Graeme Clark Collection
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ItemIssues in the development of multichannel tactile devices for hearing-impaired children and adults( 1995)Levitt, Pickett and Houde (1980), in their landmark monograph, noted that the history of tactile aid development has been characterized by periodic bursts of enthusiasm and research, often culminating in identification of new avenues to be explored for improving tactile perception of speech. While several research groups have maintained long-term interest in tactile research (Boothroyd, 1985; Oller, Payne, & Gavin, 1980; Saunders, 1985), there was a marked increase in reports of new multichannel tactile devices during the 1980s (reviewed in McGarr, 1989). This upsurge may have been spurred in part by the rapid increase world-wide in the number of hearing-impaired children and adults using cochlear implants as everyday communication devices, and the perceived need for a non-surgical approach to assisting hearing-impaired children. Despite this increase in tactile research, no tactile device has yet achieved widespread commercial use by the hearing-impaired community. It is, therefore, of interest to question why cochlear implants have been more widely accepted than tactile devices.
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ItemArticulation accuracy of children using an electrotactile speech processor( 1995)Objective: Use of wearable tactile speech perception devices is suggested to help overcome the difficulties in speech production resulting from severe and profound hearing impairment in children. This suggestion is based on the assumption that subjects can use tactile input in isolation, or in combination with information from residual aided hearing, to monitor and modify their speech. The present study evaluated the benefits to articulation provided through use of a multichannel electrotactile device (“Tickle Talker™”). Design: Six profoundly hearing-impaired children were videotaped speaking with the Tickle Talker on and with the Tickle Talker off during conversations with their audiologist. Five of the subjects also wore their binaural hearing aids during all recorded conversations. The number of vowels, consonants, and overall phonemes correctly articulated by each child in the two conditions were compared. Results: One subject improved articulation of initial consonants and initial phonemes; one subject improved articulation of total vowels, total consonants, initial consonants, total phonemes, and initial phonemes; and a third subject improved articulation of total vowels and medial phonemes. Conclusions: Use of on-line tactile feedback from the Tickle Talker may benefit the articulation accuracy of some children, and the device may therefore be suitable to use with children who have not responded to more traditional speech training techniques.
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ItemThe progress of children using the multichannel cochlear implant in Melbourne( 1995)Multi-channel cochlear implantation in children began in Australia in 1985 and there are now close to 4000 profoundly deaf children and adolescents using the Australian implant system around the world. The aim of the implant procedure is to provide adequate hearing for speech and language development through auditory input. This contrasts with the situation for adults with acquired deafness where the cochlear implant aims to restore hearing for someone with well-developed auditory processing and language skills. As with adults, results vary over a wide range for children using the Multi-channel implant. Many factors have been suggested that may contribute to differences in speech perception for implanted children. In an attempt to better understand these factors, the speech perception results for children implanted in Melbourne were reviewed and subjected to statistical analysis. This has indicated that the amount of experience with the implant and the length of sensory deprivation are strongly correlated with perceptual results. This means that younger children are likely to perform better with an implant and that a number of years of experience are required for children to reach their full potential. The results have also indicated that educational placement and management play a crucial role in children reaching their potential. Overall, 60% of the children and adolescents in the study have reached a level of open-set speech understanding using the cochlear implant without lipreading.
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ItemWithin-subject comparison of speech perception benefits with a multiple-channel cochlear implant and tactile device( 1995)In order to adequately advise prospective cochlear implant patients and their families, a clinician must have a good knowledge of the potential for particular individuals to benefit from cochlear implants and other alternatives.
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ItemSpeech self-monitoring by children using an electrotactile speech processor( 1995)For the profoundly and severely-to-profoundly hearing impaired child, lipreading and hearing aids are not always sufficient to develop adequate speech perception and production skills. Tactile devices have been investigated as a source of supplementary speech information, with most research focusing on speech perception benefits. However, speech production difficulties are also a major issue for these children, and research into tactile devices should include investigation of the option to use them as speech production aids. This paper will present the results from an initial examination of the suitability of one tactile device for speech production monitoring.
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ItemSpeech perception in children using the advanced Speak speech-processing strategy( 1995)The Speak speech-processing strategy, developed by the University of Melbourne and commercialized by Cochlear Pty Limited for use in the new Spectra 22 speech processor, has been shown to provide improved speech perception for adults in both quiet and noisy situations. The present study evaluated the ability of children experienced in the use of the Multipeak (Mpeak) speech-processing strategy (implemented in the Nucleus Minisystem-22 cochlear implant) to adapt to and benefit from the advanced Speak speech-processing strategy (implemented in the Nucleus Spectra 22 speech processor). Twelve children were assessed using Mpeak and Speak over a period of 8 months. All of the children had over 1 year's previous experience with Mpeak, and all were able to score significantly on open-set word and sentence tests using the cochlear implant alone. Children were assessed with both live-voice and recorded speech materials, including Consonant-Nucleus-Consonant monosyllabic words and Speech Intelligibility Test sentences. Assessments were made in both quiet and in noise. Assessments were made at 3-week intervals to investigate the ability of the children to adapt to the new speech-processing strategy. For most of the children, a significant advantage was evident when using the Speak strategy as compared with Mpeak. For 4 of the children, there was no decrement in speech perception scores immediately following fitting with Speak. Eight of the children showed a small (10% to 20%) decrement in speech perception scores for between 3 and 6 weeks following the changeover to Speak. After 24 weeks' experience with Speak, 11 of the children had shown a steady increase in speech perception scores, with final Speak scores higher than for Mpeak. Only 1 child showed a significant decrement in speech perception with Speak, which did not recover to original Mpeak levels.
