Graeme Clark Collection
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ItemResearch in auditory training(Academy of Rehabilitative Audiology, 1994)Speech perception and communication can improve as a result of experience, and auditory training is one way of providing experiences that may be beneficial. One of the most important factors influencing the effectiveness of auditory training is the amount of experience the client already has. Other factors include the severity of the hearing loss, the sensory device used, the environment, personal qualities of the client and clinician, the type of training, and the type of evaluation used. Despite a long history of clinical practice, the effects of these factors have been investigated in few controlled studies. Even in special cases where training has an obvious role, such as adults using cochlear implants, there has been little objective comparison of alternative training methods. One reason for this is the difficulty of carrying out definitive experiments that measure changes in performance over time in the presence of many confounding variables. These variables may also help to explain the apparently contradictory results that can be found in the literature on auditory training and in the diverse points of view expressed by practicing clinicians. Issues and methods appropriate for research in auditory training among adult clients are discussed with reference to the needs of modem clinical practice.
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ItemSignal processing for multichannel cochlear implants: past, present and future [Abstract]( 1994)Since the late 1970's, many groups have worked on developing effective signal processing for multichannel cochlear implants. The main aim of such schemes has been to provide the best possible speech perception for those using the device. Secondary aims of providing awareness and discrimination of environmental sounds and appreciation of music have also been considered. Early designs included some that attempted to simulate the normal cochlea. The application of such complex processing schemes was limited by the technology of the times. In some cases, researchers reverted to the use of single channel systems which could be controlled reliably with the existing technology. In other cases, as with the Australian implant, a simple multichannel processing scheme was devised that allowed a reliable implementation with available electronics. Over the next 15 years, largely due to the improvements in integrated circuit technology, the signal processors have slowly become more complex. Further psychophysical research has shown how additional information can be transferred effectively to implant users via electrical stimulation of the cochlea. This has lead to rapid improvement in the speech perception abilities of adults using cochlear implants. Some of the main developments in signal processing over the last 15 years will be discussed along with the latest speech perception results obtained with the new SPEAK processing scheme for the Australian 22-channel cochlear implant. Initial results for SPEAK show mean scores of 70% (equivalent to 85-90% phoneme scores) for open set monosyllabic word testing for experienced adult users. Although there remains a large range of performance for all users of cochlear implants, average speech perception scores for all implanted adults have also improved significantly with the developments in signal processing. It appears likely that multichannel cochlear implants will be a viable alternative for the treatment of severe hearing loss in the future.
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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.
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ItemHabilitation issues in the management of children using the cochlear multiple-channel cochlear prosthesis(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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ItemCochlear implants for congenitally deaf adolescents: is open-set speech perception a realistic expectation?( 1994)The prognosis for benefit from use of cochlear implants in congenitally deaf adolescents, who have a long duration of profound deafness prior to implantation, has typically been low. Speech perception results for two congenitally deaf patients implanted as adolescents at the University of Melbourne/Royal Victorian Eye and Ear Hospital Clinic show that, after 12 months of experience, both patients had significant open-set speech discrimination scores without lipreading. These results suggest that although benefits may in general be low for congenitally deaf adolescents, individuals may attain significant benefits to speech perception after a short period of experience. Prospective patients from this group should therefore be considered on an individual basis with regard to prognosis for benefit from cochlear implantation.
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ItemComparison of current speech coding strategies( 1993)This paper reports on two studies carried out at the University of Melbourne jointly with Cochlear Pty Ltd. The studies demonstrated substantial speech perception improvements over the current Multipeak strategy in background noise.
