Lip reading, also called speech reading, involves determining the meaning of speech by observing visual cues like lip movements, facial expressions, and gestures. It is difficult because only parts of speech are visible and many words look alike on the lips. Expert lip readers can only accurately understand about 66% of speech. There are four main approaches to teaching lip reading skills: analytic, synthetic, pragmatic, and holistic. The analytic approach focuses on the smallest units like syllables and sounds, while the synthetic approach emphasizes understanding overall meaning through context clues. The pragmatic approach prioritizes effective communication strategies and modifying the speaking environment.

1. Lip Reading
Zainab Hamadi
Natalie Nader
Hawraa Al-Romani
Lebanese University-Speech and Language Therapy

2. Lip-reading= Speech reading
The act or process of determining the intended meaning of a speaker
by utilizing all visual clues accompanying speech attempts, as lip
movements, facial expressions, and bodily gestures, used especially
by people with impaired hearing.
What is Lip-reading?

3. Lip reading is said to be 80% guesswork
Only 1/3 of speech is visible on the lips
An “expert” lip reader is guessing at 66% of what is said!
When considering lip-reading, be aware that there is a high incidence of
visual impairment within the hearing impaired population.. Regular eye
checks are essential.
More about lip-reading:

4. More about lip-reading:
•Amplification:
Also has a significant role - a little sound in addition to lip-reading, makes a big
difference. Appropriate, functioning hearing aids, worn consistently, do make
lip-reading much easier.
•McGurk Effect:
Even in the normally hearing population, lip movements influence what listeners
hear. An example of this is known as the 'McGurk Effect' - an illusion caused
when what you hear someone say doesn't match the lip configuration that you
see. This is why watching dubbed movies is a strange experience.

5. Lip-reading in hearing:
Speechreading is also used by people who have typical hearing, especially in
situations that are noisy or the speech is unclear.
Woodhouse (2009) published five pieces of evidence that shows:
“speech-reading is an integral part of speech processing. Hearing
people's perception of speech is influenced by speech-read cues, and
those speech-read cues cannot be ignored.”

6. What is Visible?
Anatomically Physiologically Phonetically Phonemically

7. What is visible?
Partially Visible
Tongue tip
Cheek muscles
Teeth
Visible
Lips
Jaw
Invisible
Tongue body
Velum
Vocal folds
Breathing mechanism
Anatomically - Motorically
Anatomical visibility is
described at the level of
Positions and Movements

8. Lips open/closed
Lips spread/rounded
Jaw raised/lowered
Tongue tip raised/lowered
Tongue tip forward/back
Anatomically -Motorically
Lips protruded/retracted
What is visible?

9. vocal fold vibration, nasal resonance, and airflow patterns are not visible
What is visible?

10. • Place of articulation of stressed
vowels, and of consonants, is mostly
visible.
• Duration and rhythm are partially
visible.
• Place of articulation of unstressed
vowels, voicing and manner of
articulation of consonants, pitch and
intonation, and loudness are all
invisible
What is visible?

11. • Stressed vowels are mostly
identifiable
• Unstressed vowels are not
identifiable.
• Consonants articulated at or
near the back of the mouth are
invisible (e.g., k, g, h).
• Other consonants are only
identifiable within groups
(visemes) that have different
places of articulation.
What is visible?

12. WHY IS SPEECHREADING
DIFFICULT?
Problems relate to four main areas. These are:
1. The nature
of speech
2. The speaker
3. The
environment
4. The
speechreader

13. 1-The Nature of Speech
 Frontal sounds (e.g. ‘p’) are the easiest to speechread.
 In contrast, it is very difficult to speechread middle sounds (e.g. ‘t’) or back
sounds (e.g. k, g, h - Kate, Gate and Hate) .
Many words also look alike. Alexander Graham Bell coined the term
‘homophene’ to describe words which look alike but do not sound alike.
e.g. Try saying the following three words without voice to friends. Can they tell
the difference? pat, mat, bat
Because so many speech shapes and words look alike, misunderstandings can
occur.
Why is speechreading difficult?

