Graeme Clark Collection
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ItemSpeech perception in implanted children: influence of preoperative residual hearing on outcomes [Abstract]( 1998)Since the first child was implanted with the Nucleus 22-channel prosthesis in Melbourne in 1985, several thousand children world-wide have now benefitted from this technology. More effective paediatric assessment and management procedures have now been developed, allowing cochlear implants to be offered to children under the age of 2 years. Improvements in speech processing strategy have also been implemented in the Nucleus implant system, resulting in increased mean speech perception benefits for implanted adults. Although a range of performance on formal measures of hearing, speech or language has been reported for children using implants, results from the first decade of implant experience consistently show that significant benefits are available to children receiving their implant at an early age. Reported speech perception results for implanted children show that a considerable proportion (60%) of paediatric patients in the Melbourne and Sydney clinics are able to understand some open-set speech using electrical stimulation alone. These results, and the upward trend of mean speech perception benefits shown for postlinguistically deafened adults have raised questions as to whether severely, or severely-to-profoundly deaf children currently using hearing aids would in fact benefit more from a cochlear implant. To investigate the potential influence of the degree of preoperative residual hearing on postoperative speech perception, results for all implanted children in the Melbourne and Sydney cochlear implant programs were analysed. Results showed that as a group, children with higher levels of preoperative residual hearing were consistently more likely to achieve open-set speech perception benefits. Potential factors in this finding could be higher levels of ganglion cell survival or greater patterning of the auditory pathways using conventional hearing aids prior to implantation. Conversely, children with the least preoperative residual hearing were less predictable, with some children achieving open-set perception, and others showing more limited closed-set benefits to perception. For these children, it is likely that preoperative residual hearing is of less significance than other factors in outcomes.
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ItemStudies in tactile speech perception using the University of Melbourne Tickle Talker [Abstract]( 1998)During the past four years, a series of studies have been undertaken investigating the perception of speech presented through the tactile modality. These studies formed part of a project to develop an effective and safe electro tactile speech perception device for those children and adults requiring additional communication assistance to that provided by hearing aids, but unable to benefit from cochlear implants.
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ItemAn analysis of high rate speech processing strategies using the Nucleus 24 cochlear implant [Abstract]( 1998)The effects of varying the stimulation rate on speech perception was evaluated in five postlinguistically deaf adult users of the Nucleus 24 Cochlear Implant System. Three different rates of electrical stimulation, 250, 807, and 1615 pulses per second per channel were employed. For the high stimulus rate the analysis frequency was the same as for the medium rate condition. The study investigated the effect of varying rate of stimulation when using the electrode selection technique of the SPEAK strategy. The study used a repeated ABC experimental design, in order to account for learning effects and to minimize ordering effects. Speech perception was evaluated using both monosyllabic words (open-sets of CNC words in quiet) and sentence materials (open-sets of CUNY sentences at signal-to-noise ratios from +20 to 0dB). In addition, the subjects' perception of closed-sets of 19 vowels and 24 consonants, presented in the H/VID and A/C/A context, were also investigated. The recognition and perception of distinctive features were assessed across strategies and patients. Preliminary speech perception results have shown no statistically significant difference in performance between the low and medium stimulation rates. However, significantly poorer results were observed for the high rate condition for some tests with some individuals. Individual differences may be explained by the effects of rate of stimulation on speech features.
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ItemFactors influencing gap detection in children using cochlear implants [Abstract]( 1998)Two studies on gap detection were conducted with children implanted with the Cochlear Limited multiple-electrode prosthesis. In the first study, gap thresholds were measured at three pulse rates (200, 500, and 1000 pulses/s) and two stimulus durations (500 and 1000 ms) in 15 subjects. Average gap thresholds ranged from 1.8 to 32.1 ms. There was, essentially, no effect of pulse rate and in all but two subjects, no effect of stimulus duration. For these two subjects, thresholds were higher for the 1000 ms stimulus duration. In the second study, the relationships between gap thresholds and subject characteristics, and between gap thresholds and speech perception scores were examined using data from 27 subjects. A significant negative correlation between age at onset of deafness and gap thresholds was found, indicating that subjects with an earlier onset of deafness had larger gap thresholds, and most of the variability in gap thresholds was found for the congenitally deaf subjects. Gap thresholds did not correlate with other subject variables, such as duration of deafness and duration of implant use. Significant negative correlations were found between gap thresholds and word scores for open-set BKB sentences in the auditory-visual condition and the lipreading enhancement scores for the same test, indicating that subjects with poorer gap thresholds had lower speech scores. Gap thresholds did not correlate with word scores for BKB sentences in the audition alone condition, and scores for closed-set monosyllabic word tests.
