scholarly journals Multivariate Predictors of Music Perception and Appraisal by Adult Cochlear Implant Users

2008 ◽  
Vol 19 (02) ◽  
pp. 120-134 ◽  
Author(s):  
Kate Gfeller ◽  
Jacob Oleson ◽  
John F. Knutson ◽  
Patrick Breheny ◽  
Virginia Driscoll ◽  
...  

The research examined whether performance by adult cochlear implant recipients on a variety of recognition and appraisal tests derived from real-world music could be predicted from technological, demographic, and life experience variables, as well as speech recognition scores. A representative sample of 209 adults implanted between 1985 and 2006 participated. Using multiple linear regression models and generalized linear mixed models, sets of optimal predictor variables were selected that effectively predicted performance on a test battery that assessed different aspects of music listening. These analyses established the importance of distinguishing between the accuracy of music perception and the appraisal of musical stimuli when using music listening as an index of implant success. Importantly, neither device type nor processing strategy predicted music perception or music appraisal. Speech recognition performance was not a strong predictor of music perception, and primarily predicted music perception when the test stimuli included lyrics. Additionally, limitations in the utility of speech perception in predicting musical perception and appraisal underscore the utility of music perception as an alternative outcome measure for evaluating implant outcomes. Music listening background, residual hearing (i.e., hearing aid use), cognitive factors, and some demographic factors predicted several indices of perceptual accuracy or appraisal of music. La investigación examinó si el desempeño, por parte de adultos receptores de un implante coclear, sobre una variedad de pruebas de reconocimiento y evaluación derivadas de la música del mundo real, podrían predecirse a partir de variables tecnológicas, demográficas y de experiencias de vida, así como de puntajes de reconocimiento del lenguaje. Participó una muestra representativa de 209 adultos implantados entre 1965 y el 2006. Usando múltiples modelos de regresión lineal y modelos mixtos lineales generalizados, se seleccionaron grupos de variables óptimas de predicción, que pudieran predecir efectivamente el desempeño por medio de una batería de pruebas que permitiera evaluar diferentes aspectos de la apreciación musical. Estos análisis establecieron la importancia de distinguir entre la exactitud en la percepción musical y la evaluación de estímulos musicales cuando se utiliza la apreciación musical como un índice de éxito en la implantación. Importantemente, ningún tipo de dispositivo o estrategia de procesamiento predijo la percepción o la evaluación musical. El desempeño en el reconocimiento del lenguaje no fue un elemento fuerte de predicción, y llegó a predecir primariamente la percepción musical cuando los estímulos de prueba incluyeron las letras. Adicionalmente, las limitaciones en la utilidad de la percepción del lenguaje a la hora de predecir la percepción y la evaluación musical, subrayan la utilidad de la percepción de la música como una medida alternativa de resultado para evaluar la implantación coclear. La música de fondo, la audición residual (p.e., el uso de auxiliares auditivos), los factores cognitivos, y algunos factores demográficos predijeron varios índices de exactitud y evaluación perceptual de la música.

2016 ◽  
Vol 33 (4) ◽  
pp. 493-508 ◽  
Author(s):  
Rachel M. van Besouw ◽  
Benjamin R. Oliver ◽  
Mary L. Grasmeder ◽  
Sarah M. Hodkinson ◽  
Heidi Solheim

The objective of this study was to evaluate the efficacy of a prototype interactive music awareness program (IMAP) for adult cochlear implant (CI) users. An unblinded, randomized crossover design was used. Twenty-one CI users were recruited and allocated to two groups. Group 1 received the IMAP first, followed by a retention of learning phase. Group 2 were given the IMAP after 12 weeks. Participants were instructed to undertake two half-hour sessions per week at home over 12 weeks. Both groups attended appointments at the start, halfway through, and at the end of the trial. At each appointment participants completed tests of speech perception, melodic contour identification, and instrument recognition, rated the sound quality of music, and indicated their music listening habits. Sixteen participants completed the study. Following training both groups showed improved instrument recognition abilities and feedback suggests further positive impact on participants’ lives. The findings suggest that the IMAP is beneficial for music perception and in particular, improved instrument recognition.


