This study examined how prelingually deafened children with cochlear implants combine visual information from lipreading with auditory cues in an open-set speech perception task. A secondary aim was to examine lexical effects on the recognition of words in isolation and in sentences. Fifteen children with cochlear implants served as participants in this study. Participants were administered two tests of spoken word recognition. The LNT assessed isolated word recognition in an auditory-only format. The AV-LNST assessed recognition of key words in sentences in a visual-only, auditory-only and audiovisual presentation format. On each test, lexical characteristics of the stimulus items were controlled to assess the effects of lexical competition. The children also were administered a test of receptive vocabulary knowledge. The results revealed that recognition of key words was significantly influenced by presentation format. Audiovisual speech perception was best, followed by auditory-only and visual-only presentation, respectively. Lexical effects on spoken word recognition were evident for isolated words, but not when words were presented in sentences. Finally, there was a significant relationship between auditory-only and audiovisual word recognition and language knowledge. The results demonstrate that children with cochlear implants obtain significant benefit from audiovisual speech integration, and suggest such tests should be included in test batteries intended to evaluate cochlear implant outcomes.
hearing impairment; speech perception; assessment; cochlear implant
Although there has been a great deal of recent empirical work and new theoretical interest in audiovisual speech perception in both normal-hearing and hearing-impaired adults, relatively little is known about the development of these abilities and skills in deaf children with cochlear implants. This study examined how prelingually deafened children combine visual information available in the talker’s face with auditory speech cues provided by their cochlear implants to enhance spoken language comprehension.
Twenty-seven hearing-impaired children who use cochlear implants identified spoken sentences presented under auditory-alone and audiovisual conditions. Five additional measures of spoken word recognition performance were used to assess auditory-alone speech perception skills. A measure of speech intelligibility was also obtained to assess the speech production abilities of these children.
A measure of audiovisual gain, “Ra,” was computed using sentence recognition scores in auditory-alone and audiovisual conditions. Another measure of audiovisual gain, “Rv,” was computed using scores in visual-alone and audiovisual conditions. The results indicated that children who were better at recognizing isolated spoken words through listening alone were also better at combining the complementary sensory information about speech articulation available under audiovisual stimulation. In addition, we found that children who received more benefit from audiovisual presentation also produced more intelligible speech, suggesting a close link between speech perception and production and a common underlying linguistic basis for audiovisual enhancement effects. Finally, an examination of the distribution of children enrolled in Oral Communication (OC) and Total Communication (TC) indicated that OC children tended to score higher on measures of audiovisual gain, spoken word recognition, and speech intelligibility.
The relationships observed between auditory-alone speech perception, audiovisual benefit, and speech intelligibility indicate that these abilities are not based on independent language skills, but instead reflect a common source of linguistic knowledge, used in both perception and production, that is based on the dynamic, articulatory motions of the vocal tract. The effects of communication mode demonstrate the important contribution of early sensory experience to perceptual development, specifically, language acquisition and the use of phonological processing skills. Intervention and treatment programs that aim to increase receptive and productive spoken language skills, therefore, may wish to emphasize the inherent cross-correlations that exist between auditory and visual sources of information in speech perception.
The present study examined how postlingually deafened adults with cochlear implants combine visual information from lipreading with auditory cues in an open-set word recognition task. Adults with normal hearing served as a comparison group. Word recognition performance was assessed using lexically controlled word lists presented under auditory-only, visual-only, and combined audiovisual presentation formats. Effects of talker variability were studied by manipulating the number of talkers producing the stimulus tokens. Lexical competition was investigated using sets of lexically easy and lexically hard test words. To assess the degree of audiovisual integration, a measure of visual enhancement, Ra, was used to assess the gain in performance provided in the audiovisual presentation format relative to the maximum possible performance obtainable in the auditory-only format. Results showed that word recognition performance was highest for audiovisual presentation followed by auditory-only and then visual-only stimulus presentation. Performance was better for single-talker lists than for multiple-talker lists, particularly under the audiovisual presentation format. Word recognition performance was better for the lexically easy than for the lexically hard words regardless of presentation format. Visual enhancement scores were higher for single-talker conditions compared to multiple-talker conditions and tended to be somewhat better for lexically easy words than for lexically hard words. The pattern of results suggests that information from the auditory and visual modalities is used to access common, multimodal lexical representations in memory. The findings are discussed in terms of the complementary nature of auditory and visual sources of information that specify the same underlying gestures and articulatory events in speech.
