Lien entre les profils de production acoustique et les performances linguistiques d’enfants porteurs d’implants cochléaires
DOI :
https://doi.org/10.61989/ct6s1342Mots-clés :
implant cochléaire, surdité, phonétique, phonologie, morphosyntaxe, analyses factoriellesRésumé
Contexte : Bien que l’implantation cochléaire précoce permette à de jeunes enfants présentant une surdité congénitale d’atteindre des niveaux linguistiques proches de ceux d’enfants entendants, certains domaines restent à risque, notamment les niveaux phonologique et morphosyntaxique, avec une variabilité importante des performances. L’un des facteurs explicatifs évoqués est la dégradation spectrale du signal transmis par l’implant, susceptible d’entraîner des représentations phonologiques imprécises et, par conséquent, des faiblesses linguistiques. Toutefois, plusieurs travaux ont montré que certaines stratégies de compensation (par exemple, exploitation d’indices visuellement accessibles) peuvent limiter l’impact de ces limitations perceptives.
Objectifs : La présente étude visait à examiner les liens entre les profils de production de sons de parole susceptibles d’être mal codés par l’implant cochléaire (IC) et les performances linguistiques d’enfants porteurs d’un IC et d’enfants à audition typique (AT), afin de déterminer si des stratégies de compensation des limites perceptives sont associées à de meilleures performances linguistiques.
Méthodes : Vingt-trois enfants âgés de 3 ans et 8 mois à 7 ans et 10 mois présentant une surdité congénitale et porteurs d’un IC, ainsi qu’un groupe de 47 enfants à audition typique appariés en âge chronologique et auditif, ont participé à des tâches de dénomination, de production narrative et de traitement morphémique. Des mesures acoustiques ont été extraites pour trois types de segments (voyelles nasales/orales, fricatives et occlusives) afin de caractériser les profils productifs et de les relier aux indices linguistiques reflétant les niveaux phonologique, lexical et morphosyntaxique. Des analyses en composantes principales (ACP) suivies de classifications hiérarchiques ascendantes ont permis d’identifier des profils de performance. Treize enfants porteurs d’un IC ont été réévalués un an plus tard pour analyser l’évolution longitudinale de leurs performances.
Résultats : Trois dimensions principales ont été extraites de l’ACP : la première, discriminant les deux groupes, était liée aux performances linguistiques, tandis que les deux suivantes rendaient compte des profils acoustiques de production. La classification a mis en évidence quatre classes de performance : la classe 1 (IC uniquement) regroupait les enfants aux performances linguistiques les plus faibles et aux productions les moins distinctives ; la classe 4 (AT uniquement) correspondait aux meilleures performances et à des productions acoustiquement typiques. Les classes 2 et 3, mixtes, présentaient des niveaux intermédiaires et des stratégies de production efficaces compensant l’impact des difficultés perceptives (exploitation des indices articulatoires visuellement plus accessibles par exemple). L’analyse longitudinale a montré une amélioration générale mais hétérogène, seuls quatre enfants progressant vers une classe associée à un niveau linguistique supérieur.
Conclusion : Les enfants du groupe IC dont les profils de production témoignaient de compensations efficaces face aux limites perceptives ont obtenu de meilleures performances linguistiques. Toutefois, leur progression lors du suivi à un an reste variable, ce qui suggère un possible coût cognitif associé à ces compensations.
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