Graeme Clark Collection
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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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ItemExperimental study on extracochlear electric stimulation [Abstract]( 1992)The efficiency and feasibility of chronic extracochlear implantation and electric stimulation were studied in two adult cats and four 2-month kittens. The first electrode was placed on the round window by fixing the leadwire on the bridge of aditus between the middle ear and bulla cavity; the second electrode was placed on the surface of the tympanic promontory; the third was inserted into the temporal muscle out of the bulla and the forth fixed in transverse sinus with dental cement. ABRs and EABRs were recorded pre-and postoperatively and during electric stimulation.
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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.
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ItemThe development of the Melbourne/Cochlear multiple-channel cochlear implant for profoundly deaf children( 1992)In 1978-79, a speech processing strategy which extracted the voicing (FO) and second formant (F2) frequencies and presented these as rate and place of stimulation respectively to residual auditory nerve fibres was developed for the University of Melbourne's prototype multiple-channel receiver-stimulator (Clark et aI1977, Clark et a11978, Tong et aI1980). This speech processing strategy was shown to provide post linguistically deaf adults with some open-set speech comprehension using electrical stimulation alone, and considerable help when used in combination with lipreading (Clark et al 1981).
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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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ItemPaediatric cochlear implantation: radiologic observations of skull growth( 1993)We investigated the effects of long-term implantation of auditory prostheses on skull growth in young animals. Four monkeys were implanted with dummy cochlear implants at 6 months of age. To simulate implantation in children, the bed for the receiver-stimulator or interconnecting plug was drilled across a calvarial suture down to the underlying dura. Plain skull oentgenograms were periodically taken to monitor head growth for up to 3 years after implantation. These longitudinal measurements revealed no significant asymmetric skull growth. Postmortem measurements using computed tomographic scans confirmed these results and showed no significant difference in the intracranial volumes between the implanted and control sides of each animal or between experimental and nonimplanted control monkeys. These results suggest that long-term cochlear implantation in very young children will not cause any significant deformity of the skull.
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ItemComparison of current speech coding strategies( 1993)This paper reports on two studies carried out at the University of Melbourne jointly with Cochlear Pty Ltd. The studies demonstrated substantial speech perception improvements over the current Multipeak strategy in background noise.
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ItemTinnitus management in the profoundly and totally deaf( 1993)Tinnitus is a common symptom of many cochlear or auditory system pathologies. Since tinnitus is frequently associated with a sensorineural hearing loss, it is not surprising that a large proportion of profoundly and totally deaf patients describe tinnitus as a symptom. The clinical management of severe tinnitus in these patients is discussed with particular emphasis on the use of electrical stimulation. While cochlear implants appear to provide a measure of relief when being used, significant improvements in the management of severe tinnitus will only occur when we have a greater understanding of the underlying pathophysiology, diagnostic procedures that can accurately establish the site of tinnitus generation, and more objective clinical trial procedures that include the use of controls.
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ItemThe effects of auditory feedback from the nucleus cochlear implant on the vowel formant frequencies produced by children and adults( 1993)Cochlear implants provide an auditory signal with which profoundly deaf users may monitor their own speech production. The vowel production of two adults and three children who used the Nucleus multiple-electrode cochlear implant was examined to assess the effect of altered auditory feedback. Productions of words were recorded under conditions where the talkers received auditory feedback (speech processor turned on) and where no auditory feedback was provided (speech processor turned off). Data were collected over 3 days at weekly intervals. First and second formant frequencies were measured and the data were analysed to assess significant differences between auditory feedback conditions, vowel context, and data collection points. Overall, the results varied across talkers, across the data collection days, and depended on the consonant environment of the vowel. However, two effects of auditory feedback were noted. First, there was a generalized shift in first formant frequencies between the processor on and processor off conditions across three of the five subjects, but the shift differed in direction for each subject. Second, for three of the five talkers, the two front vowels /ε/ and /I/ were more neutralised in the absence of auditory feedback. However, this effect was less pronounced than that noted by previous studies.
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ItemSteady state evoked potentials: a new tool for the accurate assessment of hearing in cochlear implant candidates( 1993)Precise determination of residual hearing in prospective cochlear implant candidates is essential. As the minimum age of implantation for young children has reduced, the use of objective measures of hearing has become more important. At the University of Melbourne Cochlear Implant Clinic, steady state evoked potential (SSEP) assessments are routinely carried out on all candidates under the age of 5 years using a microcomputer and custom-designed hardware in the manner described by Cohen et al. [1].