How we do it: adaptation of music instruction for pediatric cochlear implant recipients.
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ABSTRACT:
SUBMITTER: Hsiao FL
PROVIDER: S-EPMC3293458 | biostudies-literature | 2011 Nov
REPOSITORIES: biostudies-literature
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How we do it: adaptation of music instruction for pediatric cochlear implant recipients.
Hsiao Fei-Lin FL Gfeller Kate K
Cochlear implants international 20111101 4
This paper outlines the skills required for participation in structured music programs and possible adaptations to facilitate successful participation by pediatric cochlear implant recipients. Common curricular components that present the structural features of music and the implications for perceptual and music production skills are discussed. A checklist of practical recommendations for clinicians, educators, and parents is provided to ensure success in integrating cochlear implant recipients ...[more]
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Project description:OBJECTIVE:The purpose of this study was to assess barriers to rehabilitation care for pediatric cochlear implant (CI) recipients. STUDY DESIGN:Cross-sectional questionnaire study. SETTING:Tertiary medical center. PATIENTS:Parents of children who received a CI from October 1996 to June 2013. MAIN OUTCOME MEASURE(S):Factors related to access to and barriers in audiology and speech therapy services, factors related to CI use, and performance with CI using the Parents' Evaluation of Aural/Oral Performance of Children (PEACH). RESULTS:Thirty-five parents participated in the study (21 rural residents and 14 urban residents). Distance was a significant barrier to audiology services for rural participants compared with urban participants (p?=?0.01). Consistent CI use was complicated by mechanical complications or malfunction in 70% of rural children compared with 33% of urban children (p?=?0.05). Only 10% of rural children were able to access speech therapy services at diagnosis compared with 42% of urban children (p?=?0.04). Low socioeconomic (SES) status and Medicaid insurance were associated with a lack of local speech therapists and medical/mechanical CI complications. Higher parental educational attainment was associated with higher PEACH scores in quiet conditions compared with families with lower parental education (p?=?0.04). CONCLUSIONS:Rural children are often delayed in receipt of CI rehabilitation services. Multiple barriers including low SES, insurance type, and parental education can affect utilization of these services and may impact the recipient language development. Close follow-up and efforts to expand access to care are needed to maximize CI benefit.
| S-EPMC5940514 | biostudies-literature
Project description:This study examined speech recognition abilities of cochlear implant (CI) recipients in the spectrally complex listening condition of 3 contrasting types of background music, and compared performance based upon listener groups: CI recipients using conventional long-electrode devices, Hybrid CI recipients (acoustic plus electric stimulation), and normal-hearing adults.We tested 154 long-electrode CI recipients using varied devices and strategies, 21 Hybrid CI recipients, and 49 normal-hearing adults on closed-set recognition of spondees presented in 3 contrasting forms of background music (piano solo, large symphony orchestra, vocal solo with small combo accompaniment) in an adaptive test.Signal-to-noise ratio thresholds for speech in music were examined in relation to measures of speech recognition in background noise and multitalker babble, pitch perception, and music experience.The signal-to-noise ratio thresholds for speech in music varied as a function of category of background music, group membership (long-electrode, Hybrid, normal-hearing), and age. The thresholds for speech in background music were significantly correlated with measures of pitch perception and thresholds for speech in background noise; auditory status was an important predictor.Evidence suggests that speech reception thresholds in background music change as a function of listener age (with more advanced age being detrimental), structural characteristics of different types of music, and hearing status (residual hearing). These findings have implications for everyday listening conditions such as communicating in social or commercial situations in which there is background music.
| S-EPMC3686524 | biostudies-literature
Project description:ObjectiveTo investigate the effect of subtotal petrosectomy and mastoid obliteration (SPMO) on the overall success of adult and pediatric cochlear implant (CI) recipients.Study designRetrospective case series.SettingTertiary care referral center.PatientsThirty-nine ears in 36 patients (23 adults and 13 children) received both surgeries between 1990 and 2012.InterventionCI candidates underwent SPMO to permit implantation and minimize the risks of infectious complications in the recipient ear. SPMO was performed before (69.3%), at the time of (25.6%), and after CI (5.13%). Mastoids were obliterated with fat (30.8%), muscle (66.7%), and bone pate (2.56%).Main outcome measureFeasibility, complications, and success of SPMO and CI were assessed with standard statistical analysis and Fisher's exact test with 2-sided p values.ResultsEar disease was definitively managed, and CI was successfully placed in all but one case. Complications including abscess (n = 3), subcutaneous emphysema (n = 1), ear canal granulation formation (n = 1), and electrode extrusion (n = 1) occurred in 15.4% of patients. Predisposing syndromes were present in children more often than adults (43.8% versus 13.0%, p = 0.0598). Adults more often than children had previous mastoid surgery for middle ear disease (30.4% versus 0.0%, p = 0.0288). CIs were placed under local anesthetic and sedation (n= 3) and after radiation treatment for nasopharyngeal cancer (n = 2) in adult ears.ConclusionSPMO is an effective and safe procedure for definitively managing middle ear disease and implanting adult and pediatric CI candidates.
