Graeme Clark Collection

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    The University of Melbourne/Nucleus cochlear prosthesis
    Clark, Graeme M. ; Blamey, P. J. ; Brown, A. M. ; Busby, P. A. ; Dowell, R. C. ; Franz, B. K-H. ; Millar, J. B. ; Pyman, B. C. ; Shepherd, R. K. ; Tong, Y. C. ; Webb, R. L. ; Brimacombe, J. A. ; Hirshorn, M. S. ; Kuzma, J. ; Mecklenburg, D. J. ; Money, D. K. ; Patrick, J. F. ; Seligman, P. M. ( 1988)
    This is a review of research to develop the University of Melbourne/Nucleus cochlear prosthesis for patients with a profound-total hearing loss. A more complete review can be obtained in Clark et al. A prototype receiver-stimulator and multiple-electrode array developed at the University of Melbourne was first implanted in a postlingually deaf adult patient with a profound-total hearing loss on 1 August 1978. A speech processing strategy which could help this patient understand running speech, especially when combined with lipreading was developed in 1978 following initial psychophysical studies. A prototype wearable speech processor was fabricated in 1979, that could provide significant help for the first two patients in understanding running speech when used in combination with lipreading compared with lipreading alone, and it also enabled them to understand some running speech when using electrical stimulation alone. An implantable receiver-stimulator and wearable speech processor embodying the principles of the prototype devices were then produced for clinical trial by the Australian biomedical firm, Nucleus Ltd, and its subsidiaries, Cochlear Pty Ltd and Cochlear Corporation. This cochlear implant was initially clinically trialled on six patients at The Royal Victorian Eye & Ear Hospital in 1982, and shown to give similar results to those obtained with the prototype device. In view of these findings a clinical trial was carried out for a Premarket Approval Application to the US Food and Drug Administration (FDA), and extended to a number of centres in the US, Canada, and West Germany. This clinical trial confirmed that patients could understand running speech when electrical stimulation was combined with lipreading, and that some patients could also understand running speech when using electrical stimulation alone. Today, more than 600 patients world-wide are using cochlear implants developed from the research described in this paper.
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    Underlying structure of auditory-visual consonant perception by hearing-impaired children and the influences of syllabic compression
    Busby, P. A. ; Tong, Y. C. ; Clark, Graeme M. ( 1988)
    The identification of consonants in /a/-C-/a/ nonsense syllables, using a fourteen-alternative forced-choice procedure, was examined in 4 profoundly hearing-impaired children under five conditions: audition alone using hearing aids in free-field (A), vision alone (V), auditory-visual using hearing aids in free-field (AV1), auditory-visual with linear amplification (AV2), and auditory-visual with syllabic compression (AV3). In the AV2 and AV3 conditions, acoustic signals were binaurally presented by magnetic or acoustic coupling to the subjects' hearing aids. The syllabic compressor had a compression ratio of 10:1, and attack and release times were 1.2 ms and 60 ms. The confusion matrices were subjected to two analysis methods: hierarchical clustering and information transmission analysis using articulatory features. The same general conclusions were drawn on the basis of results obtained from either analysis method. The results indicated better performance in the V condition than in the A condition. In the three AV conditions, the subjects predominately combined the acoustic parameter of voicing with the visual signal. No consistent differences were recorded across the three AV conditions. Syllabic compression did not, therefore, appear to have a significant influence on AV perception for these children. A high degree of subject variability was recorded for the A and three AV conditions, but not for the V condition.
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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.