cochlear implants; hearing impairment; speech perception; audiovisual
The present study investigated the development of audiovisual speech perception skills in children who are prelingually deaf and received cochlear implants. We analyzed results from the Pediatric Speech Intelligibility (Jerger, Lewis, Hawkins, & Jerger, 1980) test of audiovisual spoken word and sentence recognition skills obtained from a large group of young children with cochlear implants enrolled in a longitudinal study, from pre-implantation to 3 years post-implantation. The results revealed better performance under the audiovisual presentation condition compared with auditory-alone and visual-alone conditions. Performance in all three conditions improved over time following implantation. The results also revealed differential effects of early sensory and linguistic experience. Children from oral communication (OC) education backgrounds performed better overall than children from total communication (TC backgrounds. Finally, children in the early-implanted group performed better than children in the late-implanted group in the auditory-alone presentation condition after 2 years of cochlear implant use, whereas children in the late-implanted group performed better than children in the early-implanted group in the visual-alone condition. The results of the present study suggest that measures of audiovisual speech perception may provide new methods to assess hearing, speech, and language development in young children with cochlear implants.
Despite excellent performance in speech recognition in quiet, most cochlear implant users have great difficulty with speech recognition in noise, music perception, identifying tone of voice, and discriminating different talkers. This may be partly due to the pitch coding in cochlear implant speech processing. Most current speech processing strategies use only the envelope information; the temporal fine structure is discarded. One way to improve electric pitch perception is to utilize residual acoustic hearing via a hearing aid on the non-implanted ear (bimodal hearing). This study aimed to test the hypothesis that bimodal users would perform better than bilateral cochlear implant users on tasks requiring good pitch perception.
Four pitch-related tasks were used:
Hearing in Noise Test (HINT) sentences spoken by a male talker with a competing female, male, or child talker.
Montreal Battery of Evaluation of Amusia. This is a music test with six subtests examining pitch, rhythm and timing perception, and musical memory.
Aprosodia Battery. This has five subtests evaluating aspects of affective prosody and recognition of sarcasm.
Talker identification using vowels spoken by ten different talkers (three male, three female, two boys, and two girls).
Bilateral cochlear implant users were chosen as the comparison group. Thirteen bimodal and thirteen bilateral adult cochlear implant users were recruited; all had good speech perception in quiet.
There were no significant differences between the mean scores of the bimodal and bilateral groups on any of the tests, although the bimodal group did perform better than the bilateral group on almost all tests. Performance on the different pitch-related tasks was not correlated, meaning that if a subject performed one task well they would not necessarily perform well on another. The correlation between the bimodal users' hearing threshold levels in the aided ear and their performance on these tasks was weak.
Although the bimodal cochlear implant group performed better than the bilateral group on most parts of the four pitch-related tests, the differences were not statistically significant. The lack of correlation between test results shows that the tasks used are not simply providing a measure of pitch ability. Even if the bimodal users have better pitch perception, the real-world tasks used are reflecting more diverse skills than pitch. This research adds to the existing speech perception, language, and localization studies that show no significant difference between bimodal and bilateral cochlear implant users.
cochlear implants; bimodal; bilateral
This study evaluated the maximal attainable performance of speech enhancement strategies based on coherent modulation filtering. An optimal adaptive coherent modulation filtering algorithm was designed to enhance known signals from a target talker in two-talker babble noise. The algorithm was evaluated in a closed-set, speech-recognition-in-noise task. The speech reception threshold (SRT) was measured using a one-down, one-up adaptive procedure. Five hearing-impaired subjects and five cochlear implant users were tested in three processing conditions: (1) original sounds; (2) fixed coherent modulation filtered sounds; and (3) optimal coherent modulation filtered sounds. Six normal-hearing subjects were tested with a 6-channel cochlear implant simulation of sounds processed in the same three conditions. Significant improvements in SRTs were observed when the signal was processed with the optimal coherent modulation filtering algorithm. There was no benefit when the signal was processed with the fixed modulation filter. The current study suggested that coherent modulation filtering might be a promising method for front-end processing in hearing aids and cochlear implants. An approach such as hidden Markov models could be used to generalize the optimal coherent modulation filtering algorithm to unknown utterances and to extend it to open-set speech.
