Graeme Clark Collection
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ItemArticulation accuracy of children using an electrotactile speech processor( 1995)Objective: Use of wearable tactile speech perception devices is suggested to help overcome the difficulties in speech production resulting from severe and profound hearing impairment in children. This suggestion is based on the assumption that subjects can use tactile input in isolation, or in combination with information from residual aided hearing, to monitor and modify their speech. The present study evaluated the benefits to articulation provided through use of a multichannel electrotactile device (“Tickle Talker™”). Design: Six profoundly hearing-impaired children were videotaped speaking with the Tickle Talker on and with the Tickle Talker off during conversations with their audiologist. Five of the subjects also wore their binaural hearing aids during all recorded conversations. The number of vowels, consonants, and overall phonemes correctly articulated by each child in the two conditions were compared. Results: One subject improved articulation of initial consonants and initial phonemes; one subject improved articulation of total vowels, total consonants, initial consonants, total phonemes, and initial phonemes; and a third subject improved articulation of total vowels and medial phonemes. Conclusions: Use of on-line tactile feedback from the Tickle Talker may benefit the articulation accuracy of some children, and the device may therefore be suitable to use with children who have not responded to more traditional speech training techniques.
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ItemThe progress of children using the multichannel cochlear implant in Melbourne( 1995)Multi-channel cochlear implantation in children began in Australia in 1985 and there are now close to 4000 profoundly deaf children and adolescents using the Australian implant system around the world. The aim of the implant procedure is to provide adequate hearing for speech and language development through auditory input. This contrasts with the situation for adults with acquired deafness where the cochlear implant aims to restore hearing for someone with well-developed auditory processing and language skills. As with adults, results vary over a wide range for children using the Multi-channel implant. Many factors have been suggested that may contribute to differences in speech perception for implanted children. In an attempt to better understand these factors, the speech perception results for children implanted in Melbourne were reviewed and subjected to statistical analysis. This has indicated that the amount of experience with the implant and the length of sensory deprivation are strongly correlated with perceptual results. This means that younger children are likely to perform better with an implant and that a number of years of experience are required for children to reach their full potential. The results have also indicated that educational placement and management play a crucial role in children reaching their potential. Overall, 60% of the children and adolescents in the study have reached a level of open-set speech understanding using the cochlear implant without lipreading.
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ItemCochlear implants in children: the value of cochleostomy seals in the prevention of labyrinthitis following pneumococcal otitis media( 1995)Cochlea implantation at an early age is important in rehabilitating profoundly hearing impaired children. Given the incidence of pneumococcal otitis media in young children, there has been concern that cochlear implantation could increase the possibility of otitis media, leading to labyrinthitis in this age group. Clinical experience has not indicated an increase in the frequency of otitis media and labyrinthitis in implanted adults or children over two years. However, labyrinthitis has occurred in implanted animals with otitis media. In order to assess the impact of cochlear implants on the occurrence of labyrinthitis, pneumococcal otitis media was induced in 21 kittens. Thirty-two kitten cochleas were implanted, of which 9 had a fascial graft and 9 a Gelfoam® graft. Nine control cochleas were unimplanted. Labyrinthitis occurred in 44% of unimplanted controls. 50% of implanted ungrafted cochleas, and 6% of implanted grafted cochleas. There was no statistically significant difference between the incidence of labyrinthitis in the implanted cochleas and the unimplanted controls. However there was a statistically significant difference between the ungrafted and grafted cochleas, but not between the two types of graft.
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ItemPhonetic and phonological changes in the connected speech of children using a cochlear implant( 1995)In excess of 5,000 children, with profound hearing impairment, have received a cochlear implant hearing device. Researchers have recently begun to study the speech production skills of these children.1-6 This topic is of interest because the speech of young prelingually or postlingually deaf children is in a constant state of development. The effectiveness of the implant, therefore, must be measured in its ability to provide enough auditory information for the child to develop intelligible speech. This is in addition to the maintenance of intelligible speech in the case of older postlingually deaf children or adults. The aim of the present study was to investigate some characteristics of the connected speech of a selected group of children from the University of Melbourne Cochlear Implant Programme. More specifically, the study aimed to determine how these characteristics changed over time. Studies of conversational speech samples are useful in that they do not depend on imitation yet they do reflect the child's everyday communication skills and are sensitive to co-articulatory effects. Analyses performed on the preoperative and postoperative data aimed to detect both the phonetic and phonologic changes in the segmental features of speech. The following questions were addressed: 1) What was the pattern of change in the phonetic inventories from before to after implantation? 2) Was there a difference in the correct production of consonants depending on their position in the word? 3) Did the group performance for correct production of phonemes change significantly from before to after implantation? 4) Did performance change over time for individuals? 5) What were the most common phonologic processes and was there a significant reduction in any of these processes from before to after implantation?
