Link Between Acoustic Production Profiles and Linguistic Performance in Children With Cochlear Implants
DOI:
https://doi.org/10.61989/ct6s1342Keywords:
cochlear implant, deafness, phonetics, phonology, morphosyntax, factorial analysesAbstract
Background. Although early cochlear implantation allows young children with congenital deafness to reach linguistic levels close to those of typically hearing (TH) peers, certain domains remain at risk, particularly phonology and morphosyntax, with substantial variability in performance. One explanatory factor often mentioned is the degraded spectral quality of the auditory signal transmitted through the cochlear implant (CI), which may lead to imprecise phonological representations and, consequently, weaker linguistic skills. However, several studies have shown that some compensatory strategies can mitigate the impact of these perceptual limitations, such as the use of visually accessible cues.
Objectives. This study aimed to examine the relationship between the production profiles of speech sounds that are likely to be poorly encoded through the CI and the linguistic performance of children with CI and their TH peers, to determine whether compensatory strategies for perceptual limitations are associated with better linguistic outcomes.
Methods. Twenty-three children aged from 3 years and 8 months to 7 years and 10 months with congenital deafness using cochlear implants, and a control group of 47 typically hearing children matched for chronological and hearing age, completed picture-naming, narrative production, and morphological processing tasks. Acoustic measurements were extracted for three types of speech segments (nasal/oral vowels, fricatives, and plosives) to characterize production profiles and relate them to linguistic scores reflecting phonological, lexical, and morphosyntactic levels. A principal components analysis followed by hierarchical clustering made it possible to identify distinct performance profiles. Thirteen CI children were reassessed one year later to analyze longitudinal changes in performance.
Results. Three main dimensions were extracted from the PCA: the first, discriminating between groups, was related to linguistic performance, while the second and third accounted for acoustic production profiles. Hierarchical classification revealed four performance clusters: Cluster 1 (CI participants only) included children with the lowest linguistic performance and the least distinctive productions, while Cluster 4 (TH participants only) included those with the best linguistic and acoustic performance. Clusters 2 and 3, composed of participants from both groups, showed intermediate levels of linguistic performance and effective production strategies that compensated for the impact of perceptual difficulties (for example, by exploiting articulatory cues that are more visually accessible). The longitudinal analysis showed overall but heterogeneous improvement, with only four children moving to a cluster associated with higher linguistic performance.
Conclusion. Children in the CI group whose production profiles indicated effective compensation for perceptual limitations achieved better linguistic performance. However, their progress at the one-year follow-up remained variable, suggesting a possible cognitive cost associated with these compensations.
References
Bates, D., Mächler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1-48. https://doi.org/10.18637/jss.v067.i01
Başkent, D., & Shannon, R. V. (2005). Interactions between cochlear implant electrode insertion depth and frequency-place mapping. The Journal of the Acoustical Society of America, 117(3), 1405 1416. https://doi.org/10.1121/1.1856273
Benassi, E., Boria, S., Berghenti, M. T., Camia, M., Scorza, M., & Cossu, G. (2021). Morpho-syntactic deficit in children with cochlear implant: Consequence of hearing loss or concomitant impairment to the language system? International Journal of Environmental Research and Public Health, 18(18), 9475. https://doi.org/10.3390/ijerph18189475