Coherent modulation filter; speech enhancement; hearing aids; cochlear implants
The objective of this study was to assess whether training on speech processed with an 8-channel noise vocoder to simulate the output of a cochlear implant would produce transfer of auditory perceptual learning to the recognition of non-speech environmental sounds, the identification of speaker gender, and the discrimination of talkers by voice.
Twenty-four normal hearing subjects were trained to transcribe meaningful English sentences processed with a noise vocoder simulation of a cochlear implant. An additional twenty-four subjects served as an untrained control group and transcribed the same sentences in their unprocessed form. All subjects completed pre- and posttest sessions in which they transcribed vocoded sentences to provide an assessment of training efficacy. Transfer of perceptual learning was assessed using a series of closed-set, nonlinguistic tasks: subjects identified talker gender, discriminated the identity of pairs of talkers, and identified ecologically significant environmental sounds from a closed set of alternatives.
Although both groups of subjects showed significant pre- to posttest improvements, subjects who transcribed vocoded sentences during training performed significantly better at posttest than subjects in the control group. Both groups performed equally well on gender identification and talker discrimination. Subjects who received explicit training on the vocoded sentences, however, performed significantly better on environmental sound identification than the untrained subjects. Moreover, across both groups, pretest speech performance, and to a higher degree posttest speech performance, were significantly correlated with environmental sound identification. For both groups, environmental sounds that were characterized as having more salient temporal information were identified more often than environmental sounds that were characterized as having more salient spectral information.
Listeners trained to identify noise-vocoded sentences showed evidence of transfer of perceptual learning to the identification of environmental sounds. In addition, the correlation between environmental sound identification and sentence transcription indicates that subjects who were better able to utilize the degraded acoustic information to identify the environmental sounds were also better able to transcribe the linguistic content of novel sentences. Both trained and untrained groups performed equally well (~75% correct) on the gender identification task, indicating that training did not have an effect on the ability to identify the gender of talkers. Although better than chance, performance on the talker discrimination task was poor overall (~55%), suggesting that either explicit training is required to reliably discriminate talkers’ voices, or that additional information (perhaps spectral in nature) not present in the vocoded speech is required to excel in such tasks. Taken together, the results suggest that while transfer of auditory perceptual learning with spectrally degraded speech does occur, explicit task-specific training may be necessary for tasks that cannot rely on temporal information alone.
Acoustic simulations; Cochlear implants; Noise vocoder; Speech perception; Gender identification; Environmental sound identification; Talker discrimination
This study examined the speech perception skills of a younger and older group of cochlear implant recipients to determine the benefit that auditory and visual information provides for speech understanding.
Pre- and postimplantation speech perception scores from the Consonant-Nucleus-Consonant (CNC), the Hearing In Noise sentence Test (HINT), and the City University of New York (CUNY) tests were analyzed for 34 postlingually deafened adult cochlear implant recipients. Half were elderly (i.e., >65 y old) and other half were middle aged (i.e., 39–53 y old). The CNC and HINT tests were administered using auditory-only presentation; the CUNY test was administered using auditory-only, vision-only, and audiovisual presentation conditions
No differences were observed between the two age groups on the CNC and HINT tests. For a subset of individuals tested with the CUNY sentences, we found that the preimplantation speechreading scores of the younger group correlated negatively with auditory-only postimplant performance. Additionally, older individuals demonstrated a greater reliance on the integration of auditory and visual information to understand sentences than did the younger group
On average, the auditory-only speech perception performance of older cochlear implant recipients was similar to the performance of younger adults. However, variability in speech perception abilities was observed within and between both age groups. Differences in speechreading skills between the younger and older individuals suggest that visual speech information is processed in a different manner for elderly individuals than it is for younger adult cochlear implant recipients.
Cochlear implant; speech perception; aging
Studies using vocoders as acoustic simulators of cochlear implants have generally focused on simulation of speech understanding, gender recognition, or music appreciation. The aim of the present experiment was to study the auditory sensation perceived by cochlear implant (CI) recipients with steady electrical stimulation on the most-apical electrode.
Five unilateral CI users with contralateral residual hearing were asked to vary the parameters of an acoustic signal played to the non-implanted ear, in order to match its sensation to that of the electric stimulus. They also provided a rating of similarity between each acoustic sound they selected and the electric stimulus. On average across subjects, the sound rated as most similar was a complex signal with a concentration of energy around 523 Hz. This sound was inharmonic in 3 out of 5 subjects with a moderate, progressive increase in the spacing between the frequency components.
