Dataset Information

Adult Cochlear Implant Recipients' Perspectives on Experiences With Music in Everyday Life: A Multifaceted and Dynamic Phenomenon.

ABSTRACT: 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.

SUBMITTER: Gfeller K

PROVIDER: S-EPMC6882382 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Adult Cochlear Implant Recipients' Perspectives on Experiences With Music in Everyday Life: A Multifaceted and Dynamic Phenomenon.

Gfeller Kate K Driscoll Virginia V Schwalje Adam A

Frontiers in neuroscience 20191121

<h4>Background</h4>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 co ...[more]

PMID: 31824240

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Project description:BackgroundCochlear implants (CIs) are auditory prostheses designed to support spoken communication in persons with severe to profound hearing loss. Many post-lingually deaf adult CI users achieve good speech recognition in quiet; unfortunately, CI technology conveys a degraded representation of pitch and timbre, essential components of music. Not surprisingly, most CI users achieve significantly poorer perception and enjoyment of music compared with normal hearing listeners. Anecdotal evidence indicates that this impacts music engagement, particularly singing and playing instruments requiring ongoing tuning to external pitches or producing intervallic ratios. Interestingly, a small cohort of adult CI users has shown remarkable success in recovering or developing musical skills, but their success is poorly understood. Greater understanding of their efforts and attitudes may suggest potential rehabilitative approaches for other CI users.PurposeThis article documented personal characteristics and experiences perceived to contribute to high level musicianship. Research questions included: (1) What forms of practice/experience have most contributed to (re)establishing satisfying music making? (2) What situations or musical tasks are most frustrating or challenging? (3) What attitudes, motivational factors, or forms of support help CI users persist in working toward improved music engagement?MethodsQualitative and patient-engaged research methodologies were used. Our study involved a unique collaboration of six CI users engaged in high levels of musicianship and a researcher whose scholarship focuses on music and CIs. The CI recipients conveyed their experiences and attitudes regarding music and CIs through open-ended narratives. These narratives were analyzed using an integrative approach of inductive and deductive coding methods. The codes and themes that emerged through inductive methods were then organized within the Dynamic Problem Solving Model for Management of Music Listening Environments (Gfeller et al., 2019a).OutcomesThis paper provides reflections of six CI users who successfully engage in active music making, including on-going tuning to external pitches and ensemble participation. Their perspectives emphasize the importance of pre-CI music instruction, extensive practice and immersion in music listening and playing, persistence and self-efficacy, and problem solving skills that optimize music engagement, and suggest possible strategies useful to other CI users interested in improving music experiences.

Project description:BACKGROUND:Current measures used to determine sentence recognition abilities in cochlear implant recipients often include tests with one talker and one rate of speech. Performance with these measures may not accurately represent the speech recognition abilities of the listeners. Evaluation of cochlear implant performance should include measures that reflect realistic listening conditions. For example, the use of multiple talkers who vary in gender, rate of speech, and regional dialects represent varied communication interactions that people encounter daily. The TIMIT sentences, which use multiple talkers and incorporate these variations, provide additional test material for evaluating speech recognition. Dorman and colleagues created 34 lists of TIMIT sentences that were normalized for equal intelligibility using simulations of cochlear implant processing with normal-hearing listeners. Adults with sensorineural hearing loss who listen with cochlear implants represent a different population. Further study is needed to determine if these lists are equivalent for adult cochlear implant recipients and, if not, to identify a subset of lists that may be used with this population. PURPOSE:To evaluate the speech recognition equivalence of 34 TIMIT sentence lists with adult cochlear implant recipients. RESEARCH DESIGN:A prospective study comparing test-retest results within the same group of listeners. STUDY SAMPLE:Twenty-two adult cochlear implant recipients who met the inclusion criteria of at least 3 mo device use and a monosyllabic word score of 30% or greater participated in the study. DATA COLLECTION AND ANALYSIS:Participants were administered 34 TIMIT sentence lists (20 sentences per list) at each of two test sessions several months apart. List order was randomized and results scored as percent of words correct. Test-retest correlations and 95% confidence intervals for the means were used to identify equivalent lists with high test-retest reliability. RESULTS:Mean list scores across participants ranged from 66 to 81% with an overall mean of 73%. Twenty-nine lists had high test-retest reliability. Using the overall mean as a benchmark, the 95% confidence intervals indicated that 25 of the remaining 29 lists were equivalent (e.g., the benchmark of 73% fell within the 95% confidence interval for both test and retest). CONCLUSIONS:Twenty-five of the TIMIT lists evaluated are equivalent when used with adult cochlear implant recipients who have open-set word recognition abilities. These lists may prove valuable for monitoring progress, comparing listening conditions or treatments, and developing aural rehabilitation plans for cochlear implant recipients.

Dataset Information

Adult Cochlear Implant Recipients' Perspectives on Experiences With Music in Everyday Life: A Multifaceted and Dynamic Phenomenon.

Publications

Adult Cochlear Implant Recipients' Perspectives on Experiences With Music in Everyday Life: A Multifaceted and Dynamic Phenomenon.

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