Borel, S. (2015). Perception auditive, visuelle et audiovisuelle des voyelles nasales par les adultes devenus sourds. Lecture labiale, implant cochléaire, implant du tronc cérébral. [Thèse de doctorat, Université Sorbonne Paris Cité]. HAL. https://theses.hal.science/tel-01162201v1
Bourdin, B., Ibernon, L., Le Driant, B., Levrez, C., & Vandromme, L. (2016). Troubles morphosyntaxiques chez l’enfant sourd et chez l’enfant dysphasique : similarités et spécificités. Revue de Neuropsychologie, 8(3), 161 172. https://doi.org/10.1684/nrp.2016.0386
Bouton, S., Serniclaes, W., Bertoncini, J., & Colé, P. (2012). Perception of speech features by French-speaking children with cochlear implants. Journal of Speech, Language, and Hearing Research, 55(1), 139 153. https://doi.org/10.1044/1092-4388(2011/10-0330)
Cambra, C., Losilla, J. M., Mena, N., & Pérez, E. (2021). Differences in picture naming between children with cochlear implants and children with typical hearing. Heliyon, 7(12), e08507. https://doi.org/10.1016/j.heliyon.2021.e08507
Carignan, C., Chen, J., Harvey, M., Stockigt, C., Simpson, J., & Strangways, S. (2023). An investigation of the dynamics of vowel nasalization in Arabana using machine learning of acoustic features. Laboratory Phonology, 14(1). https://doi.org/10.16995/labphon.9152
Caselli, M. C., Rinaldi, P., Varuzza, C., Giuliani, A., & Burdo, S. (2012). Cochlear implant in the second year of life: Lexical and grammatical outcomes. Journal of Speech, Language, and Hearing Research, 55(2), 382 394. https://doi.org/10.1044/1092-4388(2011/10-0248)
Chalard, M., Bonin, P., Méot, A., Boyer, B., & Fayol, M. (2003). Objective age-of-acquisition (AoA) norms for a set of 230 object names in French: Relationships with psycholinguistic variables, the English data from Morrison et al. (1997), and naming latencies. European Journal of Cognitive Psychology, 15(2), 209 245. https://doi.org/10.1080/09541440244000076
Charlier, B. (2020). Communication, ressenti psychologique et qualité de vie. In J. Leybaert & S. Borel (dir.), Surdités de l’enfant et de l’adulte. Bilans et interventions orthophoniques (p.223-231). De Boeck Supérieur.
Cheng, K., & Chen, X. (2020). The effects of intrinsic acoustic cues on categorical perception in children with cochlear implants. International Journal of English Linguistics, 10(5), 110-124. https://doi.org/10.5539/ijel.v10n5p110
Chiat, S. (2001). Mapping theories of developmental language impairment: Premises, predictions and evidence. Language and Cognitive Processes, 16(2 3), 113 142. https://doi.org/10.1080/01690960042000012
Chilosi, A. M., Comparini, A., Scusa, M. F., Orazini, L., Forli, F., Cipriani, P., & Berrettini, S. (2013). A longitudinal study of lexical and grammar development in deaf Italian children provided with early cochlear implantation. Ear & Hearing, 34(3), e28 e37. https://doi.org/10.1097/AUD.0b013e31827ad687
Cornillon, P.-A., Guyader, A., Husson, F., Jégou, N., Josse, J., Klutchnikoff, N., Le Pennec, E., Matzner-Løber, E., Rouvière, L., & Thieurmel, B. (2018). Classification non supervisée. In F. Husson (dir.), R pour la statistique et la science des données (p.243-262) Saic Edition. https://hal.science/hal-02321839v1
David, C., Tuller, L., Schweitzer, E., Lescanne, E., Bonnet-Brilhault, F., Gomot, M., & Ferré, S. (2021). Does phonological complexity provide a good index of language disorder in children with cochlear implants? Journal of Speech, Language, and Hearing Research, 64(11), 4271 4286. https://doi.org/10.1044/2021_JSLHR-20-00642
Deriaz, M., Pelizzone, M., & Fornos, A. P. (2014). Simultaneous development of 2 oral languages by child cochlear implant recipients. Otology & Neurotology, 35(9), 1541 1544. https://doi.org/10.1097/MAO.0000000000000497
Duchesne, L., Sutton, A., & Bergeron, F. (2009). Language achievement in children who received cochlear implants between 1 and 2 years of age: Group trends and individual patterns. Journal of Deaf Studies and Deaf Education, 14(4), 465 485. https://doi.org/10.1093/deafed/enp010
