Graeme Clark Collection
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ItemA clinical report on vocabulary skills in cochlear implant users [Abstract]( 1994)Receptive vocabulary results are reported for 32 children, adolescents and prelinguistically deafened adults implanted with the 22-electrode cochlear implant at the Melbourne Cochlear Implant Clinic. Age at implantation ranged from 2 years, 6 months to 20 years and implant use ranged from 1 year to 7 years, 8 months. There were significant gains from pre- to postoperative assessments on the Peabody Picture Vocabulary Test (PPVT) for the majority of subjects. Rates of improvement found are compatible with previous reports on smaller numbers of implant users, but cannot be attributable unambiguously to use of the implant. The group postoperative performance was significantly higher than mean preoperative performance (n =25). The relationship of variables such as duration of implant use, duration of profound deafness and speech perception ability to improvement on the PPVT is discussed. Expressive vocabulary results on the Renfrew Word Finding Vocabulary Scale are reported for 11 of the subjects. Less substantial gains were made on this measure.
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ItemA clinical report on speech production of cochlear implant users [Abstract]( 1994)Speech production results are reported for a group of 15 children, adolescents and prelinguistically deafened adults implanted with the 22-electrode cochlear implant. Age at implantation ranged from 5 years to 20 years and implant experience ranged from 1 year to 4 years, 7 months. On a speech intelligibility test using sentences seven implant users improved significantly over time. Mean group performance (n = 11) improved from 18% preoperatively to 43% postoperatively. Similarly on a test of articulation, eight implant users improved significantly over time and the group mean postoperative performance (n = 11) exceeded the preoperative performance (55% compared to 38%). This group effect was significant for consonants and blends but was nonsignificant for vowels. Improvements occurred for front, middle and back consonants, for stops, nasals, fricatives and glides and for voiceless and voiced consonants. Three implant users showed no significant gain on either test. The results suggest complex relationships between speech production performance and sensory information provided by a multichannel implant.
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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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ItemSpeech perception benefits for implanted children with preoperative residual hearing [Abstract]( 1995)Since the implantation of the first children with the Nucleus 22-channel cochlear prosthesis in Melbourne in 1985, there has been rapid expansion in the number of implanted children world-wide. Improved surgical technique and experience in paediatric assessment and management have contributed to a trend to implant very young children. At the same time there has also been continuing development of improved speech processing strategies resulting in greater speech perception benefits. In the Melbourne program, over 60% of children obtain significant scores on open-set word and sentence tests using their cochlear implant alone without the aid of lipreading. As parents and professionals have become aware of these improved benefits to speech perception benefits in profoundly deaf children, there have been requests to consider implanting severely-to-profoundly deaf children. In these children with higher levels of residual hearing, only those children with poorer-than-expected performance on speech perception tests using hearing aids have been considered for surgery. A number of such cases have now been implanted in the Melbourne program. The speech perception benefits for this group are reported and are being compared with benefits for the profoundly deaf group of children.
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ItemSpeech perception benefits for children using the Speak speech processing strategy in quiet and noise [Abstract]( 1995)The Speak speech processing strategy, based on the Spectral Maxima Speech Processor (SMSP) developed at the University of Melbourne, has now been implemented in the Spectra 22 speech processor developed by Cochlear Pty Limited, and clinical trials of both patients changing from the previous Multipeak strategy to Speak and patients starting up with. Speak have been conducted. Results in adult patients changing to Speak have shown significant improvements in speech perception in quiet and particularly in background noise as compared with Multipeak. Preliminary studies with children changing from Multipeak to Speak strategy, measured over a 10 month period, have also shown significant benefits from use of the Speak scheme in both quiet and noisy test situations. Results of follow up studies of these children after more than one year experience with the Speak processing strategy are presented. Statistical analysis of performance over time suggests that an increase in benefit is observed in children after additional experience with the Speak processing strategy. In addition, results for children who have used only the Speak processing strategy from the time of implantation are also presented. The results confirm that the Speak processing strategy provides significant benefits in quiet, and particularly in the presence of background noise for both groups of patients.
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ItemResults of multichannel cochlear implantation in very young children [Abstract]( 1995)Most researchers and clinicians working in the cochlear implant field have assumed that profoundly deaf children will have a better prognosis in terms of speech perception, speech production and language development. if implanted at as young an age as possible. However, it has been difficult to gather direct evidence for this hypothesis due to the problems in assessing children under the age of five years with formal tests. Recent results with older children have supported the view that early implantation may provide the optimal outcome in most cases. The implantation of very young children raises two areas of concern that do not apply in adults and older children: accurate assessment of degree of hearing loss and auditory potential; and postoperative assessment of outcomes. This paper will describe research results from the University of Melbourne which address these issues and present results for children implanted as young as eighteen months of age.