Graeme Clark Collection

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    Potential and limitations of cochlear implants in children
    Dowell, R. C. ; Blamey, P. J. ; Clark, Graeme M. ( 1995)
    Multiple-channel cochlear implants have been in use with children and adolescents for 8 years. The speech perception, speech production, and language of many of these children has been investigated in some detail.l-4 There have been many predictions about factors that may affect the performance of children with implants. For instance, it has been suggested that children with a congenital loss of hearing would not have the same potential to benefit from a cochlear implant as those with an acquired loss. Similarly, it has been suggested that younger children are likely to gain more benefit from a cochlear implant because of the effect of various critical ages for language learning.5 As more results have become available, it has been our observation that the performance of any particular child with a cochlear implant does not appear to follow well-defined rules, and that generalizations about the potential of certain groups of children are likely to encounter many exceptions. We now have a large quantity of results for children using cochlear implants, and it may be possible to determine some of the factors that have a significant effect on performance. This paper will attempt to identify some of these factors by reviewing speech perception results for 100 children implanted with the Nucleus 22-channel cochlear prosthesis in Australia and speech perception results for adult patients. This analysis will use an "information processing" model of a child using a cochlear implant. That is, we will assume that a child will benefit from a cochlear implant in terms of speech perception, production, and language development, if he or she receives a maximal amount of auditory information from the environment, and is able to process this information successfully. This model divides potential limiting or predictive factors into those that affect the information presented to the auditory system (eg, implant technology, surviving auditory neurons) and those that affect the processing of this information (eg, development of central auditory pathways, amount and consistency of auditory input).
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    Habilitation issues in the management of children using the cochlear multiple-channel cochlear prosthesis
    Cowan, Robert S. C. ; Barker, Elizabeth J. ; Dettman, Shani J. ; Blamey, Peter J. ; RANCE, GARY ; Sarant, Julia Z. ; Galvin, Karyn L. ; Dawson, Pam W. ; Hollow, Rod ; Dowell, Richard C. ; PYMAN, BRIAN ; Clark, Graeme M. (Wien, 1994)
    Since 1985, a significant proportion of patients seen in the Melbourne cochlear implant clinic have been children. The children represent a diverse population, with both congenital and acquired hearing-impairments, a wide-range of hearing levels pre-implant, and an age range from 2 years to 18 years. The habilitation programme developed for the overall group must be flexible enough to be tailored to the individual needs of each child, and to adapt to the changing needs of children as they progress. Long-term data shows that children are continuing to show improvements after 5-7 years of device use, particularly in their perception of open-set words and sentences. Habilitation programs must therefore be geared to the long-term needs of children and their families. Both speech perception and speech production need to be addressed in the specific content of the habilitation program for any individual child. In addition, for young children, the benefits of improved speech perception should have an impact on development of speech and language, and the focus of the programme for this age child will reflect this difference in emphasis. Specific materials and approaches will vary for very young children, school-age and teenage children. In addition, educational setting will have a bearing on the integration of listening and device use into the classroom environment.
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    The effects of auditory feedback from the nucleus cochlear implant on the vowel formant frequencies produced by children and adults
    Richardson, Louise M. ; Busby, Peter A. ; Blamey, Peter J. ; Dowell, Richard C. ; Clark, Graeme M. ( 1993)
    Cochlear implants provide an auditory signal with which profoundly deaf users may monitor their own speech production. The vowel production of two adults and three children who used the Nucleus multiple-electrode cochlear implant was examined to assess the effect of altered auditory feedback. Productions of words were recorded under conditions where the talkers received auditory feedback (speech processor turned on) and where no auditory feedback was provided (speech processor turned off). Data were collected over 3 days at weekly intervals. First and second formant frequencies were measured and the data were analysed to assess significant differences between auditory feedback conditions, vowel context, and data collection points. Overall, the results varied across talkers, across the data collection days, and depended on the consonant environment of the vowel. However, two effects of auditory feedback were noted. First, there was a generalized shift in first formant frequencies between the processor on and processor off conditions across three of the five subjects, but the shift differed in direction for each subject. Second, for three of the five talkers, the two front vowels /ε/ and /I/ were more neutralised in the absence of auditory feedback. However, this effect was less pronounced than that noted by previous studies.
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    Speech perception, production and language results in a group of children using the 22-electrode cochlear implant
    Busby, P. A. ; Brown, A. M. ; DOWELL, RICHARD ; Rickards, Field W. ; Dawson, Pam W. ; Blamey, Peter J. ; Rowland, L.C. ; Dettman, Shani J. ; Altidis, P. M. ; Clark, Graeme M. ( 1989)
    Paper presented at the 118th Meeting of the Acoustical Society of America
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    Results for the Nucleus multiple-electrode cochlear implant in two children [Abstract]
    Tong, Y. C. ; Blamey, P. J. ; Dowell, R. C. ; Nienhuys, T. G. ; Musgrave, G. N. ; Busby, P. A. ; Roberts, S. A. ; Rickards, F. W. ; Dettman, S. J. ; Altidis, P. M. ; Clark, Graeme M. ( 1988)
    Two males, 9 years 10 months (CHILD 1) and 5 years 5 months (CHILD 2) at time of surgery, were implanted with the Nucleus multiple-electrode cochlear implant. Both patients were deafened as a result of meningitis in their third year. Assessments of speech perception, speech production and language skills were undertaken at regular intervals, pre and post operatively. For both patients in the audition alone condition, some speech perception post operative scores were significantly higher than pre operative scores and progressive improvements in scores over successive post operative data collection times were seen. Significant differences between the visual alone and auditory-visual condition scores were also observed for CHILD 1 post operatively. Speech production post operative scores were significantly higher than pre operative scores for both patients. The receptive vocabulary scores for both patients improved at a higher rate than that of age-matched normal children. The acquisition of expressive and receptive language skills for CHILD 2 was at a higher rate than that of age-matched children. Differences in the results between the two patients were seen, and this may be related to age and duration of deafness.