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ItemAn analysis of high rate speech processing strategies using the Nucleus 24 cochlear implant [Abstract]( 1998)Speech comprehension for a group of five users of the Nucleus 24 Cochlear Implant system was explored at three rates of electrical stimulation, 250, 807, and 1615 pulses per second per channel. For the high stimulus rate the analysis frequency was the same as for the medium rate condition. The study investigated the effect of varying rate of stimulation when using the electrode selection technique of the SPEAK strategy. This has been undertaken using a repeated ABC experimental design to account for learning and minimize ordering effects. Speech perception was assessed using open-sets of CNC words in quiet and open-sets of CLTNY sentences at signal-to-noise ratios from +20 to 0dB. Closed-sets of 19 vowels and 24 consonants were also presented, in the H/V/D and A/C/A context. The recognition and perception of distinctive features were assessed across strategies and patients. Preliminary speech perception results have shown no statistically significant difference in performance between the low and medium stimulation rates. However, significantly poorer results were observed for the high rate condition for some tests. Individual differences may be explained by the effects of rate of stimulation on speech features.
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ItemCurrent speech perception benefits for adults using the speak strategy with the nucleus 22-channel cochlear implant( 1997)Present day recipients of the Nucleus 22-channel cochlear implant make use of the SPEAK speech processing strategy in the Spectra 22 speech processor. Introduced in 1994, the SPEAK strategy is based upon research conducted at the University of Melbourne and the Bionic Ear Institute. This paper compares the pre-and post-operative speech perception abilities of adults who have used the SPEAK speech processing strategy since the 'start-up' of their cochlear implant system. Data was analysed from open-set sentence and word tests administered pre-operatively and at regular intervals postoperatively. Patients showed significant improvement in their ability to recognise speech, when listening with the cochlear implant without lipreading, within the first two weeks. Mean scores for open-set sentences were 15% preoperatively and 64% two weeks after initial programming.
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ItemSpeech cues for cochlear implantees: spectral discrimination(Monduzzi Editore, 1997)The relationship between the ability of cochlear implantees to perceive speech and their ability to discriminate between stimulation on adjacent electrodes was investigated. Speech perception ability was assessed with monosyllabic words in 8 users Nucleus cochlear prosthesis. The ability of these subjects to discriminate between stimulation on adjacent electrodes, in of random loudness differences between electrodes was determined. Results were averaged in the apical, mid and basal regions of the cochlea. Regression analysis showed that speech perception ability and electrode discrimination ability were correlated in the apical to mid region of the cochlea. but the two factors were not correlated in the basal region. Therefore, these results suggest that implantees require the ability to discriminate between stimulation on adjacent electrodes in the apical to mid region of the cochlea in order to achieve high speech perception scores.
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ItemSpeech cues for cochlear implantees: spectral discrimination [Abstract]( 1997)The ability of cochlear implantees to understand speech varies over a wide range. While some implantees achieve scores close to 100 % open set word tests, other require visual cues to achieve a significant score on these tests. The focus of this research is to investigate reasons for the wide range of ability and therefore to improve the speech processors used by individual implantees. This study first investigated whether the relative importance of various frequency regions of the speech spectrum differs for implantees of different performance levels, and for implantee groups compared to normally hearing subjects.
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ItemSpeech perception of hearing aid users versus cochlear implantees [Abstract]( 1997)Recent improvements in speech recognition for profoundly deaf, cochlear implant patients have suggested that some people with a severe hearing impairment would be more successful with a cochlear implant than a hearing aid. Unfortunately, no studies have investigated the speech perception of the severely hearing impaired in order compare their speech perception abilities with those of cochlear implant users. To investigate this area further, a detailed investigation of the hearing aid performance of people with a severe hearing loss is being conducted in the Department of Otolaryngology at The University of Melbourne. The range of hearing losses for this study was defined as a pure tone average of greater than 6OdBHL, but no worse than 100dBSPL in the better ear. At present thirty-five (n=35) participants have been involved in this study. Each participant took part in a series of speech perception tests which included 24 consonant recognition, 11 vowel recognition, CNC words, CUNY sentences, and the connected speech test.
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ItemSpeech perception of hearing aid users versus cochlear implantees(Monduzzi Editore, 1997)Recent improvements in speech recognition abilities for profoundly deaf cochlear implantees suggests that some adults with a severe hearing impairment might benefit from a cochlear implant. Unfortunately, no studies have directly compared the speech perception abilities of the severely hearing impaired with those of cochlear implant users. An investigation of the speech perception performance of people with a severe hearing loss, who use hearing aids, was conducted in the Department of Otolaryngology at The University of Melbourne. Each participant (n=35) took part in a series of speech perception tests which included 11 vowel recognition tests, CNC words, CUNY sentences, and the Connected Speech Test. The results from these severely hearing impaired persons were compared to results from cochlear implant users. The group of severely hearing impaired adults performed better on tests of vowel and word perception but poorer on tests of open set sentence perception in comparison to a group of cochlear implant users.