basic parts• Sentence considered to be the basic unit• Nitchie and Kinzie methods

Mueller-Walle Method Originated in Germany Martha Emma Bruhn studied lipreading with

Julius Mueller-Walle in Hamburg, Germany and introduced method in the US

Hallmark: rapid syllable drill– emphasis on quickly identifying position and

movement of speech sounds produced– syllable rhythmic drills: she-ma-flea and she-may-free– Practiced recognizing homophenous words using

sentence cues to distinguish meaning

Nitchie Method Edward Nitchie became deaf during adolescence Eventually established his own school for the deaf

in NY Initially developed an analytic approach, altering

the approach to a synthetic approach (credited with developing synthetic approach to speechreading)

Speechreader studies articulatory movements by viewing meaningful monosyllabic words to develop eye training

Advocated use of sentences and stories to train mind to comprehend the general meaning connected discourse

Kinzie Method Cora acquired HL while medical student in PA Studied with Bruhn and then Nitchie

combining best methods from both approaches Unique feature: graded lessons for children

and adults with sentences as basis of instruction

They recommended all sentences be “definite, natural, interesting, pleasing, rhythmical, and dignified”

Jena Method Developed by Karl Brauckman in Jena,

Germany and promoted by Anna Bunger from Michigan

Emphasizes syllable drills, rhythm practice, and kinesthetic awareness

Material presented in rhythmic manner reinforcing fact that speech is rhythmic

Focused on mimetic (imitating movements) and kinesthetic (perception of movement, position, etc.) forms and sensations

Recent Speechreading Trends 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

Newer lipreading approaches tend to be eclectic– Modification or combinations of earlier

synthetic and analytic approaches

Holistic Approach Increase the child’s knowledge of the speechreading

process Increase the child’s ability to generate strategies to

facilitate more successful communication Increase the child’s confidence in the efficacy of high

probability success Increase the child’s tolerance for communicative

situations that have a higher degree of frustration Increase the child’s ability to generate personal goals

for improving speechreading Increase the child’s motivation to improve

speechreading abilities

Efficacy of Speechreading Training

Studies are mixed regarding demonstrating improvement following treatment for adults

Little research regarding children– Children may have greater potential for benefit

from speechreading training than adults

Developing Speechreading Skills

First step is usually instructional and includes consideration for the process

Second step may require speechreaders to reflect on their on habits and skills

Third step may require speechreaders to identify difficult listening situations and formulate solutions

Fourth step is introduction of formal speechreading lessons

Analytic Speechreading Training Focus on vowel and consonant recognition Underlying logic this curricula is to gradually

increase reliance on auditory signal for discriminating phonemic contrasts while they are speechreading

Reliance on Audition

Rel

ianc

e on

Vis

ion

Analytic Vowel Training

Initial training highly contrastive features• i u a

– Differ in BOTH formant structure and on the mouth

– Back vs front vowels• I i e ae front vowels

• u U o back vowels

Acoustic vs Tongue Position

Analytic Training Objectives

Examples:

Will discriminate words with i and u Will discriminate words with i and a Will discriminate words with u and a Will identify words with i u and a

Discriminate Vowels with i and u

beet/boot see/soup she/shoe

beet/boot leap/loop peel/pool

heat/hoot jeep/jewel sheet/shoot

keep/coop knee/new geese/goose

leap/loop need/nude read/rude

Identify Vowels with u

beet/boot/bat soup/seat/sap lass/lease/loose

hat/heat/hoot team/tam/tomb gas/geese/goose

pool/pal/peel jeep/jab/jude teen/tool/tan

Analytical Consonant Training

Features – manner, place, voicing– Place – visible AND audible– Manner and voicing – NOT visible, but audible

Consonant Place of Productionbi

l abi

alla

biod

enta

ld e

n ta l

alve

olar pa

lata

l

vela

r

glot

tal

p b

mf

v th

t d n

s z

l

Sh

zh c

h jd

k g

ng

h

Analytic Consonant Objectives will discriminate consonant pairs that differ in

place of production and share either voice or manner

will discriminate consonant pairs that share similar place of production but differ in manner and voice

will discriminate consonant pairs that share place and manner and/or voice

will identify consonants that share manner of production, using a four-item response set

will identify consonants from a six-item response set of voiced or voiceless consonants

Discriminate Consonant Pairs that Differ in Place and Share Either Voice or Manner

meet/geese pill/chill top/chop

moose/goose pot/hot boat/coat

bit/knit dog/jog peal/heal

make/lake tear/chair pin/chin

Synthetic Speechreading Training Objectives

1. will follow simple directions using a closed set response

2. will identify a sentence illustration from a set of four dissimilar pictures

3. will identify a sentence illustration from a set of four similar pictures

4. will listen plus lipread to two related sentences, and then draw a picture about them or paraphrase them

5. will speechread a paragraph-long narrative and then answer questions about it

Example of Synthetic ApproachSentences concerning cooking:1. I added a cup of flour.2. The bread is in the oven.3. Will you hand me the measuring cup.4. I need the box of sugar.5. The mixer is in the cabinet.6. The oven is set to 300 degrees.7. Put the bowl in the sink, please8. The pan is filled with batter.9. I will beat the eggs.10. Please pour a cup of milk.

Resources

Online resources– Gallaudet