Duchesne, L., Sutton, A., Bergeron, F., & Trudeau, N. (2010.). Le développement lexical précoce des enfants porteurs d’un implant cochléaire. Canadian Journal of Speech-Language Pathology & Audiology, 34(2), 132-145. https://cjslpa.ca/files/2010_CJSLPA_Vol_34/No_02_81-152/Duchesne_sutton_bergeron_trudeau_CJSLPA_2010.pdf
Durán, P., Malvern, D., Richards, B., & Chipere, N. (2004). Developmental trends in lexical diversity. Applied Linguistics, 25(2), 220 242. https://doi.org/10.1093/applin/25.2.220
Fagniart, S., Delvaux, V., Harmegnies, B., Huberlant, A., Huet, K., Piccaluga, M., Watterman I., & Charlier, B. (2024a). Nasal/oral vowel perception in French-speaking children with cochlear implants and children with typical hearing. Journal of Speech, Language, and Hearing Research, 67(4), 1243-1267. https://doi.org/10.1044/2024_JSLHR-23-00274
Fagniart, S., Charlier, B., Delvaux, V., Huberlant, A., Harmegnies, B. G., Piccaluga, M., & Huet, K. (2024b). Consonant and vowel production in children with cochlear implants: Acoustic measures and multiple factor analysis. Frontiers in Audiology and Otology, 2, 1425959. https://doi.org/10.3389/fauot.2024.1425959
Fagniart, S., Charlier, B., Delvaux, V., Harmegnies, B., Huberlant, A., Piccaluga, M., & Huet, K. (2024c). Production of fricative consonants in French-speaking children with cochlear implants and typical hearing: Acoustic and phonological analyses. Proceedings Interspeech 2024 (p.877-881). https://doi.org/10.21437/interspeech.2024-871
Fagniart, S., Delvaux, V., Harmegnies, B., Huberlant, A., Huet, K., Piccaluga, M., Watterman I., & Charlier, B. (2025a). Producing nasal vowels without nasalization? Perceptual judgments and acoustic measurements of nasal/oral vowels produced by children with cochlear implants and typically hearing peers. Journal of Speech, Language, and Hearing Research, 68(1), 301-322. https://doi.org/10.1044/2024_JSLHR-24-00083
Fagniart, S., Charlier, B., Delvaux, V., Harmegnies, B., Huberlant, A., Piccaluga, M., & Huet, K. (2025b). Morphosyntactic production and processing skills in relation to age effects and lexical-phonological levels among children with cochlear implants and typically hearing peers: A focus on vowel nasality. Frontiers in Human Neuroscience, 19, 1528388. https://doi.org/10.3389/fnhum.2025.1528388
Gaul Bouchard, M.-E., Le Normand, M.-T., & Cohen, H. (2007). Production of consonants by prelinguistically deaf children with cochlear implants. Clinical Linguistics & Phonetics, 21(11 12), 875 884. https://doi.org/10.1080/02699200701653634
Giezen, M. R., Escudero, P., & Baker, A. (2010). Use of acoustic cues by children with cochlear implants. Journal of Speech, Language, and Hearing Research, 53(6), 1440 1457. https://doi.org/10.1044/1092-4388(2010/09-0252)
Grandon, B. (2016). Développement typique et atypique de la production de parole : caractéristiques segmentales et intelligibilité de la parole d’enfants porteurs d’un implant cochléaire et d’enfants normo-entendants de 5 à 11 ans. [Thèse de doctorat, Université Grenoble Alpes]. HAL. https://theses.hal.science/tel-01690615v1
Grandon, B., Vilain, A., Lœvenbruck, H., Schmerber, S., & Truy, E. (2017). Realisation of voicing by French-speaking CI children after long-term implant use: An acoustic study. Clinical Linguistics & Phonetics, 31(7 9), 598 611. https://doi.org/10.1080/02699206.2017.1302511
Grandon, B., & Vilain, A. (2020). Development of fricative production in French-speaking school-aged children using cochlear implants and children with normal hearing. Journal of Communication Disorders, 86, 1 12. https://doi.org/10.1016/j.jcomdis.2020.105996
Guo, L.-Y., & Spencer, L. J. (2017). Development of grammatical accuracy in English-Speaking children with cochlear implants: A longitudinal study. Journal of Speech, Language and Hearing Research, 60(4), 1062-1075. https://doi.org/10.1044/2016_JSLHR-H-16-0182
Hage, C. (2005). De la communication au langage : développement du langage oral chez l’enfant atteint de déficience auditive profonde. In C. Transler, J. Leybaert, & J. E. Gombert (dir.), L’acquisition du langage par l’enfant sourd. Les signes, l’oral et l’écrit (p.121–146). Solal.