For these subjects, the sound sensation created by steady electric stimulation on the most-apical electrode was neither a white noise nor a pure tone, but a complex signal with a progressive increase in the spacing between the frequency components in 3 out of 5 subjects. Knowing whether the inharmonic nature of the sound was related to the fact that the non-implanted ear was impaired has to be explored in single-sided deafened patients with a contralateral CI. These results may be used in the future to better understand peripheral and central auditory processing in relation to cochlear implants.
The present study investigated the development of audiovisual comprehension skills in prelingually deaf children who received cochlear implants.
We analyzed results obtained with the Common Phrases (Robbins et al., 1995) test of sentence comprehension from 80 prelingually deaf children with cochlear implants who were enrolled in a longitudinal study, from pre-implantation to 5 years after implantation.
The results revealed that prelingually deaf children with cochlear implants performed better under audiovisual (AV) presentation compared with auditory-alone (A-alone) or visual-alone (V-alone) conditions. AV sentence comprehension skills were found to be strongly correlated with several clinical outcome measures of speech perception, speech intelligibility, and language. Finally, pre-implantation V-alone performance on the Common Phrases test was strongly correlated with 3-year postimplantation performance on clinical outcome measures of speech perception, speech intelligibility, and language skills.
The results suggest that lipreading skills and AV speech perception reflect a common source of variance associated with the development of phonological processing skills that is shared among a wide range of speech and language outcome measures.
An error analysis of the word recognition responses of cochlear implant users and listeners with normal hearing was conducted to determine the types of partial information used by these two populations when they identified spoken words under auditory-alone and audiovisual conditions. The results revealed that the two groups used different types of partial information in identifying spoken words under auditory-alone or audiovisual presentation. Different types of partial information were also used in identifying words with different lexical properties. In our study, however, there were no significant interactions with hearing status, indicating that cochlear implant users and listeners with normal hearing identify spoken words in a similar manner. The information available to users with cochlear implants preserves much of the partial information necessary for accurate spoken word recognition.
In contrast with for example audiovisual speech, the relation between visual and auditory properties of letters and speech sounds is artificial and learned only by explicit instruction. The arbitrariness of the audiovisual link together with the widespread usage of letter–speech sound pairs in alphabetic languages makes those audiovisual objects a unique subject for crossmodal research. Brain imaging evidence has indicated that heteromodal areas in superior temporal, as well as modality-specific auditory cortex are involved in letter–speech sound processing. The role of low level visual areas, however, remains unclear. In this study the visual counterpart of the auditory mismatch negativity (MMN) is used to investigate the influences of speech sounds on letter processing. Letter and non-letter deviants were infrequently presented in a train of standard letters, either in isolation or simultaneously with speech sounds. Although previous findings showed that letters systematically modulate speech sound processing (reflected by auditory MMN amplitude modulation), the reverse does not seem to hold: our results did not show evidence for an automatic influence of speech sounds on letter processing (no visual MMN amplitude modulation). This apparent asymmetric recruitment of low level sensory cortices during letter–speech sound processing, contrasts with the symmetric involvement of these cortices in audiovisual speech processing, and is possibly due to the arbitrary nature of the link between letters and speech sounds.
visual mismatch negativity; audiovisual processing; time course; automaticity; crossmodal influence; letter–speech sound pairs
Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant patients. Cochlear implantation alone may not fully meet the needs of many patients, and additional auditory rehabilitation may be necessary to maximize the benefits of the implant device. A recently developed computer-assisted speech-training program provides cochlear implant patients with the means to conduct auditory rehabilitation at home. The training software targets important acoustic contrasts between speech stimuli and provides auditory and visual feedback as well as progressive training, thereby maintaining patients’ interest in the auditory training exercises. Recent scientific studies have demonstrated the effectiveness of such specialized auditory training programs in improving cochlear implant patients’ speech recognition performance. Provided with an inexpensive and accessible auditory training program, cochlear implant patients may find the motivation and momentum to get the most from the implant device.
Auditory training; Cochlear implants; Computer-assisted speech training
Cochlear implant microphones differ in placement, frequency response, and other characteristics such as whether they are directional. Although normal hearing individuals are often used as controls in studies examining cochlear implant users’ binaural benefits, the considerable differences across cochlear implant microphones make such comparisons potentially misleading. The goal of this study was to examine binaural benefits for speech perception in noise for normal hearing individuals using stimuli processed by head-related transfer functions (HRTFs) based on the different cochlear implant microphones.
