Graeme Clark Collection
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ItemSpeech perception in implanted children: effects of preoperative residual hearing and speech processing strategy [Abstract]( 1997)Since the first child was implanted with the Nucleus 22-channel cochlear prosthesis in Melbourne in 1985, the number of implanted children world-wide has rapidly expanded. Over this period, more effective paediatric assessment and management procedures have developed, allowing cochlear implants to be offered to children under the age of 2 years. In addition, a succession of improved speech processing strategies have been implemented in the Nucleus implant system, resulting in increased mean speech perception benefits for implanted adults. Research in the Melbourne and Sydney Cochlear Implant Clinics has also demonstrated that young children can adapt to and benefit from improved speech processing strategies such as the Speak strategy. 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 speech perception benefits to improve over time with advances in speech processing. 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 effect of the level 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 8 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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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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ItemThe development of auditory comprehension in children after receiving a cochlear multiple-channel implant( 1992)Since late 1989, half the cochlear implant patients at the Royal Victorian Eye and Ear Hospital have been young children. There is a gradual improvement of auditory comprehension in most cases using the criteria of environmental sound detection, as well as, prosody, high frequency phoneme and word discrimination. The rate of improvement and final result depend on the duration of deafness, presence of residual hearing, and quality of auditory-oral habilitation. Younger children usually progress more quickly than older children. Some adolescents who use Total Communication and who have no residual hearing, achieve assistance with lipreading. Children with Usher's Syndrome should be actively encouraged to participate in auditory-oral habilitation should they become totally deaf or blind.
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ItemSpeech perception benefits for children using the 22-channel Melbourne/cochlear hearing prosthesis [Abstract]( 1993)In 1985; the first child was implanted with the Cochlear 22-channel cochlear prosthesis at the University of Melbourne Royal Victorian Eye & Ear Hospital Cochlear Implant Clinic. There are now 42 children who have received the device in Melbourne. Analysis of patient details for these children show a very heterogeneous group, with a wide range in age, hearing thresholds, duration of deafness and aetiology. The major aetiologies found were either a congenital profound deafness.; or a hearing loss due to meningitis. In all but 3 cases, the children are using 15 or more electrodes in the array. Speech perception benefits have been analyzed according to a six-level hierarchical classification scheme. All of-the children achieved a minimum benefit of discrimination of suprasegmental information (Category 2), and 59% of the children achieved open-set understanding of unfamiliar speech material without the aid of lip-reading (Categories 5 & 6). Detailed analysis suggests that the majority of children achieving open-set speech perception benefits had more than one year of experience with their implant. and less than seven years of profound deafness prior to implantation.
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ItemPreliminary speech perception results for children with the 22-electrode Melbourne / cochlear hearing prosthesis( 1992)The Cochlear 22-electrode cochlear prosthesis was first implanted in a child at the Cochlear Implant Clinic at the University of. Melbourne and Royal Victorian Eye & Ear Hospital in 1985. Since that time 42 children have received the device in Melbourne. Analysis of patient details shows that the majority of these children have a congenital as opposed to on acquired aetiology of hearing loss. In all but 3 cases, the children use 15 or more electrodes. In order to assist with evaluation of, benefits to speech perception across the very heterogeneous group of children, a six level hierarchical classification scheme for speech perception performance levels was created. All of the children achieved a minimum of Category 2 (discrimination of suprasegmental information). In total, 59 % of the children achieved Category 5 or 6 (open set recognition for unfamiliar materials). Analysis showed that the majority of these children had more than one year of experience. In contrast, the majority of children in Category 2 are those with less than one year of experience with the device.