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2- Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , amzadeh@sbmu.ac.ir
3- Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Department of Basic Sciences, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
1. Introduction
Lip reading is the extraction of speech data from the activity of the lower part of the face, especially the jaws, lips, tongue and teeth, which is a natural skill in hearing people. The main purpose of lip reading is to increase the independence of people with hearing impairments. Recent experience has shown that seeing the speaker’s lips increases sensitivity to acoustic information and decreases the speech detection threshold in the presence of noise. The experience of the person as a listener shows that spoken sounds are heard louder when looking at the speaker [1, 2].
Obtaining visual information from the speaker’s mouth and face movements play an important role in understanding spoken language [3-5]. Also, people who, for various reasons, their speech communication ability is partially or completely impaired, use this supplementary information [6, 7]. In the present study, by designing and constructing a lip-reading training program, we investigated the effect of training on lip-reading skills of 18 to 25-year-olds.
2. Materials and Methods
This intervention study was performed before and after lip reading training. The study population consisted of 27 male students aged 18-25 years with a Mean±SD age of 20.67±2.28, who participated voluntarily from the rehabilitation faculties of Shahid Beheshti University of Medical Sciences and Hamedan University. First, a questionnaire including personal and medical information of individuals as well as written consent was completed to check the inclusion criteria. Right-handedness, monolingualism, lack of hearing and vision impairment were considered as the inclusion criteria.
Sara 1 and Sara 2 lip reading tests were used to evaluate lip reading skills and to evaluate the effect of lip reading training on speech recognition of the samples in the study. For data analysis, repeated measures ANOVA and McNemar tests were used. This study consisted of two parts: the first part was the design and construction of a lip-reading training program, which included 7 stages, and the second part, included the implementation of tests and the use of the program.
3. Results
In the present study, all subjects (27 participants) were evaluated by both Sara 1 and Sara 2 lip reading tests. In statistical analysis with repeated measures ANOVA, there was a significant difference between Sara 1 test lip reading scores before and after training (P=0.000). Also, in statistical analysis to analyze the results of Sarah 2 lip reading test, a significant difference was observed between the scores of this test before and after training (P=0.000). In Table 1, statistical indicators related to Sara 1 and Sara 2 lip reading scores are reported in two situations.
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In order to investigate the effect of lip reading training, McNemar statistical analysis was used to compare the “consonant-vowel, consonant-vowel” (cv-cv) syllable scores before and after training (Figure 1 and 2). Out of 23 cv-cv syllables, 4 syllables showed a significant difference (P<0.05).
Also, in the content of Sara 1 lip reading test, which was used in a total of 20 sentences, there were 176 vowels, which in the review of vowels a significant difference between the scores before and after training in each of the 6 vowels (/a/, /e/, /i/, /â/, /o/, /u/ was observed (P=0.000).
4. Discussion
Comparing the scores of Sara 1 lip reading test before and after training, a significant difference was observed in the scores (P=0.000) which indicated the positive effect of lip training on speech recognition and efficiency of lip training program. The Mean percentage of “speech recognition by lip-reading” scores was 15.19 before training, while this Mean was 42.41 after training. Improving the scores showed the positive effect of training on lip reading and improving speech recognition skills. This results was consistent with the results of studies that have measured the effect of training on lip reading [16-19].
There are conflicting results about lip reading training; in fact, there are differences between short-term and long-term training, individual and group training, and training for children and the elderly. This sensory process appears to have limitations, at least in the visual system, although its nature is unclear. Some people may not improve on speech perception tests, but if they are asked if they have benefited from lip reading training, they would talk for hours in support of lip-reading! [12, 19].
5. Conclusion
A noteworthy point in the results of the present study was that most people acknowledged that when watching the lip reading training program and especially the filmed videos (seeing and hearing the pronunciation of syllables), their subconscious mind simultaneously repeated that phoneme or syllable so that they could have a better learning experience. This point can be justified by the motor theory of speech perception. According to this theory, speech is produced by the same process that is perceived.
According to the results of the present study, lip reading training is one of the factors that improves lip reading performance and subsequently improves speech recognition. According to this result, the lip reading training program could have a positive effect on lip-reading performance. The educational content used in this program can be used to educate people, especially hearing impaired people, either as personal use at home or as group training in rehabilitation programs.
Ethical Considerations
Compliance with ethical guidelines
Gaining informed consent and providing the results were ethical principles in this study. This research with the code IR.SBMU.REC.1394.144 has been approved by the ethics committee of Shahid Beheshti University of Medical Sciences.
Funding
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Authors' contributions
All authors contributed to the preparation of this article.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors consider it necessary to thank the assistance of the Physiotherapy Research Center, the Vice Chancellor for Research and Technology of Shahid Beheshti University of Medical Sciences, the Department of Audiology of the Faculty of Rehabilitation of Shahid Beheshti University of Medical Sciences and all students participating in this study. The cooperation of Dr. Gita Movallali is also appreciated.
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