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ItemThe effects of auditory feedback from the nucleus cochlear implant on the vowel formant frequencies produced by children and adults( 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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ItemRole of a multichannel electrotactile speech processor in a cochlear implant program for profoundly hearing-impaired adults( 1991)Four profoundly hearing-impaired adults who did not meet current selection criteria for implantation at the University of Melbourne were each fitted with a wearable multichannel electrotactile speech processor (Tickle Talker). The subjects were evaluated with a test battery of speech discrimination tests subsequent to training in use of the device. Thresholds for detection of pure tones were lower for the Tickle Talker than for hearing aids across the frequency range 250 to 4000 Hz. Mean speech detection thresholds for the Ling 5-sound test showed that all sounds were detected by users of the electrotactile device at normal conversational speech intensity levels. Mean speech discrimination scores were significantly higher (p < 0.05) in the tactually aided condition as compared with the tactually unaided for identification of vowels and consonants, on open-set words, open-set sentences, and on connected discourse tracking. Mean scores increased by 20% for vowels, 19% for consonants, 30% for openset words, and 25% for open-set sentences when the Tickle Talker was used in a multimodal combination with lipreading or lipreading and hearing aids. Speechtracking rates for three subjects showed increases of from 18 to 28 wpm when the tactile device was used. Comparison of tactually aided versus unaided tracking rates for two subjects with long-term experience shows continuing improvement with additional experience with the device. These results demonstrate that hearing impaired adults not meeting selection criteria for cochlear implantation may benefit from use of an electrotactile speech processor, and highlight the potential benefits from integration of such devices into cochlear implant programs for profoundly hearing-impaired patients.
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ItemEffects of rate and pulse manipulations of the spectral maxima speech processor upon speech production( 1993)Postlingually deafened adults experience many changes in their speech as a consequence of late-onset deafness. Previous studies have indicated changes in fundamental frequency, duration, intensity, and vowel formant frequencies in postlingually deafened adults. Postlingually deafened adults who receive multichannel cochlear implants demonstrate improved control of fundamental frequency and intensity. Shifts in formant frequencies to values similar to normal hearing. speakers also appears in some adult implant users. In order to examine how adult implant users adjust their vowel production in response to map changes, we examined vowel production following manipulations to the processing strategy of the Spectral Maxima Speech Processor. This processor uses a speech processing scheme in which six spectral maxima from the outputss of 16 bandpass filters stimulate the cochlea on a place basis at a constant rate. The rate of sampling of the filterbank output is 250 Hz, so six biphasic pulses are presented every 4 msec and there is no attempt to extract fundamental frequency or to find the formant peaks in the speech signal. Two manipulations to the scheme were examined. In the first condition, the rate of sampling remained at 250Hz but eight biphasic pulses were presented rather than six. In the second condition, six biphasic pulses were presented but the rate of sampling of the filterbank output was increased to 400 Hz. Speech samples also were acquired using the standard spectral maxima processor .and with no auditory feedback when the processor was turned off. Speech samples from three �subjects were acquired immediately after receiving the manipulated speech processors and after two weeks experience with the various processors. Preliminary data indicate one subject experienced increased fundamental frequencies while using the 400 Hz high rate strategy. No significant changes were observed in fundamental frequency between the normal SMSP processor and the eight pulse variation. Elimination of feedback resulted in significantly lower fundamental frequencies. The high rate and eight pulse variations resulted in significantly higher first formant frequencies. Second formant frequencies also appear to be influenced by the processing strategies. Comparisons of values produced immediately after receiving a new strategy versus those produced after two weeks use show shifts in primarily first formant values. Data will be presented for all three subjects and discussed in regard to sensitivity to variations in speech processing schemes and the influence of experience with manipulated schemes. (Work supported by the N1H-NIDCD).
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ItemFricative perception by cochlear implant users( 1992)Three implant users were tested with 45 syllables consisting of[v, f, �, ?, z, s, ?, ?, d?, t ?, ?, , d, n, 1] before the vowels [I ,a,u] with three wearable speech processors. The WSP3 processor coded first and second formant frequencies and amplitudes. The MSP1 processor used a similar scheme with improved measurement and coding of the formants. The MSP2 processor added amplitude information from three higher frequency bands. Average scores were 42% for WSP3, 54% for MSP1, and 57% for MSP2. Perception of voicing, manner, and place of articulation of the consonants was significantly greater for the MSP processors than the WSP3 processor. Place perception was slightly higher for MSP2 than MSP1. The listeners used three perceptual dimensions which were highly correlated with the frequencies and amplitudes of peaks in the low frequency region of the frication spectrum, amplitudes of high frequency peaks, and duration of the frication noise.