2010 ◽  
Vol 21 (07) ◽  
pp. 441-451 ◽  
Author(s):  
René H. Gifford ◽  
Lawrence J. Revit

Background: Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. Purpose: To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Research Design: Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Study Sample: Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Intervention: Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects' preferred listening programs as well as with the addition of either Beam™ preprocessing (Cochlear Corporation) or the T-Mic® accessory option (Advanced Bionics). Data Collection and Analysis: In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested “Everyday,” “Noise,” and “Focus” preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. Results: The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Conclusion: Options available in current cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise with both Cochlear Corporation and Advanced Bionics systems. For Cochlear Corporation recipients, Focus preprocessing yields the best speech-recognition performance in a complex listening environment; however, it is recommended that Noise preprocessing be used as the new default for everyday listening environments to avoid the need for switching programs throughout the day. For Advanced Bionics recipients, the T-Mic offers significantly improved performance in noise and is recommended for everyday use in all listening environments.


2005 ◽  
Vol 114 (11) ◽  
pp. 886-893 ◽  
Author(s):  
Li Xu ◽  
Teresa A. Zwolan ◽  
Catherine S. Thompson ◽  
Bryan E. Pfingst

Objectives: The present study was performed to evaluate the efficacy and clinical feasibility of using monopolar stimulation with the Clarion Simultaneous Analog Stimulation (SAS) strategy in patients with cochlear implants. Methods: Speech recognition by 10 Clarion cochlear implant users was evaluated by means of 4 different speech processing strategy/electrode configuration combinations; ie, SAS and Continuous Interleaved Sampling (CIS) strategies were each used with monopolar (MP) and bipolar (BP) electrode configurations. The test measures included consonants, vowels, consonant-nucleus-consonant words, and Hearing in Noise Test sentences with a +10 dB signal-to-noise ratio. Additionally, subjective judgments of sound quality were obtained for each strategy/configuration combination. Results: All subjects but 1 demonstrated open-set speech recognition with the SAS/MP combination. The group mean Hearing in Noise Test sentence score for the SAS/MP combination was 31.6% (range, 0% to 92%) correct, as compared to 25.0%, 46.7%, and 37.8% correct for the CIS/BP, CIS/MP, and SAS/BP combinations, respectively. Intersubject variability was high, and there were no significant differences in mean speech recognition scores or mean preference ratings among the 4 strategy/configuration combinations tested. Individually, the best speech recognition performance was with the subject's everyday strategy/configuration combination in 72% of the applicable cases. If the everyday strategy was excluded from the analysis, the subjects performed best with the SAS/MP combination in 37.5% of the remaining cases. Conclusions: The SAS processing strategy with an MP electrode configuration gave reasonable speech recognition in most subjects, even though subjects had minimal previous experience with this strategy/configuration combination. The SAS/MP combination might be particularly appropriate for patients for whom a full dynamic range of electrical hearing could not be achieved with a BP configuration.


2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Valerie Looi ◽  
Yuhan Wong ◽  
Jenny H. Y. Loo

The aim of this study was to compare the effectiveness of a music appreciation training program (MATP) to that of focused music listening (FML) for improving music and/or speech in noise perception for postlingually deafened cochlear implant (CI) recipients. It was hypothesized that the MATP would show greater improvements than FML. Ten CI recipients were randomly divided into two groups: one undertaking the MATP and the other undertaking FML. Participants completed four 30-minute sessions per week for 8 weeks, with tests of music and speech-in-noise perception being administered four times per participant: before and after a control period, immediately after the intervention, and 4–8 weeks after intervention. There was a significant pre- to posttraining difference for the MATP group on the instrument identification test, as well as for half of the quality rating assessments. Although no statistically significant improvements were obtained for the FML group, there was a trend of higher scores postintervention for the instrument and ensemble identification tests, and compliance was substantially better than for the MATP group. While the results showed that only the music training significantly improved music perception, the potential of FML to benefit some CI recipients for some tasks was also observed.


2010 ◽  
Vol 21 (01) ◽  
pp. 028-034 ◽  
Author(s):  
Kate Gfeller ◽  
Dingfeng Jiang ◽  
Jacob J. Oleson ◽  
Virginia Driscoll ◽  
John F. Knutson

