Sound Out: The connections between speech intelligibility and auditory input

Upon seeing Ella’s humorous vlog about her experience learning how to say “Merry Christmas,” I thought about how deaf adults might similar experiences with negative feelings in response to interacting verbally with hearing people. Historically the average deaf child received speech therapy since their auditory input was negligible. Today with the advancements of technology deaf children have been able to receive quality auditory stimulation through digital hearing aids and cochlear implants. As a result those children have the ability to perceive their own speech better than those who have no hearing.

Variety of Experiences with Speech Therapy

Many pre-lingually deaf adults will remember their experiences with speech-language therapists, feeling frustrated with the many hours they’ve had to endure sitting in a room having to “fix” their voice. I had the fortune of my mother requiring my first two speech therapists to be fluent in Cued Speech, which made the process easier and allowed for me to make personal connections that may not be typical of the average professional-client interaction. Others probably weren’t so lucky with their therapists having the inability to communicate visually.

I did have a lot of frustration with my last three speech therapists, which were provided by the school system. With those three professionals I don’t ever recall any constructive feedback and I would typically read from newspaper articles during each session. They were nice and meant well, but I felt as they didn’t really feel the need to push me to do better. As a result I told my mother I wouldn’t go to therapy anymore. After all I had to get to school forty-five minutes early for each session, indeed frustrating when I just wanted those extra few minutes of precious sleep.

Deaf and hard of hearing adults weren’t the only ones who had to go to speech therapy. While in Third grade I would go to speech therapy with other hearing peers who typically had trouble with speech pronunciations or reading, indicative of language issues. One boy in particular had a combination of both, so I had the perspective of observing the therapist not only with deaf or hard of hearing peers, but also hearing peers. The therapist typically used the same approach with both groups, but did go to further length when it came to certain issues I had with projection and pronouncing certain phonemes.

Self-Perception of Speech

What’s interesting is the issue of whether deaf adults have “good speech” or not. I’ve noticed that some oral adults have made statements such as “people tell me I have good speech” or “people ask me where I’m from instead of thinking I’m deaf.” To be honest, some of those people surprised me with those comments since in my mind their speech didn’t quite seem to be on par with hearing adults. There are deaf adults who do have clear speech with a slight accent, which doesn’t affect their oral communication in a significant way. Either way it boils down to how well those deaf adults communicate orally with hearing peers, setting the stage for the self-perception of their own speech.

On the other end of the spectrum, there are deaf adults who are not able to voice or lip-read with success so they rely on other forms of communication such as written form and sign languages. Some may take their inability to speak well in stride with their acceptance of their identity as a deaf individual. Others might feel frustration and wish they had better speech. They may find themselves in a position where they won’t be able to find jobs that require verbal communication. Either way, they are aware of their inability to voice out their thoughts and ideas clearly.

Perhaps the standards have historically been set lower for deaf individuals when it comes to speech, hence situations where some deaf adults were told their speech is good when they actually had difficulty being understood by others. Along with many others I have experienced this type of situation, feeling the frustration of having to make extra effort to repeat myself and be clearer in what I’m trying to say. In the end speech therapists shouldn’t go so far to make deaf clients feel that their speech sounds good when they eventually will find out that other people won’t necessarily understand them.

Speech’s Role in Mainstreaming Deaf and Hard of Hearing Children

Organizations such as AG Bell and the Central Institute of the Deaf have mission statements that include listening, talking, and thriving in mainstream society. From these statements one can assume that speech intelligibility has a direct role in a deaf child’s socialization within mainstream society. Through personal experience I know that without my good speech I probably wouldn’t have as easy a time socializing with hearing peers throughout high school and college. It also would have been more difficult for me to get good jobs that involve a lot of verbal communication.

Hearing parents often go to great lengths to ensure their deaf and hard of hearing children receive quality speech therapy, for they want their children to be able to communicate verbally with their family and friends. After all visual communication is not ideal in a society of hearing peers. I’ve met deaf parents who’ve told me that they employed speech therapists, explaining the importance of giving their deaf children the opportunity to interact with both deaf and hearing peers.

Today we see stories of children with CIs talking with their hearing peers just as if they didn’t have a hearing loss, exchanging thoughts and ideas quickly. The success of those children keeps motivating professionals further to pursue auditory input as a way of facilitating speech development, advocating the use of digital hearing aids and cochlear implants. Audiologists typically will be the first to recommend that parents fit their children with those devices so that their children will have the opportunity to be part of mainstream society.

Approaches to Speech Development

Professionals have dedicated much effort to creating the best strategies and methods for facilitating speech developing in deaf and hard of hearing children over the years. In light of this, one factor still has a direct impact on speech development. It’s apparent that auditory input has a large role in a deaf child’s perception of his or her own speech. The Auditory-Verbal Therapy approach’s growing popularity can be attributed to the concept of facilitating speech development through constant stimulation of the auditory senses, enhancing self-perception and speech.

Because children with CIs typically have specialized habilitation services in regards to auditory training, it would be prudent to deduce that those children will have improved speech compared to profoundly deaf children who have no auditory input. Medical records I found in storage indicated that six months after my CI surgery my speech intelligibility improved 50%, indicating the CI had a profound impact on my speech. However in my case Cued Speech may have had a large influence on my ability to perceive and produce speech.

This is not to say that children without significant auditory input can have good speech too, it just will take more effort to develop that same level of speech as those who utilize their auditory senses. Being one of the few children who received cochlear implants at a later age, I underwent extensive speech therapy, often being taken out of class for less than an hour at least a few days every week. I also would have therapy outside school, visiting my therapist’s house. I can’t even begin to count the number of hours that I spent in speech therapy as a child.

Since I’m not a speech-language pathologist I don’t have firsthand experience of the various approaches to speech therapy. Yet I’m aware that there are differences in how each therapist approaches a deaf child. If a child has strong language skills, but poor pronunciation the therapist will focus on producing speech sounds. If a child has poor language skills, the therapist will have to go to greater lengths, focusing on language enrichment while facilitating speech development. In the face of all the work the therapist does, the parents have a crucial role in the deaf child’s language and speech development as the home is where the child receives the vast majority of language exposure, regardless of the type of auditory input.