Hedlung, G., & Rose, Y. (2020). Phon (version 3.1) [Logiciel]. https://phon.ca
Hedrick, M., Bahng, J., von Hapsburg, D., & Younger, M. S. (2011). Weighting of cues for fricative place of articulation perception by children wearing cochlear implants. International Journal of Audiology, 50(8), 540 547. https://doi.org/10.3109/14992027.2010.549515
Horga, D., & Liker, M. (2006). Voice and pronunciation of cochlear implant speakers. Clinical Linguistics & Phonetics, 20(2 3), 211 217. https://doi.org/10.1080/02699200400027015
Husson, F., Josse, J., Lê, S., & Mazet, J. (2024). FactoMineR: Multivariate exploratory data analysis and data mining (version 2.11) [Logiciel]. https://cran.r-project.org/web/packages/FactoMineR/index.html
Joanisse, M. F., & Seidenberg, M. S. (1998). Specific language impairment: A deficit in grammar or processing? Trends in Cognitive Sciences, 2(7), 240 247. https://doi.org/10.1016/S1364-6613(98)01186-3
Karltorp, E., Eklöf, M., Östlund, E., Asp, F., Tideholm, B., & Löfkvist, U. (2020). Cochlear implants before 9 months of age led to more natural spoken language development without increased surgical risks. Acta Pædiatrica, 109(2), 332 341. https://doi.org/10.1111/apa.14954
Kassambara, A., & Mundt, F. (2020). factoextra: Extract and visualize the results of multivariate data analyses (version 1.0.7) [Logiciel]. https://cran.r-project.org/web/packages/factoextra/index.html
Kral, A., Dorman, M. F., & Wilson, B. S. (2019). Neuronal development of hearing and language: Cochlear implants and critical periods. Annual Review of Neuroscience, 42(1), 47 65. https://doi.org/10.1146/annurev-neuro-080317-061513
Landsberger, D. M., Stupak, N., Green, J., Tona, K., Padilla, M., Martinez, A. S., Eisenberg, L. S., & Waltzman, S. (2019). Temporal modulation detection in children and adults with cochlear implants: Initial results. Otology & Neurotology, 40(3), e311 e315. https://doi.org/10.1097/MAO.0000000000002122
Lane, H., Matthies, M., Perkell, J., Vick, J., & Zandipour, M. (2001). The effects of changes in hearing status in cochlear implant users on the acoustic vowel space and CV coarticulation. Journal of Speech, Language, and Hearing Research, 44(3), 552 563. https://doi.org/10.1044/1092-4388(2001/043)
Le Normand, M.-T., & Moreno-Torres, I. (2014). The role of linguistic and environmental factors on grammatical development in French children with cochlear implants. Lingua, 139, 26 38. https://doi.org/10.1016/j.lingua.2013.02.012
Le Normand, M.-T., & Thai-Van, H. (2023). Early grammar-building in French-speaking deaf children with cochlear implants: A follow-up corpus study. International Journal of Language & Communication Disorders, 58(4), 1204 1022. https://doi.org/10.1111/1460-6984.12854
Lenth, R. V., Piastowski, J., Banfai, B., Bolker, B., Buerkner, P., Giné-Vázquez, I., Herve, M., Jung, M., Love, J., Miguez, F., Riebl, H., & Singmann, H. (2023). emmeans: Estimated marginal means, aka least-squares means (version 1.8.8) [Logiciel]. https://cran.r-project.org/web/packages/emmeans/index.html
Leonard, L. B., McGregor, K. K., & Allen, G. D. (1992). Grammatical morphology and speech perception in children with specific language impairment. Journal of Speech, Language, and Hearing Research, 35(5), 1076 1085. https://doi.org/10.1044/jshr.3505.1076
Leybaert, J., Bayard, C., Colin, C., & LaSasso, C. J. (2016). Cued speech and cochlear implants: A powerful combination for natural spoken language acquisition and the development of reading. In M. Marschark & P. E. Spencer (dir.), The Oxford handbook of deaf studies in language (p.359-376). Oxford University Press.
