Visual-articulatory cues facilitate children with CIs to better perceive Mandarin tones in sentences

Children with cochlear implants (CIs) face challenges in tonal perception under noise. Nevertheless, our previous research demonstrated that seeing visual-articulatory cues (speakers’ facial/head movements) benefited these children to perceive isolated tones better, particularly in noisy environments, with those implanted earlier gaining more benefits. However, tones in daily speech typically occur in sentence contexts where visual cues are largely reduced compared to those in isolated contexts. It was thus unclear if visual benefits on tonal perception still hold in these challenging sentence contexts. Therefore, this study tested 64 children with CIs and 64 age-matched NH children. Target tones in sentence-medial position were presented in audio-only (AO) or audiovisual (AV) conditions, in quiet and noisy environments. Children selected the target tone using a picture-point task. The results showed that, while NH children did not show any perception difference between AO and AV conditions, children with CIs significantly improved their perceptual accuracy from AO to AV conditions. The degree of improvement was negatively correlated with their implantation ages. Therefore, children with CIs were able to use visual-articulatory cues to facilitate their tonal perception even in sentence contexts, and earlier auditory experience might be important in shaping this ability.