Degradation of labial information modifies audiovisual speech perception in cochlear-implanted children.

Objective: The aim of the present study was to examine audiovisual speech integration in cochlear-implanted children and in normally hearing children exposed to degraded auditory stimuli. Previous studies have shown that speech perception in cochlear-implanted users is biased toward the visual modality when audition and vision provide conflicting information. Our main question was whether an experimentally designed degradation of the visual speech cue would increase the importance of audition in the response pattern. The impact of auditory proficiency was also investigated.

Design: A group of 31 children with cochlear implants and a group of 31 normally hearing children matched for chronological age were recruited. All children with cochlear implants had profound congenital deafness and had used their implants for at least 2 years. Participants had to perform an /aCa/ consonant-identification task in which stimuli were presented randomly in three conditions: auditory only, visual only, and audiovisual (congruent and incongruent McGurk stimuli). In half of the experiment, the visual speech cue was normal; in the other half (visual reduction) a degraded visual signal was presented, aimed at preventing lipreading of good quality. The normally hearing children received a spectrally reduced speech signal (simulating the input delivered by the cochlear implant).

Results: First, performance in visual-only and in congruent audiovisual modalities were decreased, showing that the visual reduction technique used here was efficient at degrading lipreading. Second, in the incongruent audiovisual trials, visual reduction led to a major increase in the number of auditory based responses in both groups. Differences between proficient and nonproficient children were found in both groups, with nonproficient children's responses being more visual and less auditory than those of proficient children. Further analysis revealed that differences between visually clear and visually reduced conditions and between groups were not only because of differences in unisensory perception but also because of differences in the process of audiovisual integration per se.

Conclusion: Visual reduction led to an increase in the weight of audition, even in cochlear-implanted children, whose perception is generally dominated by vision. This result suggests that the natural bias in favor of vision is not immutable. Audiovisual speech integration partly depends on the experimental situation, which modulates the informational content of the sensory channels and the weight that is awarded to each of them. Consequently, participants, whether deaf with cochlear implants or having normal hearing, not only base their perception on the most reliable modality but also award it an additional weight.