HRTFs were created for different cochlear implant microphones and used to test participants on the Hearing in Noise Test. Experiment 1 tested cochlear implant users and normal hearing individuals with HRTF-processed stimuli and with sound field testing to determine whether the HRTFs adequately simulated sound field testing. Experiment 2 determined the measurement error and performance-intensity function for the Hearing in Noise Test with normal hearing individuals listening to stimuli processed with the various HRTFs. Experiment 3 compared normal hearing listeners’ performance across HRTFs to determine how the HRTFs affected performance. Experiment 4 evaluated binaural benefits for normal hearing listeners using the various HRTFs, including ones that were modified to investigate the contributions of interaural time and level cues.
The results indicated that the HRTFs adequately simulated sound field testing for the Hearing in Noise Test. They also demonstrated that the test-retest reliability and performance-intensity function were consistent across HRTFs, and that the measurement error for the test was 1.3 dB, with a change in signal-to-noise ratio of 1 dB reflecting a 10% change in intelligibility. There were significant differences in performance when using the various HRTFs, with particularly good thresholds for the HRTF based on the directional microphone when the speech and masker were spatially separated, emphasizing the importance of measuring binaural benefits separately for each HRTF. Evaluation of binaural benefits indicated that binaural squelch and spatial release from masking were found for all HRTFs and binaural summation was found for all but one HRTF, although binaural summation was less robust than the other types of binaural benefits. Additionally, the results indicated that neither interaural time nor level cues dominated binaural benefits for the normal hearing participants.
This study provides a means to measure the degree to which cochlear implant microphones affect acoustic hearing with respect to speech perception in noise. It also provides measures that can be used to evaluate the independent contributions of interaural time and level cues. These measures provide tools that can aid researchers in understanding and improving binaural benefits in acoustic hearing individuals listening via cochlear implant microphones.
Hearing in Noise Test; cochlear implant; binaural benefits
To restore hearing sensation, cochlear implants deliver electrical pulses to the auditory nerve by relying on sophisticated signal processing algorithms that convert acoustic inputs to electrical stimuli. Although individuals fitted with cochlear implants perform well in quiet, in the presence of background noise, the speech intelligibility of cochlear implant listeners is more susceptible to background noise than that of normal hearing listeners. Traditionally, to increase performance in noise, single-microphone noise reduction strategies have been used. More recently, a number of approaches have suggested that speech intelligibility in noise can be improved further by making use of two or more microphones, instead. Processing strategies based on multiple microphones can better exploit the spatial diversity of speech and noise because such strategies rely mostly on spatial information about the relative position of competing sound sources. In this article, we identify and elucidate the most significant theoretical aspects that underpin single- and multi-microphone noise reduction strategies for cochlear implants. More analytically, we focus on strategies of both types that have been shown to be promising for use in current-generation implant devices. We present data from past and more recent studies, and furthermore we outline the direction that future research in the area of noise reduction for cochlear implants could follow.
cochlear implants; single-microphone noise reduction; multi-microphone noise reduction
The latest-generation cochlear implant devices provide many deaf patients with good speech recognition in quiet listening conditions. However, speech recognition deteriorates rapidly as the level of background noise increases. Previous studies have shown that, for cochlear implant users, the absence of fine spectro-temporal cues may contribute to poorer performance in noise, especially when the noise is dynamic (e.g., competing speaker or modulated noise). Here we report on sentence recognition by cochlear implant users and by normal-hearing subjects listening to an acoustic simulation of a cochlear implant, in the presence of steady or square-wave modulated speech-shaped noise. Implant users were tested using their everyday, clinically assigned speech processors. In the acoustic simulation, normal-hearing listeners were tested for different degrees of spectral resolution (16, eight, or four channels) and spectral smearing (carrier filter slopes of −24 or −6 dB/octave). For modulated noise, normal-hearing listeners experienced significant release from masking when the original, unprocessed speech was presented (which preserved the spectro-temporal fine structure), while cochlear implant users experienced no release from masking. As the spectral resolution was reduced, normal-hearing listeners’ release from masking gradually diminished. Release from masking was further reduced as the degree of spectral smearing increased. Interestingly, the mean speech recognition thresholds of implant users were very close to those of normal-hearing subjects listening to four-channel spectrally smeared noise-band speech. Also, the best cochlear implant listeners performed like normal-hearing subjects listening to eight- to 16-channel spectrally smeared noise-band speech. These findings suggest that implant users’ susceptibility to noise may be caused by the reduced spectral resolution and the high degree of spectral smearing associated with channel interaction. Efforts to improve the effective number of spectral channels as well as reduce channel interactions may improve implant performance in noise, especially for temporally modulated noise.
