The Effect of Visual Articulatory Cues on the Identification of Mandarin Tones by Children With Cochlear Implants

Abstract

Purpose: This study explored the facilitatory effect of visual articulatory cues on the identification of Mandarin lexical tones by children with cochlear implants (CIs) in both quiet and noisy environments. It also explored whether early implantation is associated with better use of visual cues in tonal identification. Method: Participants included 106 children with CIs and 100 normal-hearing (NH) controls. A tonal identification task was employed using a two-alternative forced-choice picture-pointing paradigm. Participants' tonal identification accuracies were compared between audio-only (AO) and audiovisual (AV) modalities. Correlations between implantation ages and visual benefits (accuracy differences between AO and AV modalities) were also examined. Results: Children with CIs demonstrated an improved identification accuracy from AO to AV modalities in the noisy environment. Additionally, earlier implantation was significantly correlated with a greater visual benefit in noise. Conclusions: These findings indicated that children with CIs benefited from visual cues on tonal identification in noise, and early implantation enhanced the visual benefit. These results thus have practical implications on tonal perception interventions for Mandarin-speaking children with CIs.