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ItemImproved electrotactile speech processor: Tickle Talker( 1995)The Tickle Talker, an eight-channel electrotactile speech processor, has been developed from continuing research at the University of Melbourne. 'The development of the device has focused on production of reliable speech-processing hardware, design of cosmetically and ergonometrically acceptable electrode transducers, implementation of acute and chronic biomedical studies demonstrating device safety, design and testing of alternative speech-encoding strategies to provide benefit to speech perception and production, and design and testing of appropriate training methods for optimizing benefits. The Tickle Talker has been shown to provide benefits in supplementing lipreading or aided residual hearing for hearing-impaired adults and children. Improvements in speech processing have resulted in an increase in benefits to speech perception, and open the way for more flexible approaches to encoding speech input. Continuing development of the electrode circuitry has now produced a device that is robust and has an extended battery life. Safety studies have clearly demonstrated that there are no long-term contraindications to device use. The results suggest that the device has a role to play in rehabilitation programs for severely and profoundly hearing-impaired adults and children.
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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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ItemA review of the biological, psychophysical, and speech processing principles used to design the tickle talker( 1992)The Tickle Talker is a wearable electrotactile speech processor, designed to be used by profoundly hearing-impaired children and adults in conjunction with lipreading and residual hearing. The effectiveness of such a device is affected by an interaction between biological, human engineering, psychophysical, and speech processing considerations. The requirements, the design principles, and the performance of the Tickle Talker in each of these areas will be discussed. Electrical stimulation of the nerve bundles lying along the sides of the fingers was chosen to provide safe, comfortable, energy-efficient stimulation of a well-organised and sensitive part of the tactile sensory system. This is achieved at a small cost to the appearance and mobility of one hand when using the Tickle Talker. The biphasic pulse waveform used to stimulate the nerve bundles has been chosen to ensure a biologically safe stimulus. The electrical parameters (pulse duration, pulse rate, and electrode position) that are used to encode speech information are varied within ranges that are matched to the characteristics of the tactile sense. The usable ranges and information-carrying potential of each of these parameters have been assessed in psychophysical experiments. A comparison of these results with similar experimental data for cochlear implant and hearing aid users is instructive in assessing the possible limitations of tactile and auditory speech processors. The results discussed will include the discrimination and identification of stimuli differing in intensity, duration and pulse rate; the identification of different spatial patterns of stimulation, and the detection of gaps in stimuli. In most respects, the tactile results are similar to the corresponding auditory measures. The resolution of temporal differences such as pulse rate discrimination or gap detection are generally not as good as in the auditory case, but may be as good or better than the corresponding results for some profoundly hearing-impaired individuals. The speech processor used in the Tickle Talker is a "feature extraction" device that explicitly estimates the second formant frequency, amplitude envelope, and fundamental frequency of the voice and encodes them in terms of electrode position, pulse width and pulse rate of the electrical stimulation pattern. Consideration of the psychophysical results and the speech information available from these parameters allows optimization of the Tickle Talker's operation and a broad estimation of its potential performance in speech discrimination. The perception of duration and place of articulation (front/back) of vowels, and the manner and voicing of consonants are expected to be improved by the Tickle Talker. Prosodic variations conveyed by pulse rate are expected to be perceived by some users, but not all. High frequency consonants such as: /s/,/z/./?/, and /t?/ are encoded in a particularly salient manner by the Tickle Talker.
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ItemClinical experience with the University of Melbourne multichannel electrotactile speech processor (Tickle Talker)( 1992)The Tickle Talker is a multiple channel electrotactile speech processor, developed for use by profoundly hearing-impaired adults and children. The device is intended to be used in combination with lipreading and aided residual hearing, to assist the greatest potential range of users. Sound detection and speech reception threshold levels for a group of 14 congenitally hearing-impaired children were shown to be lower when using the Tickle Talker than for hearing aids across the speech frequency range. Tactile-alone feature contrast testing with adults demonstrated that both segmental and suprasegmental speech feature information was available from the tactual display presented by the Tickle Talker. Clinical results from an ongoing program involving fourteen hearing-impaired children demonstrate benefits in speech perception achieved through use of the Tickle Talker. The children have a range of degree of hearing impairment and educational setting. Results show improvements in discrimination scores for vowel and consonant speech features, and increased scores for recognition of closed-set words and for open-set words and sentences. In addition, anecdotal evidence indicates changes in speech production which may be attributed to perceptual input from the device (both from perception of other speakers, and from voice self-monitoring). Results from a group of 4 adult patients show that tactile input may be effectively combined with either aided residual hearing, or aided residual hearing and lipreading to improve speech discrimination across a similar range of closed and open-set word and sentence tests and on speech tracking. The results indicate that some specific tailoring of the speech information provided through the device for the needs of users with differing degrees of hearing-impairment may be required to optimize potential benefits to speech discrimination.