| S-EPMC3830621 | biostudies-literature
Project description:Background:Cochlear implants (CIs), which have been designed primarily to support spoken communication of persons with severe to profound hearing loss, are highly effective in supporting speech perception in quiet listening conditions. CI users as a group achieve significantly poorer perception and appraisal of music, and speech perception is compromised when background music is present, though outcomes vary considerably across recipients. A number of factors have been identified that contribute to variable music listening experiences, but many questions remain, particularly regarding experiences in everyday life from the perspective of CI users. Purpose:The purpose of this study was twofold: The first aim was to explore the perspectives of adult CI recipients regarding two experiences with music in everyday life: purposeful music listening and background music that competes with spoken conversation. The second aim was to develop a framework of everyday music experiences based upon CI perspectives that could inform future rehabilitative practices and research initiatives. Methods:Qualitative and patient-engaged research methodologies were used to emphasize the perspectives of the CI users. Participants included 40 experienced adult CI users ranging in age from 19 to 81 enrolled in 13 CI centers. Participants completed on-line semi-structured open-ended questionnaires regarding purposeful music listening and background music in conjunction with spoken communication. Responses were analyzed using an iterative inductive coding process consistent with grounded theory methodology. The interrelated themes that emerged from the data were then organized into a model synthesizing components from models on music response and self-management for persons with chronic health conditions. Outcomes:Data analyses informed the development of a Dynamic Problem Solving Model for Management of Music Listening Environments adapted from Hill-Briggs (2003) Problem Solving Model of Chronic Illness Self-Management. Key findings were: (1) Music listening is a dynamic, multifaceted experience; satisfactory listening depended upon optimal combinations of factors; (2) Music listening is effortful, but the extent of satisfaction is influenced by expectations and self-management of the situation; (3) CI users have limited access to resources for optimizing music experiences. Many CI users would consider rehabilitation, but level of commitment and priorities differ across CI users.
| S-EPMC6882382 | biostudies-literature
Project description:IntroductionDespite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear.ObjectivesThis investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant.MethodsObservational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1+HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1+CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1+CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis.ResultsCompared to the CI1+HA, CI1+CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio=4.38, 95% confidence interval - 95%=1.07-17.93, p=0.04).ConclusionsThe children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.
| S-EPMC9443016 | biostudies-literature
Project description:PurposeMusic perception is one of the greatest challenges for cochlear implant (CI) users. The aims of this study were: (i) to evaluate the music perception of CI users using the online Meludia music training program as music testing platform, (ii) to compare performance among three age groups, and (iii) to compare CI users with their normal hearing (NH) peers.Methods138 individuals participated, divided between children (6-10 y), adolescents (11-16 y), and adults (≥ 17 y). Five music perception tasks were evaluated: Rhythm, Spatialization, Stable/unstable, Melody, and Density. We also administered the music related quality of life (MuRQoL) questionnaire for adults, and a music questionnaire for pediatric population (6-16 y) (MuQPP).ResultsA significantly higher percentage of the adolescent CI users completed the five tasks compared to the other age groups. Both pediatric and adolescent CI users had similar performance to their NH peers in most categories. On the MuRQoL, adult NH listeners reported more music exposure than CI users (3.8 ± 0.6 vs 3.0 ± 0.6, p < 0.01), but both groups reported similar levels of perceived music importance (3.4 ± 0.7 vs 3.2 ± 1.1, p = 0.340). On the MuQPP, pediatric CI users who scored highly on music perception also had higher reported questionnaire scores (54.2 ± 12.9 vs 40.9 ± 12.1, p = 0.009).ConclusionsMeludia can be used to evaluate music perception and to use for music training in CI users of all ages. Adolescents had the highest performance in most musical tasks. Pediatric CI users were more similar to their NH peers. The importance of music in adult CI users was comparable to their NH peers.
