scholarly journals Involving Children and Teenagers With Bilateral Cochlear Implants in the Design of the BEARS (Both EARS) Virtual Reality Training Suite Improves Personalization

2021 ◽  
Vol 3 ◽  
Author(s):  
Deborah Vickers ◽  
Marina Salorio-Corbetto ◽  
Sandra Driver ◽  
Christine Rocca ◽  
Yuli Levtov ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Action Research ◽  
Young People ◽  
Cochlear Implants ◽  
Participatory Design ◽  
Spatial Hearing ◽  
Well Being ◽  
Research Protocol ◽  
Bilateral Cochlear Implants ◽  
Speech In Noise

Older children and teenagers with bilateral cochlear implants often have poor spatial hearing because they cannot fuse sounds from the two ears. This deficit jeopardizes speech and language development, education, and social well-being. The lack of protocols for fitting bilateral cochlear implants and resources for spatial-hearing training contribute to these difficulties. Spatial hearing develops with bilateral experience. A large body of research demonstrates that sound localisation can improve with training, underpinned by plasticity-driven changes in the auditory pathways. Generalizing training to non-trained auditory skills is best achieved by using a multi-modal (audio-visual) implementation and multi-domain training tasks (localisation, speech-in-noise, and spatial music). The goal of this work was to develop a package of virtual-reality games (BEARS, Both EARS) to train spatial hearing in young people (8–16 years) with bilateral cochlear implants using an action-research protocol. The action research protocol used formalized cycles for participants to trial aspects of the BEARS suite, reflect on their experiences, and in turn inform changes in the game implementations. This participatory design used the stakeholder participants as co-creators. The cycles for each of the three domains (localisation, spatial speech-in-noise, and spatial music) were customized to focus on the elements that the stakeholder participants considered important. The participants agreed that the final games were appropriate and ready to be used by patients. The main areas of modification were: the variety of immersive scenarios to cover age range and interests, the number of levels of complexity to ensure small improvements were measurable, feedback, and reward schemes to ensure positive reinforcement, and an additional implementation on an iPad for those who had difficulties with the headsets due to age or balance issues. The effectiveness of the BEARS training suite will be evaluated in a large-scale clinical trial to determine if using the games lead to improvements in speech-in-noise, quality of life, perceived benefit, and cost utility. Such interventions allow patients to take control of their own management reducing the reliance on outpatient-based rehabilitation. For young people, a virtual-reality implementation is more engaging than traditional rehabilitation methods, and the participatory design used here has ensured that the BEARS games are relevant.

scholarly journals Sound Localization in Toddlers with Normal Hearing and with Bilateral Cochlear Implants Revealed Through a Novel “Reaching for Sound” Task

2020 ◽  
Vol 31 (03) ◽  
pp. 195-208 ◽  
Author(s):  
Erica E. Bennett ◽  
Ruth Y. Litovsky
Keyword(s):  
Cochlear Implants ◽  
Root Mean Square ◽  
Sound Localization ◽  
Spatial Hearing ◽  
Normal Hearing ◽  
Mean Square ◽  
Sound Location ◽  
Bilateral Cochlear Implants ◽  
Single Implant ◽  
Hearing Abilities

AbstractSpatial hearing abilities in children with bilateral cochlear implants (BiCIs) are typically improved when two implants are used compared with a single implant. However, even with BiCIs, spatial hearing is still worse compared to normal-hearing (NH) age-matched children. Here, we focused on children who were younger than three years, hence in their toddler years. Prior research with this age focused on measuring discrimination of sounds from the right versus left.This study measured both discrimination and sound location identification in a nine-alternative forced-choice paradigm using the “reaching for sound” method, whereby children reached for sounding objects as a means of capturing their spatial hearing abilities.Discrimination was measured with sounds randomly presented to the left versus right, and loudspeakers at fixed angles ranging from ±60° to ±15°. On a separate task, sound location identification was measured for locations ranging from ±60° in 15° increments.Thirteen children with BiCIs (27–42 months old) and fifteen age-matched (NH).Discrimination and sound localization were completed for all subjects. For the left–right discrimination task, participants were required to reach a criterion of 4/5 correct trials (80%) at each angular separation prior to beginning the localization task. For sound localization, data was analyzed in two ways. First, percent correct scores were tallied for each participant. Second, for each participant, the root-mean-square-error was calculated to determine the average distance between the response and stimulus, indicative of localization accuracy.All BiCI users were able to discriminate left versus right at angles as small as ±15° when listening with two implants; however, performance was significantly worse when listening with a single implant. All NH toddlers also had >80% correct at ±15°. Sound localization results revealed root-mean-square errors averaging 11.15° in NH toddlers. Children in the BiCI group were generally unable to identify source location on this complex task (average error 37.03°).Although some toddlers with BiCIs are able to localize sound in a manner consistent with NH toddlers, for the majority of toddlers with BiCIs, sound localization abilities are still emerging.