14. • A moustache or beard
• Poor lip movement (either minimal or exaggerated) ‘dead-pan’ faces.
• Hands covering mouths.
• Talking too quickly.
Why is speechreading difficult?
2-The Speaker:
Some people’s speaking habits or features make life very difficult for speech reader:

15. Why is speechreading difficult?
3-The Environment:
Lighting Distance Distractions
Poor lighting that is shining into
the speechreader’s eyes rather
than on the speaker’s face is a
problem.
A speechreader should try to be
positioned with his/her back to
the light source.
A speechreader should be a
comfortable distance from the
speaker so that hearing and
vision are maximised. (not too
close or too far)
Distractions in the environment
can make concentration difficult
for the speechreader.
In group situations, a
speechreader must try to be in
touch with topic changes and
who is speaking, otherwise
he/she is ‘left out’ very quickly.

16. o The innate ability to speechread varies from person to
person. This can only be improved to a certain extent by
training.
o To help speechreading, any visual defects should be
identified and corrected if possible.
o Speechreaders should also be prepared to admit when
they have not understood, rather than passively pretend
they have.
Why is speechreading difficult?
4-The SpeechReader:

17. Tips for Speechreading
Make sure you can see the speaker’s face clearly.
Hold the conversation in a quiet environment, with good lighting, and not a lot of
visual distractions.
Make sure that light is behind you, not the person you are trying to speechread.
Gently remind people that you need to see their face when they forget and look
down or away from you.

18. Tips for Speechreading
Ask for the topic of the conversation, if you are not sure.
If the speaker over–exaggerates, or talks too loudly, gently request that they speak
normally.
Remind speakers to move their hands or other objects away from their face.
If you still don’t understand after a repeat, ask the speaker to rephrase.

19. There are Four general approaches used to impart
speechreading skills (Tye-Murray, 1998).
Analytic Synthetic Pragmatic Holistic
Each approach had different models associated with them

20. 1 Analytic

21. • The Analytic approach was considered a traditional method of instruction
for teaching speechreading skills,
• and is generally defined as an approach that focused on the smallest units
of speech to understand spoken communication.
• Hallmarks of this approach are rapid syllable drills emphasizing the practice
of building smaller verbal units (the syllable or viseme) into words and then
sentences (Hanavan, 2013).
definition
1- Analytic Approach:

22. 1- Analytic Approach:

23. Theory
They assume that speech perception is, a bottom-up process
Where that 1st task is to analyze the incoming visual signal into its basic components
before assembling those components into words and sentences (Kaplan, et al. 1985).
1- Analytic Approach:
Instruction
Instruction: 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

24. Exercises:
• Some of the practices include syllable discrimination exercises,
• With practice and improved proficiency, similar exercises can be done using
words selected based on the syllables intended for practice.
1- Analytic Approach:
where the speech-
reader would be
presented with two
syllables:
(e.g., “GA-BA” or
“BA-BA”)
two syllables were
the same or
different

25. limitations
• While studies have reported from modest to significant improvements in speech
recognition performance, there are limitations to this approach.
1- Analytic Approach:
English-speaking person
will creates about 13/15
specific speech
movements per second
in a comfortably paced
conversation
But even the best
trained professional
speechreaders can only
register about 8/9
movements per sec at
most.

26. Synthetic2

27. definition
Top-down approach
where the perception of the whole, or the overall meaning of the message is emphasized
more so than concentrating on smaller parts.
Exercises
for this method include speechreading sentence practice in a known context to aid in
determination of overall meaning.
(The sentences used to practice this approach should be “definite, natural, interesting,
pleasing, rhythmical and dignified”)
2- Synthetic Approach:

28. 2- Synthetic Approach:

29. goal
The goal of the synthetic approach is for speechreaders to use context and any
known information to allow for educated guessing, when some sounds or parts of
the sentence is missing from auditory perception.
In other words, the meaning of a given sentence, if the context is known but
some of the words are ambiguous, can be inferred.
2- Synthetic Approach:

30. limitations
Include situations when:
o Speechreader is unable to determine the context of the message, or is
o Unable to determine the overall meaning of a message
o Unknowingly misinterprets the information,
leading to misunderstanding.
While repair strategies can help in such situations, it is largely the responsibility of the
speechreader to recognize when this is happening and to take the needed steps to
mitigate any confusion.
2- Synthetic Approach:

31. exercises
There are many exercises that can be used in this approach, most focusing 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 in a variety of ways.
For example, the speechreader could:
o reply to a specific question,
o repeat a passage, or
o incorporate details from the presented message into subsequent discussion
2- Synthetic Approach:

32. Pragmatic3

33. definition
The Pragmatic Approach focuses primarily on creating the ideal environment and
context for the person with hearing loss in dialogue.
They employ communication strategies to ensure that residual hearing is
maximized to increase comprehension of the speaker.
3- Pragmatic Approach:
(Lind, 2009).

