Date of Award
Spring 2026
Document Type
Open Access Dissertation
Department
Public Health
First Advisor
Suzanne Adlof
Abstract
Background: Prosody, the suprasegmental features of speech that encompass pitch, duration, and loudness, supports syntactic parsing, sentence-type identification, and comprehension of academic language. Children who use cochlear implants (CIs) often experience difficulty with emotional prosody, yet less is known about their perception of linguistic prosody. Much of the existing literature treats prosody as a single construct, limiting conclusions about which acoustic dimensions may underlie observed difficulties. Given that cochlear implants transmit pitch and duration cues with differing fidelity, examining these components separately may clarify whether prosodic differences reflect global impairment or cue-specific vulnerability. This study investigated pitch- and duration-based linguistic prosody perception in school-age children (ages 9-12) who use bilateral CIs compared to peers with typical hearing (TH).
Methods: Participants were 20 children with bilateral CIs and 25 children with TH, all ages 9–12. Standardized assessments of language, phonological processing, and reading were administered to characterize both groups. Two experimental tasks measured prosody perception: (1) a pitch task requiring classification of declarative versus interrogative sentences, and (2) a duration task requiring identification of phrase boundaries in globally ambiguous sentences. Item-level analyses, reliability analyses, group comparisons, and mixed-effects modeling were conducted.
Results: The pitch task demonstrated strong internal consistency and revealed statistically significant group differences. Children with CIs performed more poorly and with greater variability than children with TH, particularly for interrogative sentences. These findings are consistent with known limitations in the transmission of pitch through cochlear implants.In contrast, no statistically significant group differences were observed on the duration task. However, both groups demonstrated modest overall accuracy and substantial variability. Although estimated effect sizes were moderate, the study was underpowered to detect small-to-moderate differences. Consequently, the absence of statistically significant findings should not be interpreted as definitive evidence of equivalent duration perception across groups. Across tasks, prosody performance showed moderate associations with broader language abilities, suggesting that linguistic prosody may interact with general language processing skills.
Conclusions: Findings suggest greater vulnerability for pitch-based linguistic prosody cues than for duration cues in children who use cochlear implants. Results for duration perception were less conclusive. While duration cues may be relatively preserved in CI signal processing, behavioral equivalence was not clearly established. Variability within both groups and power limitations suggest cautious interpretation. By isolating pitch and duration, this study moves beyond determining whether children who use cochlear implants struggle with prosody in general and instead begins to clarify how specific acoustic dimensions contribute to performance differences. Further research with larger samples and revised tasks is needed to determine whether similar behavioral outcomes reflect similar or reorganized underlying mechanisms.
Rights
© 2026, Marren Claire Brooks
Recommended Citation
Brooks, M. C.(2026). Linguistic Prosody Perception in Children who use Cochlear Implants. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/8964