noise susceptibility; cochlear implants; spectral resolution; spectral smearing; gated noise
The Mismatch Negativity component of the auditory event-related brain potentials can be used as a probe to study the representation of sounds in Auditory Sensory Memory (ASM). Yet, it has been shown that an auditory MMN can also be elicited by an illusory auditory deviance induced by visual changes. This suggests that some visual information may be encoded in ASM and is accessible to the auditory MMN process. However, it is not known whether visual information influences ASM representation for any audiovisual event or whether this phenomenon is limited to specific domains in which strong audiovisual illusions occur. To highlight this issue, we have compared the topographies of MMNs elicited by non-speech audiovisual stimuli deviating from audiovisual standards on the visual, the auditory or both dimensions. Contrary to what occurs with audiovisual illusions, each unimodal deviants elicited sensory-specific MMNs and the MMN to audiovisual deviants included both sensory components. The visual MMN was however different from a genuine visual MMN obtained in a visual-only control oddbbal paradigm, suggesting that auditory and visual information interacts before the MMN process occurs. Furthermore, the MMN to audiovisual deviants was significantly different from the sum of the two sensory-specific MMNs, showing that the processes of visual and auditory change detection are not completely independent.
Acoustic Stimulation; Adult; Attention; physiology; Auditory Perception; physiology; Electroencephalography; Evoked Potentials, Auditory; physiology; Evoked Potentials, Visual; physiology; Female; Humans; Male; Memory; physiology; Photic Stimulation; Visual Perception; physiology; Mismatch Negativity; Multisensory Integration; Sensory Memory; Integration Multisensorielle; Mémoire sensorielle
This case study describes a 45 year old female with bilateral, profound sensorineural hearing loss due to Meniere’s disease. She received her first cochlear implant in the right ear in 2008 and the second cochlear implant in the left ear in 2010. The case study examines the enhancement to speech recognition, particularly in noise, provided by bilateral cochlear implants.
Speech recognition tests were administered prior to obtaining the second implant and at a number of test intervals following activation of the second device. Speech recognition in quiet and noise as well as localization abilities were assessed in several conditions to determine bilateral benefit and performance differences between ears. The results of the speech recognition testing indicated a substantial improvement in the patient’s ability to understand speech in noise and her ability to localize sound when using bilateral cochlear implants compared to using a unilateral implant or an implant and a hearing aid. In addition, the patient reported considerable improvement in her ability to communicate in daily life when using bilateral implants versus a unilateral implant.
This case suggests that cochlear implantation is a viable option for patients who have lost their hearing to Meniere’s disease even when a number of medical treatments and surgical interventions have been performed to control vertigo. In the case presented, bilateral cochlear implantation was necessary for this patient to communicate successfully at home and at work.
Cochlear implant; hearing aid; Meniere’s disease; sensorineural hearing loss; speech recognition; vertigo
The number of patients with bilateral cochlear implant (CI) has gradually increased as patients and/or parents recognize its effectiveness. The purpose of this report is to evaluate the efficacy of 29 bilateral CI out of 169 pediatric CI users, who received auditory-verbal/oral habilitation at our hearing center.
We evaluated the audiological abilities 29 Japanese children with bilateral CIs including wearing threshold, word recognition score, speech discrimination score at 1 m from front speaker (SP), 1 m from second CI side SP, speech discrimination score under the noise (S/N ratio=80 dB sound pressure level [SPL]/70 dB SPL, 10 dB) at 1 m from front SP, word recognition score under the noise (S/N ratio=80 dB SPL/70 dB SPL, 10 dB) at 1 m from front SP.