Loizou, P. C. (2006). Speech processing in vocoder-centric cochlear implants. Advances in Oto-Rhino-Laryngology, 64, 109 143. https://doi.org/10.1159/000094648
Machart, L., Vilain, A., Lœvenbruck, H., Tiede, M., & Ménart, L. (2024). Exposure to Canadian French cued speech improves consonant articulation in children with cochlear implants: Acoustic and articulatory data. Journal of Speech, Language, and Hearing Research, 67(10S), 4069-4095. https://doi.org/10.1044/2023_JSLHR-23-00078
Macmillan, N. A., & Creelman, C. D. (1991). Detection theory. A user’s guide. Cambridge University Press.
MacWhinney, B. (2000, 3rd ed.). The CHILDES Project: Tools for analyzing talk. Lawrence Erlbaum Associates.
Majorano, M., Persici, V., Santangelo, M., Ferrari, R., Bertelli, B., Florit, E., Lavelli, M., Bastianello, T., Guerzoni, L., & Cuda, D. (2024). Narrative skills and language comprehension in preschool children with cochlear implants: A comparison with children with developmental language disorder or typical development. Journal of Communication Disorders, 109, 106424. https://doi.org/10.1016/j.jcomdis.2024.106424
Mayer, M. (1969). Frog, where are you? Dial Press.
Medina, V., Loundon, N., Busquet, D., Petroff, N., & Serniclaes, W. (2004). Perception catégorielle des sons de parole chez des enfants avec implants cochléaires. 25es Journées d’Etude sur la Parole (JEP-TALN-RECITAL 2004). Fès, Maroc. https://www.afcp-parole.org/doc/Archives_JEP/2004_XXVe_JEP_Fes/actes/jep2004/Medina.pdf
Mildner, V., & Liker, M. (2008). Fricatives, affricates, and vowels in Croatian children with cochlear implants. Clinical Linguistics & Phonetics, 22(10-11), 845 856. https://doi.org/10.1080/02699200802130557
Mildner, V., Šindija, B., & Vrban Zrinski, K. (2006). Speech perception of children with cochlear implants and children with traditional hearing aids. Clinical Linguistics & Phonetics, 20(2-3), 219 229. https://doi.org/10.1080/02699200400027031
Moreno-Torres, I., Madrid-Cánovas, S., & Blanco-Montañez, G. (2016). Sensitive periods and language in cochlear implant users. Journal of Child Language, 43(3), 479 504. https://doi.org/10.1017/S0305000915000823
Parisse, C., & Le Normand, M.-T. (2000). Automatic disambiguation of morphosyntax in spoken language corpora. Behavior Research Methods, Instruments, & Computers, 32(3), 468 481. https://doi.org/10.3758/BF03200818
Parisse, C., & Maillart, C. (2008). Interplay between phonology and syntax in French-speaking children with specific language impairment. International Journal of Language & Communication Disorders, 43(4), 448 472. https://doi.org/10.1080/13682820701608209
Peng, Z. E., Hess, C., Saffran, J. R., Edwards, J. R., & Litovsky, R. Y. (2019). Assessing fine-grained speech discrimination in young children with bilateral cochlear implants. Otology and Neurotology, 40(3), e191 e197. https://doi.org/10.1097/MAO.0000000000002115
Philippart De Foy, M., Delvaux, V., Huet, K., Monnier, M., Piccaluga, M., & Harmegnies, B. (2018, juin 7). Un protocole de recueil de productions orales chez l’enfant préscolaire : Une étude préliminaire auprès d’enfants bilingues. Actes des 32es Journées d’étude de la Parole (p.639-647). Aix-en-Provence, France. https://jep2018.sciencesconf.org/resource/page/id/19.html
