Graeme Clark Collection
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ItemContributing factors to improved speech perception in children using the nucleus 22-channel cochlear prosthesis( 1997)It has been established that use of multiple-channel intracochlear implants can significantly improve speech perception for postlinguistically deafened adults. In the development of the Nucleus 22-channel cochlear implant, there have been significant developments in speech processing strategies, providing additional benefits to speech perception for users. This has recently culminated in the release of the Speak speech processing strategy, developed from research at the University of Melbourne. The Speak strategy employs 20 programmable bandpass filters which are scanned at an adaptive rate, with the largest outputs of these filters presented to up to ten stimulation channels along the electrode array. Comparative studies of the Speak processing strategy (in the Nucleus Spectra-22 speech processor), with the previously-used Multipeak (Multipeak) speech processing strategy (in the Minisystem-22 speech processor), with profoundly deaf adult cochlear implant users have shown that the Speak processing strategy provides a significant benefit to adult users both in quiet situations and particularly in the presence of background noise. Since the first implantation of the Nucleus device in a profoundly hearing-impaired child in Melbourne in 1985, there has been a rapid growth in the number of children using this device. Studies of cochlear implant benefits for children using the Nucleus 22-channel cochlear implant have also shown that children can obtain significant benefits to speech perception, speech production and language, including open-set understanding of words and sentences using the cochlear implant alone. In evaluating contributing factors to speech perception benefits available for children, four specific factors are important to investigate: (1) earlier implantation -resulting from earlier detection of deafness; (2) improved hardware and surgical techniques -allowing implantation in infants; (3) improved speech processing, and (4) improved habilitation techniques. Results reported previously have been recorded primarily for children using the Multipeak strategy implemented in the MSP speech processor. While it is important to evaluate the factors which might contribute to improvements in speech perception benefits, an important question is the effect of improved speech processing strategy, since this will determine what is perceived through the device. Given that adult patients changing to the Spectra speech processor had also shown improved perception in noisy situations, and the fact that children are in general in noisy environments in the classroom setting for a large proportion of their day, it was of obvious interest to evaluate the potential for benefit in poor signal-to-noise ratios from use of the Speak processing strategy and from specific training in the ability to perceive in background noise. The study was aimed at evaluating whether children who were experienced in use of the Multipeak speech processing strategy would be able to changeover to the new Speak processing strategy, which provides a subjectively different output. Secondly, the study aimed to evaluate the benefits which might accrue to children from use of controlled habilitation in background noise.
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ItemVowel imitation task: results over time for 28 cochlear implant children under the age of eight years( 1995)With increasing numbers of implanted children under the age of 4 years, numerous researchers have reminded us of the need for valid, sensitive, and reliable tests of developing speech perception.1,2 In addition to studies of the efficacy of implanted prostheses, there is a need to investigate the many variables that influence children's communicative performance, such as changes in speech-coding strategy, updated speech-processing systems, the effects of various training regimens, and the selection of educational and communication modes.
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ItemSpeech perception, production and language results in a group of children using the 22-electrode cochlear implant( 1992)Five children out of a group of nine (aged 5.5 to 19.9 years) implanted with the 22-electrode cochlear implant (Cochlear Ply. Ltd.) have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores for monosyllabic words ranged from 40% to 72%. Word scores in sentences ranged from 26% to 74%. Four of these five children were implanted during preadolescence. The fifth child, who had a progressive loss and was implanted during adolescence after a short period of very profound deafness, scored highest on all speech perception tests. The remaining four children who did not demonstrate open-set recognition were implanted during adolescence after a long duration of profound deafness. Post-operative performance on closed-set speech perception tests was better than pre-operative performance for all children. Improvements in speech and language assessments were also noted. These improvements tended to be greater for the younger children. The results are discussed with reference to variables which may contribute to successful implant use: such as age at onset, duration of profound hearing loss, age at implantation, aetiology, educational program, and the type of training provided.
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ItemResults for two children using a multiple-electrode intracochlear implant( 1989)Abstract not available due to copyright.
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ItemSpeech perception in implanted children: effects of speech processing strategy and residual hearing(Mendoza Editor, 1997)The ability of implanted children to adapt to different speech processing strategies has been demonstrated for the Nucleus implant system. Children previously experienced with the Multipeak speech processing strategy. were able to gain significant improvements in consonant, word and sentence perception using the Speak speech processing strategy. suggesting some degree of neural plasticity in neural-auditory coding. Of 192 implanted children with different degrees of preoperative residual hearing, 65% were found to obtain significant scores on open-set speech materials using electrical stimulation alone. Those children with more residual hearing had a greater probability of achieving open-set understanding and at a minimum level, perceived high frequency consonant information which would not have been available through conventional hearing aids.
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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.