Binaural hearing using bilateral CI is better than first CI in all speech understanding tests. Especially, there were significant differences between the results of first CI and bilateral CI on SDS at 70 dB SPL (P=0.02), SDS at 1 m from second CI side SP at 60 dB SPL (P=0.02), word recognition score (WRS) at 1 m from second CI side SP at 60 dB SPL (P=0.02), speech discrimination score (SDS) at 1 m from front SP under the noise (S/N=80/70; P=0.01) and WRS at 1 m from front SP under the noise (S/N=80/70; P=0.002). At every age, a second CI is very effective. However, the results of under 9 years old were better than of over 9 years old on the mean SDS under the noise (S/N=80/70) on second CI (P=0.04). About use of a hearing aid (HA) in their opposite side of first CI, on the WRS and SDS under the noise, there were significant differences between the group of over 3 years and the group of under 10 months of HA non user before second CI.
These results may show important binaural effectiveness such as binaural summation and head shadow effect. Bilateral CI is very useful medical intervention for many children with severe-to-profound hearing loss in Japan as well as elsewhere.
Cochlear implant; Children; Bilateral; Binaural; Binaural summation; Head shadow effect; Japan
While everyone has experienced that vision of lip movements may improve speech perception, little is known about the neural mechanisms by which audiovisual speech information is combined. Event-related potentials (ERPs) were recorded while subjects performed an auditory recognition task among four different natural syllables randomly presented in the auditory (A), visual (V) or congruent bimodal (AV) condition. We found that (1) bimodal syllables were identified more rapidly than auditory-alone stimuli; (2) this behavioural facilitation was associated with crossmodal [AV − (A+V)] ERP effects around 120–190 ms latency, mainly expressed as a decrease of unimodal N1 generator activities in the auditory cortex. This finding provides evidence for suppressive, speech-specific audiovisual integration mechanisms, which are likely to be related to the dominance of the auditory modality for speech perception. Furthermore, the latency of the effect indicates that integration operates at pre-representational stages of stimulus analysis, probably via feedback projections from visual and/or polymodal areas.
Acoustic Stimulation; methods; Adult; Auditory Cortex; physiology; Evoked Potentials; physiology; Female; Humans; Least-Squares Analysis; Male; Photic Stimulation; methods; Reaction Time; physiology; Speech; physiology; Multisensory Intregration; Intégration Multisensorielle; Visual Perception; Perception visuelle
Cochlear implants provide good speech discrimination ability despite highly limited amount of information they transmit compared with normal cochlea. Noise vocoded speech, simulating cochlear implants in normal hearing listeners, have demonstrated that spectrally and temporally degraded speech contains sufficient cues to provide accurate speech discrimination. We hypothesized that neural activity patterns generated in the primary auditory cortex by spectrally and temporally degraded speech sounds will account for the robust behavioral discrimination of speech. We examined the behavioral discrimination of noise vocoded consonants and vowels by rats and recorded neural activity patterns from rat primary auditory cortex (A1) for the same sounds. We report the first evidence of behavioral discrimination of degraded speech sounds by an animal model. Our results show that rats are able to accurately discriminate both consonant and vowel sounds even after significant spectral and temporal degradation. The degree of degradation that rats can tolerate is comparable to human listeners. We observed that neural discrimination based on spatiotemporal patterns (spike timing) of A1 neurons is highly correlated with behavioral discrimination of consonants and that neural discrimination based on spatial activity patterns (spike count) of A1 neurons is highly correlated with behavioral discrimination of vowels. The results of the current study indicate that speech discrimination is resistant to degradation as long as the degraded sounds generate distinct patterns of neural activity.
Electronic supplementary material
The online version of this article (doi:10.1007/s10162-012-0328-1) contains supplementary material, which is available to authorized users.
speech processing; neural code; noise vocoded speech; primary auditory cortex; cochlear implants; spatiotemporal patterns; spatial patterns
Advances in implant technology and speech processing have provided great benefit to many cochlear implant patients. However, some patients receive little benefit from the latest technology, even after many years’ experience with the device. Moreover, even the best cochlear implant performers have great difficulty understanding speech in background noise, and music perception and appreciation remain major challenges. Recent studies have shown that targeted auditory training can significantly improve cochlear implant patients’ speech recognition performance. Such benefits are not only observed in poorly performing patients, but also in good performers under difficult listening conditions (e.g., speech noise, telephone speech, music, etc.). Targeted auditory training has also been shown to enhance performance gains provided by new implant devices and/or speech processing strategies. These studies suggest that cochlear implantation alone may not fully meet the needs of many patients, and that additional auditory rehabilitation may be needed to maximize the benefits of the implant device. Continuing research will aid in the development of efficient and effective training protocols and materials, thereby minimizing the costs (in terms of time, effort and resources) associated with auditory rehabilitation while maximizing the benefits of cochlear implantation for all recipients.