scholarly journals Using Participatory Design Methodologies to Co-Design and Culturally Adapt the Spanish Version of the Mental Health eClinic: Qualitative Study

10.2196/14127 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e14127 ◽  
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey Davenport ◽  
Antonio Mendoza Diaz ◽  
Alvaro Navarro-Mancilla ◽  
Elizabeth M Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Professionals ◽  
Help Seeking ◽  
Participatory Design ◽  
Well Being ◽  
Self Report ◽  
User Testing ◽  
Spanish Speaking ◽  
English Speaking

Background The Mental Health eClinic (MHeC) aims to deliver best-practice clinical services to young people experiencing mental health problems by making clinical care accessible, affordable, and available to young people whenever and wherever they need it most. The original MHeC consists of home page with a visible triage system for those requiring urgent help; a online physical and mental health self-report assessment; a results dashboard; a booking and videoconferencing system; and the generation of a personalized well-being plan. Populations who do not speak English and reside in English-speaking countries are less likely to receive mental health care. In Australia, international students have been identified as disadvantaged compared with their peers; have weaker social support networks; and have higher rates of psychological distress. This scenario is acquiring significant relevance as Spanish-speaking migration is rapidly growing in Australia, and the mental health services for culturally and linguistically diverse populations are limited. Having a Spanish version (MHeC-S) of the Mental Health eClinic would greatly benefit these students. Objective We used participatory design methodologies with users (young people aged 16-30 years, supportive others, and health professionals) to (1) conduct workshops with users to co-design and culturally adapt the MHeC; (2) inform the development of the MHeC-S alpha prototype; (3) test the usability of the MHeC-S alpha prototype; (4) translate, culturally adapt, and face-validate the MHeC-S self-report assessment; and (5) collect information to inform its beta prototype. Methods A research and development cycle included several participatory design phases: co-design workshops; knowledge translation; language translation and cultural adaptation; and rapid prototyping and user testing of the MHeC-S alpha prototype. Results We held 2 co-design workshops with 17 users (10 young people, 7 health professionals). A total of 15 participated in the one-on-one user testing sessions (7 young people, 5 health professionals, 3 supportive others). We collected 225 source documents, and thematic analysis resulted in 5 main themes (help-seeking barriers, technology platform, functionality, content, and user interface). A random sample of 106 source documents analyzed by 2 independent raters revealed almost perfect agreement for functionality (kappa=.86; P<.001) and content (kappa=.92; P<.001) and substantial agreement for the user interface (kappa=.785; P<.001). In this random sample, no annotations were coded for help-seeking barriers or the technology platform. Language was identified as the main barrier to getting medical or psychological services, and smartphones were the most-used device to access the internet. Acceptability was adequate for the prototype’s 5 main elements: home page and triage system, self-report assessment, dashboard of results, booking and video visit system, and personalized well-being plan. The data also revealed gaps in the alpha prototype, such as the need for tailored assessment tools and a greater integration with Spanish-speaking services and communities. Spanish-language apps and e-tools, as well as online mental health information, were lacking. Conclusions Through a research and development process, we co-designed and culturally adapted, developed and user tested, and evaluated the MHeC-S. By translating and culturally adapting the MHeC to Spanish, we aimed to increase accessibility and availability of e-mental health care in the developing world, and assist vulnerable populations that have migrated to English-speaking countries.

scholarly journals Initial Development of a Spatially Separated Speech-in-Noise and Localization Training Program

2010 ◽  
Vol 21 (06) ◽  
pp. 390-403 ◽  
Author(s):  
Richard S. Tyler ◽  
Shelley A. Witt ◽  
Camille C. Dunn ◽  
Wenjun Wang
Keyword(s):  
Cochlear Implants ◽  
Hearing Aids ◽  
Spatial Separation ◽  
Binaural Hearing ◽  
Training System ◽  
Initial Development ◽  
Bilateral Cochlear Implants ◽  
Speech In Noise ◽  
Novel Approach ◽  
Home Based

