Recognition of Speech Presented at Soft to Loud Levels by Adult Cochlear Implant Recipients of Three Cochlear Implant Systems

Firszt, Jill B.; Holden, Laura K.; Skinner, Margaret W.; Tobey, Emily A.; Peterson, AM; Gaggl, Wolfgang; Runge-Samuelson, Christina L.; Wackym, Phillip A.

doi:10.1097/01.aud.0000134552.22205.ee

Cited by 269 publications

(234 citation statements)

References 16 publications

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“…NIH-PA Author Manuscript NIH-PA Author Manuscript has been quite successful in providing reasonably good speech understanding in quiet, adult users often experience increased difficulty understanding speech in a noisy environment (e.g., Fetterman & Domico, 2002;Firszt, Holden, Skinner, et al, 2004), and they are placed at a distinct disadvantage when sound is coming from the direction of their nonimplanted ear.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Simultaneous Bilateral Cochlear Implantation in Adults: A Multicenter Clinical Study

Litovsky¹,

Parkinson²,

Arcaroli³

et al. 2006

Ear and Hearing

282

304

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Objective-To determine the efficacy of "simultaneous" bilateral cochlear implantation (both implants placed during a single surgical procedure) by comparing bilateral and unilateral implant use in a large number of adult subjects tested at multiple sites.Design-Prospective study of 37 adults with postlinguistic onset of bilateral, severe to profound sensorineural hearing loss. Performance with the bilateral cochlear implants, using the same speech processor type and speech processing strategy, was compared with performance using the left implant alone and the right implant alone. Speech understanding in quiet (CNCs and HINT sentences) and in noise (BKB-SIN Test) were evaluated at several postactivation time intervals, with speech presented at 0° azimuth, and noise at either 0°, 90° right, or 90° left in the horizontal plane. APHAB questionnaire data were collected after each subject underwent a 3-wk "bilateral deprivation" period, during which they wore only the speech processor that produced the best score during unilateral testing, and also after a period of listening again with the bilateral implants.Results-By 6-mo postactivation, a significant advantage for speech understanding in quiet was found in the bilateral listening mode compared with either unilateral listening modes. For speech understanding in noise, the largest and most robust bilateral benefit was when the subject was able to take advantage of the head shadow effect; i.e., results were significantly better for bilateral listening compared with the unilateral condition when the ear opposite to the side of the noise was added to create the bilateral condition. This bilateral benefit was seen on at least one of the two unilateral ear comparisons for nearly all (32/34) subjects. Bilateral benefit was also found for a few subjects in spatial configurations that evaluated binaural redundancy and binaural squelch effects. A subgroup of subjects who had asymmetrical unilateral implant performances were, overall, similar in performance to subjects with symmetrical hearing. The questionnaire data indicated that bilateral users perceive their own performance to be better with bilateral cochlear implants than when using a single device.Conclusions-Findings with a large patient group are in agreement with previous reports on smaller groups, showing that, overall, bilateral implantation offers the majority of patients advantages when listening in simulated adverse conditions. Persons with bilateral severe to profound sensorineural hearing loss have traditionally received a single cochlear implant. To date, health care professionals have recommended unilateral, rather than bilateral, cochlear implant fittings for these patients for several reasons, including: 1) cost/reimbursement issues, 2) preservation of one ear for future technologies, 3) additional risk of two, or extended, surgeries, and 4) lack of sufficient objective and/or subjective evidence documenting bilateral cochlear implant benefit. Although unilateral use of cochlear implants NIH-PA A...

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Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Simultaneous Bilateral Cochlear Implantation in Adults: A Multicenter Clinical Study

Litovsky¹,

Parkinson²,

Arcaroli³

et al. 2006

Ear and Hearing

282

304

View full text Add to dashboard Cite

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“…Aided soundfield thresholds are used to verify that the CI provides access to soft-level speech inputs across the frequency range from 250 to 4000 Hz, and lower or better aided thresholds have been associated with better speech perception at soft and conversational levels without detrimental effects on speech perception in noise (Davidson, Geers, Blamey, Tobey, & Brenner, 2011;Davidson, Skinner, Holstad, et al 2009;Firszt et al, 2004). Aided thresholds that approximate 20 dB HL (250-4000 Hz) have been associated with better speech perception scores for adults (Holden et al, 2013) and better speech perception, novel word learning, and ultimately vocabulary level for children (Davidson, Geers, & Nicholas, 2014).…”

Section: Predicting Language Delay In Children With Cismentioning

confidence: 99%

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

Geers

Nicholas

Tobey

et al. 2016

J Speech Lang Hear Res

113

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Purpose: The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation. Materials and Method: Children receiving unilateral CIs at young ages (12-38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined.Results: Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy. Conclusion: CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes.

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“…Modern devices provide relatively coarse representations of spectral information, which are adequate for perceiving speech in ideal listening conditions (Shannon, Zeng, Kamath, Wygonski & Ekelid, 1995;Wilson, 2000), but they are inadequate for perceiving speech in noise (Fetterman & Domico, 2002;Firszt et al, 2004), identifying emotion from speech prosody (Hopyan-Misakyan, Gordon, Dennis & Papsin, 2009;Meister, Landwehr, Pyschny, Walger & Von Wedel, 2009), differentiating one speaker from another (Meister et al, 2009), identifying musical timbres or instruments , and recognizing melodies from pitch cues alone (Kang et al, 2009;Kong, Cruz, Ackland-Jones & Zeng, 2004). …”

Section: Introductionmentioning

confidence: 99%

Prosody perception and musical pitch discrimination in adults using cochlear implants

Kalathottukaren

Purdy

Ballard

2015

International Journal of Audiology

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Cochlear implants (CIs) provide coarse representations of pitch, which are adequate for speech but not for music. Despite increasing interest in music processing by CI users, the available information is fragmentary. The present experiment attempted to fill this void by conducting a comprehensive assessment of music processing in adult CI users. CI users (n =6) and normally hearing (NH) controls (n = 12) were tested on several tasks involving melody and rhythm perception, recognition of familiar music, and emotion of recognition in speech and music. CI performance was substantially poorer than NH performance and at chance levels on pitch processing tasks. Performance was highly variable, however, with one individual achieving NH performance levels on some tasks, probably because of low-frequency residual hearing in his unimplanted ear. Future research with a larger sample of CI users can shed light on factors associated with good and poor music processing in this population.iii

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Recognition of Speech Presented at Soft to Loud Levels by Adult Cochlear Implant Recipients of Three Cochlear Implant Systems

Cited by 269 publications

References 16 publications

Simultaneous Bilateral Cochlear Implantation in Adults: A Multicenter Clinical Study

Simultaneous Bilateral Cochlear Implantation in Adults: A Multicenter Clinical Study

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

Prosody perception and musical pitch discrimination in adults using cochlear implants

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