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P1-10 Rehabilitation for children – speech production, speech perception
Identification of nasal vowels by French Parisian cochlear-implanted adults
Borel S. , Vaissière J. , Ferrary E. , Ambert-Dahan E. , Smadja M. , Sterkers O.
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Unité Otologie, Implants auditifs et Chirurgie de la base du crâne, Paris, France, 2Laboratoire
d'excellence Empirical Foundations of Linguistics (EFL), Sorbonne Paris Cité, Paris, France, 3UMR-S 1159 Inserm / Université Paris 6 Pierre
et Marie Curie, France, Paris, France, 4Université Paris 6 Pierre et Marie Curie, France, Paris, France
Intro: Cochlear implant (CI) dramatically improves global speech perception, communication, and quality of life
of post-lingual hearing-impaired adults. However, because correct identification of the phonemes is not always
completely achieved, numerous studies were performed to identify specific problems in recognition of
consonants and vowels (Valimäa et al., 2012). Nasal vowels are absent in English or Finnish and present in less
than ¼ of worldwide languages including French with / /, / /, and / /. Nasal vowels are produced with added
nasal cavity resonator, which introduced additional formants and antiformants. Acoustic cues of the nasal vowels
are not only based on the frequencies of the formants but also on their relative intensity. In normal-hearing
population, the listener strategy used to identify the nasal vowels is not completely known. Furthermore, cochlear
implanted patients complain to recognize the nasal vowels. The aim of this study was to identify the nasal vowels
recognition in CI patients.
Methods: A retrospective study was done on 52 women and 30 men (age = 55±15 years, mean ± SD, [26-81])
presenting post-lingual hearing loss, implanted from 1991 to 2008 in Beaujon hospital (Paris, France) with
different CI systems/coding strategies (Speak: 25, ACE: 40, CIS: 12, HiRes90k: 2, MPIS: 3). Tests were
performed at the earliest stage of rehabilitation (3±0.9 months [1-4]) and later, after at least one year after
implantation (35±26 months [12-120]). Patients were asked to recognize 7 oral and 3 nasal vowels associated to
the /p/ consonant pronounced by female speech therapists at direct voice.
Results: At the both stages, nasal vowels were significantly less well perceived than oral vowels (p< 0.05):
77%±24.2 vs 36%±37.9 for oral and nasal vowels, respectively, at the earliest stage, and 87%±16.3 vs
57%±38.4 at the latest stage. In case of error on nasal vowel, CI patients identified not another nasal one but an
oral vowel in 94% of the cases.
Discussion: In French, nasal vowels are more difficult to perceive than oral vowels by CI-users and this difficulty
remains even late after implantation. Contrary to the non-implanted hearing-impaired patients, who confused
nasal vowels between them (Adam & Lefevre, 2006), CI users mainly gave oral vowels as responses when nasal
vowel is presented, missing the specific feature allowing them to categorize the vowel as nasal.
Conclusion: Further studies would try to explain which acoustics cues are missing to CI-users to identify the
nasal feature. Studies of nasal vowels perception could provide a new light on the phonetic perception of
cochlear implant users. It should be very interesting to verify this difficulty in nasal vowel recognition in
Meridional/Canadian French, Polish/Hindi or Portuguese speakers.