Graeme Clark Collection

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    Preoperative residual hearing as a predictor of postoperative speech scores for adult cochlear implant users [Abstract]
    COWAN, ROBERT ; HOLLOW, RODNEY ; DOWELL, RICHARD ; PYMAN, BRIAN ; Clark, Graeme M. ( 1994)
    The development of multiple channel cochlear implants has been a significant advance in the rehabilitation of profound hearing loss. Speech perception benefits have been particularly evident for postlinguistically deafened adults, who as a group have shown not only supplementation of lipreading scores but also significant comprehension of words and sentences using an implant alone, without the aid of lipreading. In many cases, patients are able to use their implant for telephone conversation. Speech perception benefits for adult users have increased with advances in speech processing and improved means of habilitation. These improvements in open-set speech benefits for adult users have resulted in a steady increase in group mean scores and a reevaluation of selection criteria for cochlear implantation. In the initial development of cochlear implants, only those with little or no residual hearing were considered as candidates. Current selection criteria now include those with substantial residual hearing, who may score up to 40% in the best-aided condition on word and sentence speech perception tests. In order to provide realistic expectations for prospective cochlear implant patients, it is important to establish the relationship of many preimplant factors to postimplant speech perception benefits. For severely hearing impaired adults, the relationship between preoperative residual hearing, as measured by aided word and sentence speech perception test scores, and postoperative speech perception benefits is of significant interest. Analysis of data collected over a 15 year period for adult patients is presented. The rationale for conducting full speech perception assessments for all potential cochlear implant patients is stressed.
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    A clinical report on vocabulary skills in cochlear implant users [Abstract]
    Dawson, P. ; Blamey, P. ; Dettman, S. ; Rowland, L. ; Barker, E. ; Cowan, R. ; Clark, Graeme M. ( 1994)
    Receptive vocabulary results are reported for 32 children, adolescents and prelinguistically deafened adults implanted with the 22-electrode cochlear implant at the Melbourne Cochlear Implant Clinic. Age at implantation ranged from 2 years, 6 months to 20 years and implant use ranged from 1 year to 7 years, 8 months. There were significant gains from pre- to postoperative assessments on the Peabody Picture Vocabulary Test (PPVT) for the majority of subjects. Rates of improvement found are compatible with previous reports on smaller numbers of implant users, but cannot be attributable unambiguously to use of the implant. The group postoperative performance was significantly higher than mean preoperative performance (n =25). The relationship of variables such as duration of implant use, duration of profound deafness and speech perception ability to improvement on the PPVT is discussed. Expressive vocabulary results on the Renfrew Word Finding Vocabulary Scale are reported for 11 of the subjects. Less substantial gains were made on this measure.
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    The evolution continues: the clinical trials of the SPEAK strategy in Nucleus 22 channel cochlear implant users [Abstract]
    Antognelli, Trisha ; Whitford, Lesley ; SELIGMAN, PETER ; Everingham, Colleen ; Skok, Marisa ; Plant, Kerrie ; Hollow, Rod ; Staller, Steve ( 1994)
    Research in the field of cochlear implants continues in centres around the world. The aim of all centres is to improve the speech perception abilities of those children and adults fitted with a cochlear implant. Most recently the work of Hugh McDermott and Colette McKay (Melbourne University, Department of Otolaryngology) in developing and researching the SMSP (Spectral Maxima Sound Processor) has greatly enhanced the speech understanding abilities of a number of subjects implanted with the Nucleus 22 Channel Cochlear Implant.
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    The spectral maxima sound processor: recent findings in speech perception and psychophysics
    McKay, Colette M. ; McDermott, Hugh J. ; Vandali, Andrew E. ; Clark, Graeme M. (Wien, 1994)
    The Spectral Maxima Sound Processor (SMSP) was developed at the University of Melbourne for use with the Mini System 22 implant manufactured by Cochlear Pty Ltd. The SMSP has been shown in recent studies to provide improved speech perception to implantees when compared to the currently commercially available processor for this implant (the MSP (MULTIPEAK) processor). In the first of three experiments, the effect on speech perception of increasing the rate of stimulation of the SMSP and of increasing the number of electrodes activated in each stimulation cycle was studied. It was found that these parameter changes made little difference to speech perception in quiet but both changes were advantageous for some subjects when listening in noise. The second and third experiments investigated psychophysically the effects of two aspects of the SMSP strategy which differ from previous processors for this implant. In the second experiment, it was found that concurrent stimulation of two adjacent or nearby electrodes evoked a pitch which was intermediate to that of either electrode. This may explain, in part, the better discrimination of vowel formants by users of the SMSP. In the third experiment, it was found that a pitch related to the modulation frequency was evoked by amplitude-modulating a constant rate stimulus, provided that the rate of stimulation was sufficiently high (four times the modulation frequency) or a multiple of the modulation frequency. This result may explain the equal ability of SMSP and MSP users to perceive speaker differences and intonation patterns, even though the rate of stimulation is constant In the SMSP.
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    Psychophysical and speech perception studies: a case report on a binaural cochlear implant subject
    van Hoesel, R. J. M. ; Tong, Y. C. ; Hollow, R. D. ; Clark, Graeme M. ( 1993)
    Abstract not available due to copyright.
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    Speech processing for cochlear implants
    Tong, Y. C. ; Millar, J. B. ; Blamey, P. J. ; Clark, Graeme M. ; Dowell, R. C. ; Patrick, J. F. ; Seligman, P. M. (JAI Press Ltd, 1992)
    The cochlear implant is a hearing prosthesis designed to replace the function of the ear. The operation of the prosthesis can be described as a sequence of four functions: the processing of the acoustic signal received by a microphone; the transfer of the processed signal through the skin; the creation of neural activity in the auditory nerve; and the integration of the experience of this neural activity into the perceptual and cognitive processing of the implantee.
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    Cochlear implants in children, adolescents, and prelinguistically deafened adults: speech perception
    Dawson, Pam. W ; Blamey, Peter J. ; Rowland, Louise C. ; Dettman, Shani J. ; Clark, Graeme M. ; Busby, Peter A. ; Brown, Alison M. ; Dowell, Richard C. ; Rickards, Field W. ( 1992)
    A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Pty Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11 to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.
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    The development of speech processing strategies for the University of Melbourne/cochlear multiple channel implantable hearing prosthesis.
    Clark, Graeme M. ( 1992)
    The speech processing strategies that have been used with the University of Melbourne/Cochlear multiple channel implantable hearing prosthesis have been developed systematically from the inaugural one that extracted the second formant and presented this on a place coding basis and the voicing frequency which determined the rate of stimulation. Speech processing has also depended heavily on biological research to ensure that the stimulus parameters used or the operative approach did not damage the spiral ganglion cells it was hoped to stimulate. The advances in speech processing from Melbourne primarily have been to extract more features and spectral information and present this on a place coding basis. This has led to a progressive improvement in speech perception, and a small number of patients can achieve nearly 100% correct scores for open sets of phonetically-balanced words using electrical stimulation alone.
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    A new portable sound processor for the University of Melbourne/ Nucleus Limited multielectrode cochlear implant
    McDermott, Hugh J. ; McKay, Colette M. ; Vandali, Andrew E. ( 1992)
    Abstract not available due to copyright.
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    Cochlear implants in children, adolescents, and prelinguistically deafened adults: speech perception
    Dawson, Pam W. ; Blamey, Peter J. ; Rowland, Louise C. ; Dettman, Shani J. ; Clark, Graeme M. ; Busby, Peter A. ; Brown, Alison M. ; Dowell, Richard C. ; Rickards, Field W. ( 1992)
    A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Ply Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.