Speechreading

Speechreading is not like reading – not all of the information is on the lips.
Watch the video: Can You Read My Lips?

Read my lipsSpeechreading as used here means using the visual clues of the speaker’s lip and facial movements, gestures, posture and body language, along with residual hearing to make use of the speaker’s verbal communication, intonation and context to infer meaning (formerly known as lip reading). Speechreading is used by persons with typical hearing and those with hearing loss, especially when there are communication challenges such as background noise, and is an integral part of speech processing.

Speechreading conversation: On average, an English-speaking person will create about 13 to 15 specific speech movements per second in a comfortably paced conversation, but even the best-trained professional speechreaders can only register about 8 or 9 movements per second at most. Even modern day speechreaders trained with conventional techniques (E.G.: extended training procedures that include video recordings that can be paused, slowed-down, rewound, enlarged and have in depth analysis to accompany) can only ascertain a maximum of about 30% to 35% of spoken English in real time conversations, even under optimal conditions. Thus, it is very difficult to capture all of the necessary information to decode meaningful sentences, and building the message from the sum of its parts. Often, the processing time required to visually recognize and interpret recognizable speech movements, arrange them into words, and then arrange the words into sentences outlasts the speakers rate of speech and the sentence the speechreader was trying to follow would have long since passed. For more information go to this review of the literature.

Video examples illustrating the challenges of speechreading use alone for communication: The first YouTube clip is a funny example of speechreading during football.  Clip   Not so funny is The Lost Joke clip that shows a student with hearing loss amongst a group of secondary school age peers when an amusing anecdote is being described. The clips are also powerful examples of why the sentiment, “He may not hear everything but he is a great lipreader and gets it all!” are very concerning. Test your lipreading skills on Can Your Read My Lips and also on the Speechreading Challenge at the bottom of this webpage. 

Assessing speechreading ability:

Functional use of speechreading can be identified via the Functional Listening Evaluation. Alternately you can use the Utley Test of Lipreading Ability.

Methods to teach speechreading:

The first inclination in education is to improve speechreading in order to improve outcomes. Therefore teaching methods are mentioned below:

  • Lipreading mouth positionsThe Analytic approach focuses on the smallest units of speech to understand spoken communication. It is a bottom-up approach that concentrates on the details of the sounds – learning to recognize how they look on the lips and practicing their recognition in isolation and in single words. As mentioned above, it is very difficult to build the message from the sum of its parts and the use of this approach exclusively can be a frustrating and cumbersome experience for persons with hearing loss, with lower chances for success in everyday situations.
  • The Synthetic approach is a top-down approach, where the perception of the the overall meaning of the message is emphasized more than concentrating on smaller parts. Common exercises focus on giving the speechreader some clues such as key words or a topic that will be discussed, presenting the message and having the speechreader respond to what he thought was said. The goal is to use context and any known information to allow for educated guessing, when parts of spoken information are missed. Limitations include situations when a speechreader is unable to determine the context of the message or unknowingly misinterprets the information, leading to misunderstanding.

Although these approaches may be a limited way to teach ‘lipreading’ or use of context, they have little evidence to support extensive instruction. Individuals naturally vary in how much speechreading benefits their understanding of speech in everyday situations. A bottom-up approach does not really improve this natural ability and a top-down approach may improve understanding in predictable situations with known vocabulary and topics, but is certainly not enough to improve performance in a dynamic educational environment teaching new concepts using previously unheard vocabulary.

Methods to improve speech understanding:

As mentioned, the analytic and synthetic instruction methods to teach ‘lipreading’ lack a strong evidence base. Although they can be used as brief teaching strategies, goals developed around improving these specific skills are not really warranted. The Pragmatic approach below is often included in discussions of speechreading training, yet it is more commonly recognized today as ‘hearing tactics’ or ‘communication repair strategies’.

  • kids in a groupThe Pragmatic approach focuses primarily on employing communication strategies to ensure that residual hearing is maximized to increase comprehension of the speaker (hearing tactics). The aim of this approach is for the individual to concentrate on interaction more than the reception of specific cues or sounds, to ask for modification of the speakers message, the context in which dialogue takes place, and develop specific strategies that they can employ in particular situations that are found to be most difficult to communicate. The focus of this approach is based on how language is used in social situations and how the use of language can affect those communicating; as a result, most of the exercises are framed from the perspective of interaction. Specific training of communication repair strategies also occurs to ensure they are fully engaged as a responsible communicator and can respond when misunderstandings occur. Exercises can include narratives, question/answer, discussion, and role-playing. Cues such as word order and sequencing, tense and word endings, matching language to the situation and context, among others are considerations when using this approach.