Background: An extensive body of literature indicates that cochlear implants (CIs) are effective in supporting speech perception of persons with severe to profound hearing losses who do not benefit to any great extent from conventional hearing aids. Adult CI recipients tend to show significant improvement in speech perception within 3 mo following implantation as a result of mere experience. Furthermore, CI recipients continue to show modest improvement as long as 5 yr postimplantation. In contrast, data taken from single testing protocols of music perception and appraisal indicate that CIs are less than ideal in transmitting important structural features of music, such as pitch, melody, and timbre. However, there is presently little information documenting changes in music perception or appraisal over extended time as a result of mere experience. Purpose: This study examined two basic questions: (1) Do adult CI recipients show significant improvement in perceptual acuity or appraisal of specific music listening tasks when tested in two consecutive years? (2) If there are tasks for which CI recipients show significant improvement with time, are there particular demographic variables that predict those CI recipients most likely to show improvement with extended CI use? Research Design: A longitudinal cohort study. Implant recipients return annually for visits to the clinic. Study Sample: The study included 209 adult cochlear implant recipients with at least 9 mo implant experience before their first year measurement. Data Collection and Analysis: Outcomes were measured on the patient's annual visit in two consecutive years. Paired t-tests were used to test for significant improvement from one year to the next. Those variables demonstrating significant improvement were subjected to regression analyses performed to detect the demographic variables useful in predicting said improvement. Results: There were no significant differences in music perception outcomes as a function of type of device or processing strategy used. Only familiar melody recognition (FMR) and recognition of melody excerpts with lyrics (MERT-L) showed significant improvement from one year to the next. After controlling for the baseline value, hearing aid use, months of use, music listening habits after implantation, and formal musical training in elementary school were significant predictors of FMR improvement. Bilateral CI use, formal musical training in high school and beyond, and a measure of sequential cognitive processing were significant predictors of MERT-L improvement. Conclusion: These adult CI recipients as a result of mere experience demonstrated fairly consistent music perception and appraisal on measures gathered in two consecutive years. Gains made tend to be modest, and can be associated with characteristics such as use of hearing aids, listening experiences, or bilateral use (in the case of lyrics). These results have implications for counseling of CI recipients with regard to realistic expectations and strategies for enhancing music perception and enjoyment.


Author(s):  
Ning Zhou ◽  
Zhen Zhu ◽  
Lixue Dong ◽  
John Galvin

AbstractIn cochlear implants, loudness has been shown to grow more slowly with increasing pulse phase duration (PPD) than with pulse amplitude (PA), possibly due to “leaky” charge integration. This leakiness has been recently quantified in terms of “charge integration efficiency,” defined as the log difference between the PPD dynamic range and PA dynamic range (both expressed in charge units), relative to a common threshold anchor. Such leakiness may differ across electrodes and/or test ears, and may reflect underlying neural health. In this study, we examined the across-site variation of charge integration in recipients of Cochlear© devices. PPD and PA dynamic ranges were measured relative to two threshold anchors with either a 25- or 50-microsecond PPD. Strength-duration functions, previously shown to relate to survival of spiral ganglion cells and peripheral processes, were compared to charge integration efficiency on selected electrodes. Results showed no significant or systematic relationship between the across-site variation in charge integration efficiency and electrode position or threshold levels. Charge integration efficiency was poorer with the 50-μs threshold anchor, suggesting that greater leakiness was associated with larger PPD dynamic ranges. Poorer and more variable charge integration efficiency across electrodes was associated with longer duration of any hearing loss, consistent with the idea that poor integration is related to neural degeneration. More variable integration efficiency was also associated with poorer speech recognition performance across test ears. The slopes of the strength-duration functions at maximum acceptable loudness were significantly correlated with charge integration efficiency. However, the strength-duration slopes were not predictive of duration of any hearing loss or speech recognition performance in our participants. As such, charge integration efficiency may be a better candidate to measure leakiness in neural populations across the electrode array, as well as the general health of the auditory nerve in human cochlear implant recipients.


2007 ◽  
Vol 18 (04) ◽  
pp. 292-303
Author(s):  
Janet E. Shanks ◽  
Richard H. Wilson ◽  
Patricia Stelmachowicz ◽  
Gene W. Bratt ◽  
David W. Williams