34. Theory
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.
• develop specific strategies that they can employ in particular situations that are
found to be most difficult to communicate.
3- Pragmatic Approach:

35. 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.
3- Pragmatic Approach:

36. exercises
Practices and exercises used in the Pragmatic Approach tend to incorporate dialogue
between pairs or groups of speechreaders, or the speechreader and the
instructor/clinician.
With practice, the speechreader will employ communication strategies to ensure they are
fully engaged and correctly understanding the conversation.
3- Pragmatic Approach:
During dialogue btw
speechreader &
instructor/clinician, the
speechreader will have to
reply appropriately
The instructor provides
prompts & cues to help
the person get back on
track
if they do not

37. exercises
Other exercises can include:
 narratives,
 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 important considerations
when using this approach
3- Pragmatic Approach:

38. limitations
• The most notable is that it is the speechreader’s existing skills that are
maximized, with little emphasis on developing new skills.
• There is no effort made to incorporate a bimodal approach (two sensory inputs
including both auditory and visual cues) to overcoming conversation
difficulties.
• Another serious limitation, is that there is currently no evidenced-based
research to be found on the efficacy of this approach.
3- Pragmatic Approach:

39. Holistic4

40. Definition (Eclectic approach)
The Holistic Approach incorporated aspects from the Analytic, Synthetic and
Pragmatic approaches.
The main objectives of a Holistic Approach included:
“the evaluation and management 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”
4- Holistic Approach:

41. goals
Yoshinaga-Itano (1988) also described a holistic approach to instructing
speechreading techniques to children.
The training goals included:
4- Holistic Approach:
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.
their motivation to
improve their
speechreading abilities

42. The rationale behind a Holistic Approach is two fold;
Firstly Analytic, Synthetic and Pragmatic approaches each train specific
aspects of speech perception and communication strategies that are useful, and
the starting point in determining which strategies could be applied is the
individual living with hearing loss.
Secondly, while there are both benefits and detriments to the Analytic,
Synthetic and Pragmatic approaches, an approach that incorporates aspects of
each is flexible and can be adapted to specific situations when called for.
4- Holistic Approach:

43. benifit
The benefit to using a Holistic paradigm is the client-oriented approach, which is
much more empowering to the person seeking help in coping with their hearing
loss, and ensures a program that is tailored to the individual or groups’ unique
needs.
4- Holistic Approach:

44. limitations
Unfortunately, there is a lack of evidence-based research to provide any validity
to this particular method, and an obvious need for this remains.
It could be argued however, that the research that upholds the value of the
Analytic, Synthetic and Pragmatic Approaches could be transferred to the
Holistic Approach as it incorporates aspects of all three of the preceding
methods, and the skills imparted are not new inventions without prior precedent.
4- Holistic Approach:

45. Study: Does lipreading improve?
The study addressed the research questions: Does lipreading improve between the ages
of 7 and 14 years? Does hearing loss affect the development of lipreading?
children with normal hearing (NH) and with hearing loss (HL) were tested using 4
lipreading instruments.
Results: For both groups, lipreading performance improved with age on all 4 measures
of lipreading, with the HL group performing better than the NH group.
Conclusions:
• Results showed that children's lipreading ability improves.
• Experience plays an important role in the development of this ability. (HL children
lipread better than those with NH)
In Hearing
In Deaf

46. References:
• The Impact of Speechreading Programs on Adults with Hearing Loss, Literature Review
Alena Wickware, Project Manager, National Speechreading Program, The Canadian Hard of
Hearing Association .
• http://www.ssc.education.ed.ac.uk/courses/deaf/ddec05f.html
• SLHS 511: Lipreading. Slides and study notes
• http://www.vicdeaf.com.au/files/editor_upload/File/Information%20Sheets/Speechreading%20_
Visual%20Cues_.pdf
• http://jslhr.pubs.asha.org/article.aspx?articleid=1802630