Graeme Clark Collection
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ItemCognitive processing in children using cochlear implants: the relationship between visual memory, attention, and executive functions and developing language skills( 2002)We performed this study to determine whether children using a cochlear implant performed differently from age- and gender-matched hearing aid users on 8 neuropsychological measures of visual memory, attention, and executive functioning. The study also examined whether differences in cognitive skills could account for some of the observed variance in speech perception, vocabulary, and language abilities of hearing-impaired children. In contrast to previous studies, our results revealed no significant cognitive differences between children who use a cochlear implant and children who use hearing aids. Partial correlation analysis indicated that the children’s visual memory skills, i.e., their recognition memory, delayed recall, and paired associative learning memory skills, correlated significantly with their language skills. When examined at a significance level of .01, attention and executive functioning skills did not relate to the children’s developing speech perception, vocabulary, or language skills. The results suggested that differences in visual memory skills may account for some of the variance seen in the language abilities of children using implants and children using hearing aids.
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ItemVariation in speech perception scores among children with cochlear implants(LIPPINCOTT WILLIAMS & WILKINS, 2001-02)OBJECTIVE: The objective of this study was to identify common factors affecting speech perception scores in children with cochlear implants. DESIGN: Speech perception data for 167 implanted children were collected at two cochlear implant centres in Melbourne and Sydney. The data comprised audition-alone scores on open-set word and sentence tests. Children were selected on the basis that they had a Nucleus 22-electrode cochlear implant. The average age of the children was 5 yr. Information was also collected about 12 factors that may have influenced speech perception scores for each child. Analysis of covariance was used to identify factors that significantly affected speech perception scores. Pearson pairwise correlation coefficients were also calculated for all factors analyzed. RESULTS: The analyses in this study identified factors that accounted for 51%, 34%, and 45% of the variance in phoneme, word and sentence perception scores. Scores decreased by 1.4 to 2.4% per year of profound deafness prior to implantation. Children who normally use oral communication scored significantly higher than children normally using sign or simultaneous oral and sign communication. Children implanted in Sydney scored higher on average than children implanted in Melbourne. CONCLUSIONS: The results show that a significant part of the variation in speech perception scores is systematically related to audiological and environmental factors for each child. The reasons for significant differences between children using different communication modes or from different clinics were not identified.
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ItemThe effect of language knowledge on speech perception: what are we really assessing?( 1997)Objective: The authors examined whether open-set speech perception scores are limited by knowledge of vocabulary and syntax and further considered whether remediation of vocabulary and syntax will increase open-set speech perception scores. Study Design: This was a repeated-measures study design in the setting of a primary (elementary) school for the hearing impaired. Patients: The study population was composed of three hearing-impaired children using Nucleus 22-channel cochlear implant. Intervention: Intervention used was language remediation sessions. Main Outcome Measures: The main outcome measures were assessment of auditory-alone speech perception benefit using open-set words and sentences and assessment of syntactic knowledge using the Test of Syntactic Ability. Outcome measures were applied before and after remediation. Results: Child 1 and child 2 showed a significant postremediation improvement in their overall scores on the Test of Syntactic Ability and in their ability to perceive words learned during remediation. Child I and child 2 also showed a significant improvement in their scores on a modified Bamford-Kowal-Bench open-set sentence test, which specifically targeted grammatical constructs trained in remediation sessions. Conclusions: Remediation of language knowledge deficits significantly improved open-set speech perception for two children, suggesting a need to include language remediation in cochlear implant habilitation programs.
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ItemWithin-subject comparison of speech perception benefits for congenitally deaf adolescents with an electrotactile speech processor and a cochlear implant( 1996)This study assessed speech perception benefits for three congenitally deaf adolescents who used an electrotactile speech processor (Tickle Talker™) and subsequently went on to use a Nucleus Minisystem 22 cochlear implant. Both devices provided significant and comparable benefits for all children in the device plus lipreading condition. All children benefited from the additional information provided by either the Tickle Talker™ or the cochlear implant, and were able to perceive speech information with these devices that was not available through either aided residual hearing or lipreading. None of the three children were able to understand open-set words or sentences using either hearing aids alone or Tickle Talker™ alone, without the aid of lipreading. Two of the children showed significant open-set speech perception benefits while using their cochlear implant alone.
