Speech Perception In Cochlear Implant Users Research Articles

Sound therapy for cochlear implant users with tinnitus

Objective Despite the positive effect of a cochlear implant (CI) on tinnitus in many patients, tinnitus remains a problem for a significant proportion of CI users. We investigated the acceptability and effect of sound therapy (a combination of natural background sounds and one concise tinnitus counselling session) on tinnitus and speech perception in CI users who still experienced tinnitus during CI use. Design and study sample Thirty-two CI users (32–78 years) participated in phase 1: a test at the clinic to evaluate six background sounds provided by the sound processor. Eighteen out of the 32 CI users participated in phase 2: an optional take-home evaluation of 2 weeks without sound therapy, followed by 5 weeks with sound therapy, ending with an evaluation visit. Results Thirty subjects (93.8%) found at least one background sound acceptable. In phase 2, a small improvement with sound therapy was found for tinnitus loudness, annoyance, and intrusiveness. 50% of the subjects subjectively reported benefit of sound therapy. Especially the sense of control on their tinnitus was highly appreciated. No detrimental effect on speech perception was observed. Conclusion The background sounds were acceptable and provided tinnitus relief in some CI users with tinnitus during CI use.

A Preliminary Study of the Effects of Attentive Music Listening on Cochlear Implant Users' Speech Perception, Quality of Life, and Behavioral and Objective Measures of Frequency Change Detection.

IntroductionMost cochlear implant (CI) users have difficulty in listening tasks that rely strongly on perception of frequency changes (e.g., speech perception in noise, musical melody perception, etc.). Some previous studies using behavioral or subjective assessments have shown that short-term music training can benefit CI users’ perception of music and speech. Electroencephalographic (EEG) recordings may reveal the neural basis for music training benefits in CI users.ObjectiveTo examine the effects of short-term music training on CI hearing outcomes using a comprehensive test battery of subjective evaluation, behavioral tests, and EEG measures.DesignTwelve adult CI users were recruited for a home-based music training program that focused on attentive listening to music genres and materials that have an emphasis on melody. The participants used a music streaming program (i.e., Pandora) downloaded onto personal electronic devices for training. The participants attentively listened to music through a direct audio cable or through Bluetooth streaming. The training schedule was 40 min/session/day, 5 days/week, for either 4 or 8 weeks. The pre-training and post-training tests included: hearing thresholds, Speech, Spatial and Qualities of Hearing Scale (SSQ12) questionnaire, psychoacoustic tests of frequency change detection threshold (FCDT), speech recognition tests (CNC words, AzBio sentences, and QuickSIN), and EEG responses to tones that contained different magnitudes of frequency changes.ResultsAll participants except one finished the 4- or 8-week training, resulting in a dropout rate of 8.33%. Eleven participants performed all tests except for two who did not participate in EEG tests. Results showed a significant improvement in the FCDTs as well as performance on CNC and QuickSIN after training (p < 0.05), but no significant improvement in SSQ scores (p > 0.05). Results of the EEG tests showed larger post-training cortical auditory evoked potentials (CAEPs) in seven of the nine participants, suggesting a better cortical processing of both stimulus onset and within-stimulus frequency changes.ConclusionThese preliminary data suggest that extensive, focused music listening can improve frequency perception and speech perception in CI users. Further studies that include a larger sample size and control groups are warranted to determine the efficacy of short-term music training in CI users.

The role of speech rate for Italian-speaking cochlear implant users: insights for everyday speech perception

This study investigated the effect of speech rate for Italian-speaking cochlear implant (CI) users with the aim of gaining insight into everyday listening situations where speaker’s rate may vary considerably together with speech level in fluctuating background noise. The test material was prepared by processing the Italian STARR test with temporal compression of sentence material. Twelve adult CI users were divided into two subgroups based on their STARR performance: good and poor performers. The effect of varying speech rate was remarkable for both subgroups. Good performers showed significant performance deterioration for the faster speech rate, whereas outcomes for poor performers improved significantly for the slower speech rate. Background noise is inevitable during daily life and CI users face a variety of speakers, so must cope with changes in both speech level and rate. Traditional tests with a single talker speaking very clearly while using a moderate to low speech rate may overestimate everyday speech perception for CI users. The use of tests that mimic everyday perception is of great importance and should become a routine part of audiometric measures for hearing impaired people.

Behavioral Perception and Neural Correlates of Categorical Perception in Cochlear Implant Users

Background and Objectives Although many cochlear implant (CI) recipients receive significant benefits from using the implants, speech perception ability is still known to vary among CI users, and the variability is closely related to the ability of users to process temporal information. As one of the important temporal cues for speech perception in CI users, voice onset time (VOT) can be used to examine behavioral perception and neural correlates of temporal processing. In this study, we measured categorical perception and N1-P2 cortical auditory evoked potentials (CAEPs) using a /ba/-/pa/ VOT continuum in CI users as well as in normal-hearing (NH) listeners. Subjects and Method Ten CI subjects and 11 NH controls participated in syllable identification tasks and in electroencephalography recording. CI subjects were divided into two groups, which were ‘good’ and ‘poor’ performers based on their speech perception scores. The stimuli used in both experiments were a synthetic /ba/-/pa/ VOT continuum. The identification boundary and N1-P2 peak-to-peak amplitude were measured for each subject group. Results Behavioral results revealed that poor CI performers had a delayed identification boundary compared to NH listeners and good CI performers. However, N1-P2 peak-to-peak amplitudes in both good and poor CI performers were significantly smaller than those in NH group. Conclusion N1-P2 amplitudes reflected decreased auditory cortical activity of temporal cues in CI users. The categorical perception of good CI performers was similar to that of NH listeners, whereas their cortical responses were decreased to the level similar to that of poor CI performers. This finding indicates that CAEPs would be more sensitive to altered temporal processing of CI users than to behavioral measures. Key words: Categorical perception ㆍ Cochlear implant ㆍ N1-P2 cortical auditory evoked potentials ㆍ Temporal processing ㆍ Voice onset time

Influence of Telecommunication Modality, Internet Transmission Quality, and Accessories on Speech Perception in Cochlear Implant Users.

BackgroundTelecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users.ObjectiveWe sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions.MethodsTelephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS).ResultsSpeech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001).ConclusionsSkype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality.

Auditory-visual speech perception in normal-hearing and cochlear-implant listeners

The present study evaluated auditory-visual speech perception in cochlear-implant users as well as normal-hearing and simulated-implant controls to delineate relative contributions of sensory experience and cues. Auditory-only, visual-only, or auditory-visual speech perception was examined in the context of categorical perception, in which an animated face mouthing ba, da, or ga was paired with synthesized phonemes from an 11-token auditory continuum. A three-alternative, forced-choice method was used to yield percent identification scores. Normal-hearing listeners showed sharp phoneme boundaries and strong reliance on the auditory cue, whereas actual and simulated implant listeners showed much weaker categorical perception but stronger dependence on the visual cue. The implant users were able to integrate both congruent and incongruent acoustic and optical cues to derive relatively weak but significant auditory-visual integration. This auditory-visual integration was correlated with the duration of the implant experience but not the duration of deafness. Compared with the actual implant performance, acoustic simulations of the cochlear implant could predict the auditory-only performance but not the auditory-visual integration. These results suggest that both altered sensory experience and improvised acoustic cues contribute to the auditory-visual speech perception in cochlear-implant users.