The effect of language knowledge on speech perception: What are we really assessing?

Objective: The authors examined whether open-set speech perception scores are limited by knowledge of vocabulary and syntax and further considered whether remediation of vocabulary and syntax will increase open- set speech perception scores. Study Design: This was a repeated-measures study design in the setting of a primary (elementary) school for the hearing- impaired. Patients: The study population was composed of three hearing- impaired children using Nucleus 22-channel cochlear implant. Intervention: Intervention used was language remediation sessions. Main Outcome Measures: The main outcome measures were assessment of auditory-alone speech perception benefit using open-set words and sentences and assessment of syntactic knowledge using the Test of Syntactic Ability. Outcome measures were applied before and after remediation. Results: Child 1 and child 2 showed a significant postremediation improvement in their overall scores on the Test of Syntactic Ability and in their ability to perceive words learned during remediation. Child 1 and child 2 also showed a significant improvement in their scores on a modified Bamford-Kowal-Bench open-set sentence test, which specifically targeted grammatical constructs trained in remediation sessions. Conclusions: Remediation of language knowledge deficits significantly improved open-set speech perception for two children, suggesting a need to include language remediation in cochlear implant habilitation programs.