| S-EPMC10796694 | biostudies-literature
Project description:IntroductionCandidacy criteria for cochlear implantation in the United States has expanded to include children with single-sided deafness (SSD) who are at least 5 years of age. Pediatric cochlear implant (CI) users with SSD experience improved speech recognition with increased daily device use. There are few studies that report the hearing hour percentage (HHP) or the incidence of non-use for pediatric CI recipients with SSD. The aim of this study was to investigate factors that impact outcomes in children with SSD who use CIs. A secondary aim was to identify factors that impact daily device use in this population.MethodsA clinical database query revealed 97 pediatric CI recipients with SSD who underwent implantation between 2014 and 2022 and had records of datalogs. The clinical test battery included speech recognition assessment for CNC words with the CI-alone and BKB-SIN with the CI plus the normal-hearing ear (combined condition). The target and masker for the BKB-SIN were presented in collocated and spatially separated conditions to evaluate spatial release from masking (SRM). Linear mixed-effects models evaluated the influence of time since activation, duration of deafness, HHP, and age at activation on performance (CNC and SRM). A separate linear mixed-effects model evaluated the main effects of age at testing, time since activation, duration of deafness, and onset of deafness (stable, progressive, or sudden) on HHP.ResultsLonger time since activation, shorter duration of deafness, and higher HHP were significantly correlated with better CNC word scores. Younger age at device activation was not found to be a significant predictor of CNC outcomes. There was a significant relationship between HHP and SRM, with children who had higher HHP experiencing greater SRM. There was a significant negative correlation between time since activation and age at test with HHP. Children with sudden hearing loss had a higher HHP than children with progressive and congenital hearing losses.ConclusionThe present data presented here do not support a cut-off age or duration of deafness for pediatric cochlear implantation in cases of SSD. Instead, they expand on our understanding of the benefits of CI use in this population by reviewing the factors that influence outcomes in this growing patient population. Higher HHP, or greater percentage of time spent each day using bilateral input, was associated with better outcomes in the CI-alone and in the combined condition. Younger children and those within the first months of use had higher HHP. Clinicians should discuss these factors and how they may influence CI outcomes with potential candidates with SSD and their families. Ongoing work is investigating the long-term outcomes in this patient population, including whether increasing HHP after a period of limited CI use results in improved outcomes.
| S-EPMC10213360 | biostudies-literature
Project description:In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects on speech and music perception, as it remains unclear which approach to music training might be best. The approaches differed in terms of music exercises and social interaction. For the pitch/timbre group, melodic contour identification (MCI) training was performed using computer software. For the music therapy group, training involved face-to-face group exercises (rhythm perception, musical speech perception, music perception, singing, vocal emotion identification, and music improvisation). For the control group, training involved group nonmusic activities (e.g., writing, cooking, and woodworking). Training consisted of weekly 2-hr sessions over a 6-week period. Speech intelligibility in quiet and noise, vocal emotion identification, MCI, and quality of life (QoL) were measured before and after training. The different training approaches appeared to offer different benefits for music and speech perception. Training effects were observed within-domain (better MCI performance for the pitch/timbre group), with little cross-domain transfer of music training (emotion identification significantly improved for the music therapy group). While training had no significant effect on QoL, the music therapy group reported better perceptual skills across training sessions. These results suggest that more extensive and intensive training approaches that combine pitch training with the social aspects of music therapy may further benefit CI users.
| S-EPMC5894911 | biostudies-literature
Project description:Attempts to develop speech enhancement algorithms with improved speech intelligibility for cochlear implant (CI) users have met with limited success. To improve speech enhancement methods for CI users, we propose to perform speech enhancement in a cochlear filter-bank feature space, a feature-set specifically designed for CI users based on CI auditory stimuli. We leverage a convolutional neural network (CNN) to extract both stationary and non-stationary components of environmental acoustics and speech. We propose three CNN architectures: (1) vanilla CNN that directly generates the enhanced signal; (2) spectral-subtraction-style CNN (SS-CNN) that first predicts noise and then generates the enhanced signal by subtracting noise from the noisy signal; (3) Wiener-style CNN (Wiener-CNN) that generates an optimal mask for suppressing noise. An important problem of the proposed networks is that they introduce considerable delays, which limits their real-time application for CI users. To address this, this study also considers causal variations of these networks. Our experiments show that the proposed networks (both causal and non-causal forms) achieve significant improvement over existing baseline systems. We also found that causal Wiener-CNN outperforms other networks, and leads to the best overall envelope coefficient measure (ECM). The proposed algorithms represent a viable option for implementation on the CCi-MOBILE research platform as a pre-processor for CI users in naturalistic environments.
| S-EPMC8296973 | biostudies-literature
Project description:The objectives were to evaluate the relationships among music perception, appraisal, and experience in cochlear implant users in multiple clinical settings and to examine the viability of two assessments designed for clinical use.Background questionnaires (IMBQ) were administered by audiologists in 14 clinics in the United States and Canada. The CAMP included tests of pitch-direction discrimination, and melody and timbre recognition. The IMBQ queried users on prior musical involvement, music listening habits pre and post implant, and music appraisals.One-hundred forty-five users of Advanced Bionics and Cochlear Ltd cochlear implants.Performance on pitch direction discrimination, melody recognition, and timbre recognition tests were consistent with previous studies with smaller cohorts, as well as with more extensive protocols conducted in other centers. Relationships between perceptual accuracy and music enjoyment were weak, suggesting that perception and appraisal are relatively independent for CI users.Perceptual abilities as measured by the CAMP had little to no relationship with music appraisals and little relationship with musical experience. The CAMP and IMBQ are feasible for routine clinical use, providing results consistent with previous thorough laboratory-based investigations.
| S-EPMC4297259 | biostudies-literature