R Core Team. (2022). R: A language and environment for statistical computing. [Logiciel]. https://www.R-project.org/
Reidy, P. F., Kristensen, K., Winn, M. B., Litovsky, R. Y., & Edwards, J. R. (2017). The acoustics of word-initial fricatives and their effect on word-level intelligibility in children with bilateral cochlear implants. Ear and Hearing, 38(1), 42 56. https://doi.org/10.1097/AUD.0000000000000349
Rinaldi, P., Baruffaldi, F., Burdo, S., & Caselli, M. C. (2013). Linguistic and pragmatic skills in toddlers with cochlear implant. International Journal of Language & Communication Disorders, 48(6), 715 725. https://doi.org/10.1111/1460-6984.12046
Shadle, C. H., Chen, W. R., Koenig, L. L., Preston, J. L. (2023). Refining and extending measures for fricative spectra, with special attention to the high-frequency range. The Journal of the Acoustical Society of America, 154, 1932-1944. https://doi.org/10.1121/10.0021075
Sharma, S. D., Cushing, S. L., Papsin, B. C., & Gordon, K. A. (2020). Hearing and speech benefits of cochlear implantation in children: A review of the literature. International Journal of Pediatric Otorhinolaryngology, 133, 109984. https://doi.org/10.1016/j.ijporl.2020.109984
Todd, A. E., Edwards, J. R., & Litovsky, R. Y. (2011). Production of contrast between sibilant fricatives by children with cochlear implants. The Journal of the Acoustical Society of America, 130(6), 3969 3979. https://doi.org/10.1121/1.3652852
Uchanski, R. M., & Geers, A. E. (2003). Acoustic characteristics of the speech of young cochlear implant users: A comparison with normal-hearing age-mates. Ear and Hearing, 24(1), 90S 105S. https://doi.org/10.1097/01.AUD.0000051744.24290.C1
Van Bogaert, L., Machart, L., Gerber, S., Lœvenbruck, H., Vilain, A., & Consortium EULALIES. (2023). Speech rehabilitation in children with cochlear implants using a multisensory (French Cued Speech) or a hearing-focused (Auditory Verbal Therapy) approach. Frontiers in Human Neuroscience, 17, 1152516. https://doi.org/10.3389/fnhum.2023.1152516
Van der Straten Waillet, P., Crowe, K., Charlier, B., & Colin, C. (2025). Speech production skills of bilingual children using cochlear implants. Journal of Deaf Studies and Deaf Education, 30(2), 182-194. https://doi.org/10.1093/jdsade/enae038Fagniart
Vukkadala, N., Perez, D., Cabala, S., Kapur, C., & Chan, D. K. (2018). Linguistic and behavioral performance of bilingual children with hearing loss. International Journal of Pediatric Otorhinolaryngology, 112, 34 38. https://doi.org/10.1016/j.ijporl.2018.06.020
Warner-Czyz, A. D., & Davis, B. L. (2008). The emergence of segmental accuracy in young cochlear implant recipients. Cochlear Implants International, 9(3), 143 166. https://doi.org/10.1179/cim.2008.9.3.143
Yang, J., & Xu, L. (2023). Acoustic characteristics of sibilant fricatives and affricates in Mandarin-speaking children with cochlear implants. The Journal of the Acoustical Society of America, 153(6), 3501-3512. https://doi.org/10.1121/10.0019803
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