Graeme Clark Collection
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ItemFactors affecting speech perception outcomes for older children using multichannel cochlear implants( 2002)Experience with cochlear implantation in early-deafened teenagers or young adults has been somewhat disappointing, however, in recent years a proportion of older children have demonstrated excellent speech perception performance. There appears to be a wide gap between the good and poor performers within this group. It is important to investigate the possible factors influencing performance so that adolescents and their families are able to make informed decisions regarding cochlear implant surgery. This study considered a number of factors in a group of 25 children implanted in Melbourne between the ages of 8 and 18 years. Each subject completed open set speech perception testing using BKB sentences before and after implantation and pre-operative language testing using the Peabody Picture Vocabulary Test. Data were collected regarding the type of hearing loss, age at implant, age at hearing aid fitting, audiometric details, and the pre-and postoperative communication mode. Multivariate analysis suggested that three factors have a significant predictive value for post-implant speech perception: pre-operative open-set sentence score, duration of profound hearing loss and equivalent language age. These three factors accounted for 66% of the variance in this group. The results of this study suggest that children who have useful pre-implant speech perception, and higher age-equivalent scores on language measures, would be expected to do well with a cochlear implant. A shorter duration of profound hearing loss is also advantageous. Mean speech perception scores for the older group were not significantly different from younger children.
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ItemPost-implant habilitation for children using cochlear implants: effects on long-term outcome( 2002)Most clinicians working in the cochlear implant field advocate a regular habilitation program for young children receiving implants. The development of auditory skills and the incorporation of these skills into language development are thought to be key areas for such programs. Studies of speech perception and language outcomes demonstrate that an educational approach that emphasises spoken language development appears to enhance the results for implanted children. It remains difficult, however, to demonstrate clearly the effect of habilitation objectively and to determine how much individual attention is desirable for each child. This pilot study considered the long term speech perception and language outcomes for two groups of children who received Nucleus cochlear implants in Melbourne. One group (n=17) was identified as receiving regular habilitation from the Melbourne Cochlear Implant Clinic over a four year post-operative period. Another group (n=l1) was identified as receiving very little regular habilitation over the post-operative period. The language and speech perception results for these two groups showed a significant difference in performance on a wide range of measures with the group receiving regular formal habilitation demonstrating better performance on all measures. These groups included only congenitally, profoundly hearing-impaired children and did not differ significantly on mean age at implant or experience at the time of assessment. Further studies are needed to clarify these results on a larger group of children, and to control for additional confounding variables. Nonetheless, these preliminary results provide support for the incorporation of regular long-term habilitation into cochlear implant programs for children.
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ItemInitial speech perception results with the new multipeak speech processor for the 22-electrode cochlear prosthesis [Abstract]( [1990])A new speech processor has been developed for the 22-electrode cochlear prosthesis by Cochlear Pty Ltd working in conjunction with the Department of Otolaryngology at the University of Melbourne. The new device, known as the MSP, combines smaller, more efficient hardware with a new speech coding scheme in an attempt to provide better speech perception in everyday environments for implant users. The MSP operates with the current implant device so there is no need for existing implantees to have revision surgery to make use of the new development. The multipeak speech coding scheme, which has been implemented in the MSP, provides information from three high frequency spectral bands, in addition to the parameters of voice pitch, amplitude and first and second formants which have been provided in the existing FOFIF2 coding scheme for the last four years. Initial speech perception results with research subjects have shown significant improvements in performance for the MSP over the older system (WSP III). The most encouraging result is that open-set speech perception in the presence of competing noise has improved substantially. For example, mean scores for BKB sentences in a 10 dB signal-to-noise ratio were 64% for the MSP and 31% for the WSP III. Further investigations have shown that both the hardware improvements and the new multipeak speech coding scheme have contributed significantly to the overall improvement in performance. Studies are continuing to analyse further the potential of the new system.