Looking at the "Stars": A First Report on the Intercorrelations Among Measures of Speech Perception, Intelligibility and Language Development in Pediatric Cochlear Implant Users

Author: David B. Pisoni, Mario Svirsky, Karen I. Kirk, and Richard T. Miyamoto

Abstract:
It is now well-established in the field of pediatric cochlear implantation that some prelingually deaf children perform significantly better on standardized tests of speech perception and spoken word recognition than other prelingually deaf children. The differences are seen most clearly on very difficult open-set tests of spoken word recognition such as the PBK test. The children who do well on this particular test are frequently referred to as the "Stars," and their extraordinarily good performance is typically reported at scientific meetings and highlighted in journal publications. Unfortunately, very little is actually known about the basis for the superior performance of these children or the audiological and psychological factors that predict which children will become "Stars" and which ones will perform closer to the mean. In this paper, we report the initial results of a correlational analysis of a small group of exceptionally good cochlear implant users, the so-called "Stars." Our goal was to identify the primary factors that underlie their exceptionally good performance on open-set tests of speech perception and spoken word recognition. Speech perception, intelligibility and language scores were examined for a group of children who scored in the top 20% on the PBK test two years post-implant and a "control" group of children who scored in the bottom 20% on the PBK test. Separate correlational analyses were then carried out on the test scores for these subjects 1 year post-implant in order to examine the relations among these dependent measures. The results of our analyses revealed that the "Stars" not only display superior performance on the criterial PBK test but also show very high levels of performance on several other speech perception and language tests. Most notable were the unusually high correlations among several different measures of spoken word recognition and scores on the Reynell receptive and expressive language scales. This suggests that one common underlying factor in these children may be the acquisition of language, specifically, the development of the lexicon, which serves as the "interface" between the initial sensory input and the phonological representation of the sound patterns of words in lexical memory. In addition, word recognition performance was also highly correlated with speech intelligibility scores and open-set measures of language comprehension that required children to interpret spoken language in meaningful ways. Taken together, our analyses of these exceptionally good cochlear implant users suggest that the "Stars" are the children who have been able to begin the normal process of language acquisition. The pattern of intercorrelations among several measures of speech perception, intelligibility, and language development suggests that these children are receiving sufficient sound input through their cochlear implants to map sound patterns onto meanings and build a lexicon of words, two necessary prerequisites for constructing a grammar of the target language from the ambient language spoken in their environment.