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ItemPotential and limitations of cochlear implants in children( 1995)Multiple-channel cochlear implants have been in use with children and adolescents for 8 years. The speech perception, speech production, and language of many of these children has been investigated in some detail.l-4 There have been many predictions about factors that may affect the performance of children with implants. For instance, it has been suggested that children with a congenital loss of hearing would not have the same potential to benefit from a cochlear implant as those with an acquired loss. Similarly, it has been suggested that younger children are likely to gain more benefit from a cochlear implant because of the effect of various critical ages for language learning.5 As more results have become available, it has been our observation that the performance of any particular child with a cochlear implant does not appear to follow well-defined rules, and that generalizations about the potential of certain groups of children are likely to encounter many exceptions. We now have a large quantity of results for children using cochlear implants, and it may be possible to determine some of the factors that have a significant effect on performance. This paper will attempt to identify some of these factors by reviewing speech perception results for 100 children implanted with the Nucleus 22-channel cochlear prosthesis in Australia and speech perception results for adult patients. This analysis will use an "information processing" model of a child using a cochlear implant. That is, we will assume that a child will benefit from a cochlear implant in terms of speech perception, production, and language development, if he or she receives a maximal amount of auditory information from the environment, and is able to process this information successfully. This model divides potential limiting or predictive factors into those that affect the information presented to the auditory system (eg, implant technology, surviving auditory neurons) and those that affect the processing of this information (eg, development of central auditory pathways, amount and consistency of auditory input).
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ItemSpeech self-monitoring by children using an electrotactile speech processor( 1995)For the profoundly and severely-to-profoundly hearing impaired child, lipreading and hearing aids are not always sufficient to develop adequate speech perception and production skills. Tactile devices have been investigated as a source of supplementary speech information, with most research focusing on speech perception benefits. However, speech production difficulties are also a major issue for these children, and research into tactile devices should include investigation of the option to use them as speech production aids. This paper will present the results from an initial examination of the suitability of one tactile device for speech production monitoring.
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ItemFluctuating sensorineural hearing loss in children with Mondini malformation of the cochlea: implications for audiological management [Abstract]( 1994)Long term audiological data is presented for three children, who experienced fluctuating sensorineural hearing loss. Two children were preschool age and the third was in primary school at the time of fluctuation. All were subsequently diagnosed as having fistulas in association with Mondini malformation of the cochlea. These results serve to highlight the need for vigilance in monitoring hearing loss stability in young children when other external factors may limit the extent of information which can be obtained in any one appointment.
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ItemIssues in long-term management of children with cochlear implants and tactile devices [Abstract]( 1994)For many children with severe and profound hearing losses, conventional hearing aids are unable to provide sufficient amplification to ensure good oral communication and/or in the case of very young children, development of speech and language. Traditionally a number of these children have opted for the use of sign language alone or in Total Communication approaches as a primary means of communication. The advent of multiple channel cochlear implants for children and the continuing development of multiple channel speech processing tactile devices provide auditory approaches to resolving communication difficulties for these children. The successful use of such devices depends on a number of factors including the information provided through the aid; the ease of use, convenience and reliability of the aid; the individual communication needs of the child; and the habilitation and management program used with the device. Long-term data has shown that children continue to show increased speech perception benefits from improvements in speech processing and from further experience with these devices. Habilitation and management programs must therefore be geared to meet the changing needs of children as they progress and of families as children mature and face new challenges. Habilitation must address specific individual needs in speech perception and in speech production. For very young children, benefits of improved speech perception should have an impact on the development of speech and language, and habilitation and management must emphasise the need for language growth.
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ItemAccuracy of behavioural threshold prediction using steady-state evoked potentials [Abstract]( 1994)This paper examines the confidence with which predictions of hearing level can be made using the steady-state evoked potential (SSEP) technique. Steady-state evoked potentials are scalp potentials that can be elicited in response to sinusoidally amplitude and/or frequency modulated tones in sleeping or awake subjects. SSEP thresholds were obtained using frequency specific stimuli at octave frequencies between 250Hz and 4000Hz in 25 children and 35 adults with varying degrees of sensori-neural hearing loss. These levels, determined automatically by a computerised detection system, were then compared with thresholds obtained behaviourally. Linear regression analyses of this data have shown that the SSEP procedure allows objective estimates of hearing level to be made for a range of carrier frequencies to within 10dB accuracy on 96% of occasions.
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ItemThe diagnostic assessment of infants using steady-state evoked potentials [Abstract]( 1994)This paper examines the relationship between the steady-state potential and behavioural thresholds obtained in two groups of young children. The first group consists of 10 babies referred to the Victorian Children's Hearing Centre following abnormal findings on screening ABR assessments. The second group contains 20 difficult to test infants who had unconfirmed hearing losses at the time of the SSEP assessment. The hearing levels predicted by the regression lines (described in the companion paper presented at this conference) were in close agreement with the behavioural levels obtained subsequently from children in both groups.