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ItemIssues in the development of multichannel tactile devices for hearing-impaired children and adults( 1995)Levitt, Pickett and Houde (1980), in their landmark monograph, noted that the history of tactile aid development has been characterized by periodic bursts of enthusiasm and research, often culminating in identification of new avenues to be explored for improving tactile perception of speech. While several research groups have maintained long-term interest in tactile research (Boothroyd, 1985; Oller, Payne, & Gavin, 1980; Saunders, 1985), there was a marked increase in reports of new multichannel tactile devices during the 1980s (reviewed in McGarr, 1989). This upsurge may have been spurred in part by the rapid increase world-wide in the number of hearing-impaired children and adults using cochlear implants as everyday communication devices, and the perceived need for a non-surgical approach to assisting hearing-impaired children. Despite this increase in tactile research, no tactile device has yet achieved widespread commercial use by the hearing-impaired community. It is, therefore, of interest to question why cochlear implants have been more widely accepted than tactile devices.
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ItemArticulation accuracy of children using an electrotactile speech processor( 1995)Objective: Use of wearable tactile speech perception devices is suggested to help overcome the difficulties in speech production resulting from severe and profound hearing impairment in children. This suggestion is based on the assumption that subjects can use tactile input in isolation, or in combination with information from residual aided hearing, to monitor and modify their speech. The present study evaluated the benefits to articulation provided through use of a multichannel electrotactile device (“Tickle Talker™”). Design: Six profoundly hearing-impaired children were videotaped speaking with the Tickle Talker on and with the Tickle Talker off during conversations with their audiologist. Five of the subjects also wore their binaural hearing aids during all recorded conversations. The number of vowels, consonants, and overall phonemes correctly articulated by each child in the two conditions were compared. Results: One subject improved articulation of initial consonants and initial phonemes; one subject improved articulation of total vowels, total consonants, initial consonants, total phonemes, and initial phonemes; and a third subject improved articulation of total vowels and medial phonemes. Conclusions: Use of on-line tactile feedback from the Tickle Talker may benefit the articulation accuracy of some children, and the device may therefore be suitable to use with children who have not responded to more traditional speech training techniques.
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ItemWithin-subject comparison of speech perception benefits with a multiple-channel cochlear implant and tactile device( 1995)In order to adequately advise prospective cochlear implant patients and their families, a clinician must have a good knowledge of the potential for particular individuals to benefit from cochlear implants and other alternatives.
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ItemSpeech self-monitoring by children using an electrotactile speech processor( 1995)For the profoundly and severely-to-profoundly hearing impaired child, lipreading and hearing aids are not always sufficient to develop adequate speech perception and production skills. Tactile devices have been investigated as a source of supplementary speech information, with most research focusing on speech perception benefits. However, speech production difficulties are also a major issue for these children, and research into tactile devices should include investigation of the option to use them as speech production aids. This paper will present the results from an initial examination of the suitability of one tactile device for speech production monitoring.
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ItemImproved electrotactile speech processor: Tickle Talker( 1995)The Tickle Talker, an eight-channel electrotactile speech processor, has been developed from continuing research at the University of Melbourne. 'The development of the device has focused on production of reliable speech-processing hardware, design of cosmetically and ergonometrically acceptable electrode transducers, implementation of acute and chronic biomedical studies demonstrating device safety, design and testing of alternative speech-encoding strategies to provide benefit to speech perception and production, and design and testing of appropriate training methods for optimizing benefits. The Tickle Talker has been shown to provide benefits in supplementing lipreading or aided residual hearing for hearing-impaired adults and children. Improvements in speech processing have resulted in an increase in benefits to speech perception, and open the way for more flexible approaches to encoding speech input. Continuing development of the electrode circuitry has now produced a device that is robust and has an extended battery life. Safety studies have clearly demonstrated that there are no long-term contraindications to device use. The results suggest that the device has a role to play in rehabilitation programs for severely and profoundly hearing-impaired adults and children.
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ItemIssues in long-term management of children with cochlear implants and tactile devices [Abstract]( 1994)For many children with severe and profound hearing losses, conventional hearing aids are unable to provide sufficient amplification to ensure good oral communication and/or in the case of very young children, development of speech and language. Traditionally a number of these children have opted for the use of sign language alone or in Total Communication approaches as a primary means of communication. The advent of multiple channel cochlear implants for children and the continuing development of multiple channel speech processing tactile devices provide auditory approaches to resolving communication difficulties for these children. The successful use of such devices depends on a number of factors including the information provided through the aid; the ease of use, convenience and reliability of the aid; the individual communication needs of the child; and the habilitation and management program used with the device. Long-term data has shown that children continue to show increased speech perception benefits from improvements in speech processing and from further experience with these devices. Habilitation and management programs must therefore be geared to meet the changing needs of children as they progress and of families as children mature and face new challenges. Habilitation must address specific individual needs in speech perception and in speech production. For very young children, benefits of improved speech perception should have an impact on the development of speech and language, and habilitation and management must emphasise the need for language growth.