Larson et al (2000) reported the findings of a multicenter, NIDCD/VA clinical trial that compared hearing aid performance for three output limiting circuits in 360 adults with symmetrical sensorineural hearing loss. The current study was undertaken to examine long-term hearing aid benefit in this same group of participants following five to six years of hearing aid use. The speech-recognition portion of the follow-up study enrolled 108 participants from the original study, 85% of whom were current hearing aid users and 15% of whom had not worn hearing aids during the past month (nonusers). Recognition performance in sound field on the NU-6 (quiet at 62 dB SPL) and the CST (quiet at 74 dB SPL and with -3 and 3 dB signal-to-babble ratios [S/B] at 62 and 74 dB SPL) was measured unaided and aided whenever possible. Speech-recognition abilities decreased significantly since the original study. Speech-recognition decrements were observed regardless of the speech materials (NU-6 and CST), test condition (quiet and noise), S/B (-3 and 3 dB), or stimulus level (62 and 74 dB SPL). Despite decreases in speech recognition, hearing aid benefit remained largely unchanged since the original study; aided performance exceeded unaided performance regardless of presentation level or noise condition. As in the original study, the relations among stimulus level, S/B, and speech-recognition performance were complex. Larson y col. (2000) reportaron los hallazgos de un estudio clínicos multicéntrico del NIDCD/VA que comparó el desempeño en el uso de auxiliares auditivos (AA) con tres circuitos de limitación de la salida, en 360 adultos con pérdida auditiva sensorineural simétrica. El estudio actual fue conducido para examinar el beneficio a largo plazo del AA en el mismo grupo de participantes, luego de cinco a seis años de utilización del AA. La porción de reconocimiento de lenguaje del estudio de seguimiento involucró a 108 participantes del estudio original, 85% de los cuáles eran actuales usuarios de AA y 15% que no habían usado AA durante el mes anterior (no usuarios). El desempeño en reconocimiento del lenguaje en campo sonoro con el NU-6 (en silencio a 62 dB SPL) y con el CST (en silencio a 74 dB SPL, y con tasas de señal/balbuceo de -3 y +3 dB [S&B] a 62 y 74 dB SPL), fue medido con y sin amplificación cuando resultó posible. Las habilidades de reconocimiento del lenguaje habían disminuido significativamente desde el estudio original. Se observó reducción en el reconocimiento del lenguaje independientemente del material logoaudiométrico (NU-6 y CST), las condiciones de la prueba (en silencio o en ruido), S/B (-3 y +3 dB), o la intensidad del estímulo (62 y 74 dB SPL). A pesar de la disminución en el reconocimiento del lenguaje, el beneficio del AA permaneció sin cambios en relación al estudio original; el desempeño con amplificación superó el desempeño sin amplificación sin importar la intensidad de la presentación o las condiciones de ruido. Al igual que en el estudio original, las relaciones entre el nivel de estímulo, la S/B y el desempeño en el reconocimiento de lenguaje fueron complejas.


2015 ◽  
Vol 26 (10) ◽  
pp. 872-884 ◽  
Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Xuyang Zhang ◽  
Ruth A. Bentler

Background: Ecological momentary assessment (EMA) is a methodology involving repeated assessments/surveys to collect data describing respondents’ current or very recent experiences and related contexts in their natural environments. The use of EMA in audiology research is growing. Purpose: This study examined the construct validity (i.e., the degree to which a measurement reflects what it is intended to measure) of EMA in terms of measuring speech understanding and related listening context. Experiment 1 investigated the extent to which individuals can accurately report their speech recognition performance and characterize the listening context in controlled environments. Experiment 2 investigated whether the data aggregated across multiple EMA surveys conducted in uncontrolled, real-world environments would reveal a valid pattern that was consistent with the established relationships between speech understanding, hearing aid use, listening context, and lifestyle. Research Design: This is an observational study. Study Sample: Twelve and twenty-seven adults with hearing impairment participated in Experiments 1 and 2, respectively. Data Collection and Analysis: In the laboratory testing of Experiment 1, participants estimated their speech recognition performance in settings wherein the signal-to-noise ratio was fixed or constantly varied across sentences. In the field testing the participants reported the listening context (e.g., noisiness level) of several semicontrolled real-world conversations. Their reports were compared to (1) the context described by normal-hearing observers and (2) the background noise level measured using a sound level meter. In Experiment 2, participants repeatedly reported the degree of speech understanding, hearing aid use, and listening context using paper-and-pencil journals in their natural environments for 1 week. They also carried noise dosimeters to measure the sound level. The associations between (1) speech understanding, hearing aid use, and listening context, (2) dosimeter sound level and self-reported noisiness level, and (3) dosimeter data and lifestyle quantified using the journals were examined. Results: For Experiment 1, the reported and measured speech recognition scores were highly correlated across all test conditions (r = 0.94 to 0.97). The field testing results revealed that most listening context properties reported by the participants were highly consistent with those described by the observers (74–95% consistency), except for noisiness rating (58%). Nevertheless, higher noisiness rating was associated with higher background noise level. For Experiment 2, the EMA results revealed several associations: better speech understanding was associated with the use of hearing aids, front-located speech, and lower dosimeter sound level; higher noisiness rating was associated with higher dosimeter sound level; listeners with more diverse lifestyles tended to have higher dosimeter sound levels. Conclusions: Adults with hearing impairment were able to report their listening experiences, such as speech understanding, and characterize listening context in controlled environments with reasonable accuracy. The pattern of the data aggregated across multiple EMA surveys conducted in a wide range of uncontrolled real-world environment was consistent with the established knowledge in audiology. The two experiments suggested that, regarding speech understanding and related listening contexts, EMA reflects what it is intended to measure, supporting its construct validity in audiology research.


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