Objective: This article describes the initial development of a novel approach for training hearing-impaired listeners to improve their ability to understand speech in the presence of background noise and to also improve their ability to localize sounds. Design: Most people with hearing loss, even those well fit with hearing devices, still experience significant problems understanding speech in noise. Prior research suggests that at least some subjects can experience improved speech understanding with training. However, all training systems that we are aware of have one basic, critical limitation. They do not provide spatial separation of the speech and noise, therefore ignoring the potential benefits of training binaural hearing. In this paper we describe our initial experience with a home-based training system that includes spatially separated speech-in-noise and localization training. Results: Throughout the development of this system patient input, training and preliminary pilot data from individuals with bilateral cochlear implants were utilized. Positive feedback from subjective reports indicated that some individuals were engaged in the treatment, and formal testing showed benefit. Feedback and practical issues resulted from the reduction of an eight-loudspeaker to a two-loudspeaker system. Conclusions: These preliminary findings suggest we have successfully developed a viable spatial hearing training system that can improve binaural hearing in noise and localization. Applications include, but are not limited to, hearing with hearing aids and cochlear implants.

scholarly journals Studies on Bilateral Cochlear Implants at the University of Wisconsin’s Binaural Hearing and Speech Laboratory

2012 ◽  
Vol 23 (06) ◽  
pp. 476-494 ◽  
Author(s):  
Ruth Y. Litovsky ◽  
Matthew J. Goupell ◽  
Shelly Godar ◽  
Tina Grieco-Calub ◽  
Gary L. Jones ◽  
...  
Keyword(s):  
Cochlear Implants ◽  
Age At Onset ◽  
Free Field ◽  
Spatial Hearing ◽  
Binaural Hearing ◽  
Systematic Investigation ◽  
Spatial Cues ◽  
Bilateral Cochlear Implants ◽  
Adults And Children ◽  
The Impact

This report highlights research projects relevant to binaural and spatial hearing in adults and children. In the past decade we have made progress in understanding the impact of bilateral cochlear implants (BiCIs) on performance in adults and children. However, BiCI users typically do not perform as well as normal hearing (NH) listeners. In this article we describe the benefits from BiCIs compared with a single cochlear implant (CI), focusing on measures of spatial hearing and speech understanding in noise. We highlight the fact that in BiCI listening the devices in the two ears are not coordinated; thus binaural spatial cues that are available to NH listeners are not available to BiCI users. Through the use of research processors that carefully control the stimulus delivered to each electrode in each ear, we are able to preserve binaural cues and deliver them with fidelity to BiCI users. Results from those studies are discussed as well, with a focus on the effect of age at onset of deafness and plasticity of binaural sensitivity. Our work with children has expanded both in number of subjects tested and age range included. We have now tested dozens of children ranging in age from 2 to 14 yr. Our findings suggest that spatial hearing abilities emerge with bilateral experience. While we originally focused on studying performance in free field, where real world listening experiments are conducted, more recently we have begun to conduct studies under carefully controlled binaural stimulation conditions with children as well. We have also studied language acquisition and speech perception and production in young CI users. Finally, a running theme of this research program is the systematic investigation of the numerous factors that contribute to spatial and binaural hearing in BiCI users. By using CI simulations (with vocoders) and studying NH listeners under degraded listening conditions, we are able to tease apart limitations due to the hardware/software of the CI systems from limitations due to neural pathology.

scholarly journals Give Us More Credit! Recommendations for Young and Adult Researchers on Conducting Adolescent-Led Research

2021 ◽  
Vol 16 (2-3) ◽  
pp. 227-238
Author(s):  
Georgiana Vasiloiu ◽  
Julia Smith-Brake ◽  
Simona Eugenia Mihai
Keyword(s):  
Social Work ◽  
Action Research ◽  
Young People ◽  
Sexual Violence ◽  
Participatory Action Research ◽  
Well Being ◽  
Lessons Learned ◽  
Youth Participatory Action Research ◽  
Participatory Action ◽  
Fear And Anxiety

Youth participatory action research, child-led research, and child-led activism are being increasingly employed to counter adultism in social work and development contexts, in a way to break down barriers for young people to have their voices heard on issues and decisions about their lives. This commentary comprises 2 open letters from a young researcher and advocate for children’s well-being and rights in Romania. The first letter is addressed to fellow young people and shares the journey of learning about and subsequently researching the issue of sexual violence, as well as a call to young people to stand up and use their voice to bring attention to issues important to them. The fear and anxiety of doing something new, that is usually in an adult space, cedes to empowerment and confidence found through the process. The second letter is addressed to adult researchers and practitioners and shares the methodology and findings of the child-led research project, lessons learned, and recommendations for adults engaging in child-led research. A key recommendation is for adults to support child researchers without manipulating the process, and to give young people more credit in commonly adult-held spaces.

Sign in / Sign up

Export Citation Format

Share Document