The Holistic approach combines the teaching strategies of the analytic and synthetic approaches combined with hearing tactics and communication repair strategies. Training programs encompassing all of these features have been found to have some evidence base.

  • holistic treeThe Holistic approach incorporates aspects from the Analytic, Synthetic and Pragmatic approaches. The main objectives include improvement of overall communication skills, the psychosocial aspects of hearing loss, the education of significant others (e.g. parents, siblings and close friends), hearing aid orientation, an emphasis on improving conversational and interactive skills, and the use of assistive listening devices. Training goals include: increasing the child’s knowledge of the speechreading process, their ability to generalize strategies to facilitate more successful communication, their tolerance for difficult/frustrating communicative situations, their role in generating personal goals, and their motivation to improve their speechreading abilities.


Summary on Teaching Speechreading

FindingsAs mentioned previously, learning goals specific to the top down or bottom up focus of the first two approaches are not warranted. Rather, it is recommended that the teacher develop goals related to improving speech understanding via communication repair strategies, auditory skill development (focus on the visual aspects of speech sounds can be incorporated into auditory discrimination training), and use of hearing tactics to improve communication in situations in which the student has identified as being challenging for listening.

 

The Negative Impacts of Speechreading

If a student has challenges hearing everything in class then encouraging him or her to speechread will help understanding, right? Not necessarily.

LookOne study had typically hearing students answer comprehension questions about a story that was presented in a lecture format or when parts of the story were presented from locations around the student, to simulate listening to classroom discussion. The first finding was that accuracy when repeating sentences in quiet or noise (like on a Functional Listening Evaluation) does not predict the true impact of classroom acoustics on listening comprehension for lecture or discussion. In all cases, listening to lecture yielded higher comprehension than listening to discussion. For example, children who achieved a 95% accuracy repeating sentences in a typical classroom listening environment (+7 S/N noise, 0.6s reverberation) had poorer comprehension under more typical classroom lecture or discussion activities. Average results for 11-year olds when listening to lecture was 80% accuracy and 75% for discussion, whereas for 8-year-olds it was 40% and 33% respectively. If the noise level was improved (from +7 S/N to +10 S/N) the scores for understanding class discussion improved from 33%/75% to 60%/90% for 8/11 year-olds respectively.

This study further found that the younger participants (age 8) looked around more to aid their understanding during discussion. Most often these students were unable to visually keep up as the discussion moved from student to student. Furthermore, it appeared as though the act of trying to visually track class discussions could actually use up more cognitive resources, resulting in reduced comprehension, especially for younger students.

Additional research studies on persons with typical hearing  found that considerable listening effort is required when listening at noise levels typical of the school classroom. In low noise, being able to watch the speaker improves speech understanding and reduces listening effort. Listening in high noise while watching the speaker results in greater effort to understand speech. Listeners who are better speechreaders benefit more from visual cues than those that are naturally poorer speechreaders.

Implications of this research

FindingsIn a relatively quiet classroom listening environment, if a student has good speechreading ability (i.e., 15%+ improvement over auditory alone) he or she should be encouraged to watch the teacher while she is speaking and during classroom discussion. However, the very effort expended to try to view students’ faces during discussion will diminish understanding of what has been heard. It remains critical for the teacher to summarize or repeat key points during discussion, regardless of how well a student speechreads. Indeed, with comprehension lower while trying to visually track discussion, this summarization is important for many students with normal hearing as well.

 

Take the Speechreading Challenge!

Our thanks to ProCare Therapy for allowing us to share this fun challenge with you. 

 

Information on speechreading training from here. For more information on the impact of speechreading refer to the article: Access is the Issue Not Hearing Loss: New Policy Clarification Requires Schools to Ensure Effective Communication Access by Karen Anderson from ASHA Perspectives on Hearing and Hearing Disorders in Childhood, Volume 25, pg 24-36. Published April 2015.

Original post of this material in January 2016. Written by Karen L. Anderson, PhD, Director, Supporting Success for Children with Hearing Loss. Updated July 2016.