Cochlear Implants; Targeted Auditory Training; Auditory Rehabilitation
Cochlear implant speech processors stimulate the auditory nerve by delivering amplitude-modulated electrical pulse trains to intracochlear electrodes. Studying how auditory nerve cells encode modulation information is of fundamental importance, therefore, to understanding cochlear implant function and improving speech perception in cochlear implant users. In this paper, we analyze simulated responses of the auditory nerve to amplitude-modulated cochlear implant stimuli using a point process model. First, we quantify the information encoded in the spike trains by testing an ideal observer’s ability to detect amplitude modulation in a two-alternative forced-choice task. We vary the amount of information available to the observer to probe how spike timing and averaged firing rate encode modulation. Second, we construct a neural decoding method that predicts several qualitative trends observed in psychophysical tests of amplitude modulation detection in cochlear implant listeners. We find that modulation information is primarily available in the sequence of spike times. The performance of an ideal observer, however, is inconsistent with observed trends in psychophysical data. Using a neural decoding method that jitters spike times to degrade its temporal resolution and then computes a common measure of phase locking from spike trains of a heterogeneous population of model nerve cells, we predict the correct qualitative dependence of modulation detection thresholds on modulation frequency and stimulus level. The decoder does not predict the observed loss of modulation sensitivity at high carrier pulse rates, but this framework can be applied to future models that better represent auditory nerve responses to high carrier pulse rate stimuli. The supplemental material of this article contains the article’s data in an active, re-usable format.
Point process model; Cochlear implant; Auditory nerve; Amplitude modulation; Neural coding
Children who experience long periods of auditory deprivation are susceptible to large-scale reorganization of auditory cortical areas responsible for the perception of speech and language. One consequence of this reorganization is that integration of combined auditory and visual information may be altered after hearing is restored with a cochlear implant. Our goal was to investigate the effects of reorganization in a task that examines performance during multisensory integration.
Reaction times to the detection of basic auditory (A), visual (V), and combined auditory-visual (AV) stimuli were examined in a group of normally hearing children, and in two groups of cochlear implanted children: (1) early implanted children in whom cortical auditory evoked potentials (CAEPs) fell within normal developmental limits, and (2) late implanted children in whom CAEPs were outside of normal developmental limits. Miller’s test of the race model inequality was performed for each group in order to examine the effects of auditory deprivation on multisensory integration abilities after implantation.
Results revealed a significant violation of the race model inequality in the normally hearing and early implanted children, but not in the group of late implanted children.
These results suggest that coactivation to multi-modal sensory input cannot explain the decreased reaction times to multi-modal input in late implanted children. These results are discussed in regards to current models for coactivation to redundant sensory information.
Multisensory integration; cochlear implants; redundant signal effect (RSE); race model inequality
Bilateral cochlear implantation seeks to restore the advantages of binaural hearing to the profoundly deaf by providing binaural cues normally important for accurate sound localization and speech reception in noise. Psychophysical observations suggest that a key issue for the implementation of a successful binaural prosthesis is the ability to match the cochlear positions of stimulation channels in each ear. We used a cat model of bilateral cochlear implants with eight-electrode arrays implanted in each cochlea to develop and test a noninvasive method based on evoked potentials for matching interaural electrodes. The arrays allowed the cochlear location of stimulation to be independently varied in each ear. The binaural interaction component (BIC) of the electrically evoked auditory brainstem response (EABR) was used as an assay of binaural processing. BIC amplitude peaked for interaural electrode pairs at the same relative cochlear position and dropped with increasing cochlear separation in either direction. To test the hypothesis that BIC amplitude peaks when electrodes from the two sides activate maximally overlapping neural populations, we measured multiunit neural activity along the tonotopic gradient of the inferior colliculus (IC) with 16-channel recording probes and determined the spatial pattern of IC activation for each stimulating electrode. We found that the interaural electrode pairings that produced the best aligned IC activation patterns were also those that yielded maximum BIC amplitude. These results suggest that EABR measurements may provide a method for assigning frequency–channel mappings in bilateral implant recipients, such as pediatric patients, for which psychophysical measures of pitch ranking or binaural fusion are unavailable.
binaural hearing; electric stimulation; neural prosthesis; cochlear implant; inferior colliculus