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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ItemElectrical stimulation of the auditory nerve: the coding of frequency, the perception of pitch and the development of cochlear implant speech processing strategies for profoundly deaf people( 1996)1. The development of speech processing strategies for multiple-channel cochlear implants has depended on encoding sound frequencies and intensities as temporal and spatial patterns of electrical stimulation of the auditory nerve fibres so that speech information of most importance for intelligibility could be transmitted. 2. Initial physiological studies showed that rate encoding of electrical stimulation above 200 pulses/s could not reproduce the normal response patterns in auditory neurons for acoustic stimulation in the speech frequency range above 200 Hz and suggested that place coding was appropriate for the higher frequencies. 3. Rate difference limens in the experimental animal were only similar to those for sound up to 200 Hz. 4. Rate difference limens in implant patients were similar to those obtained in the experimental animal. 5. Satisfactory rate discrimination could be made for durations of 50 and 100 ms, but not 25 ms. This made rate suitable for encoding longer duration suprasegmental speech information, but not segmental information, such as consonants. The rate of stimulation could also be perceived as pitch, discriminated at different electrode sites along the cochlea and discriminated for stimuli across electrodes. 6. Place pitch could be scaled according to the site of stimulation in the cochlea so that a frequency scale was preserved and it also had a different quality from rate pitch and was described as tonality. Place pitch could also be discriminated for the shorter durations (25 ms) required for identifying consonants. 8. As additional speech frequencies have been encoded as place of stimulation, the mean speech perception scores have continued to increase and are now better than the average scores that severely-profoundly deaf adults and children with some residual hearing obtain with a hearing aid.
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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.
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ItemAdvances in cochlear implant speech processing(Monduzzi Editore, 1997)A cochlear implant is a device which restores some hearing in severely-to-profoundly deaf people when the organ of Corti has not developed or is destroyed by disease or injury to such an extent no comparable hearing can be obtained with a hearing aid. When the organ of Corti is severely malfunctioning or absent, sound vibrations cannot be transduced into temporo-spatial patterns of action potentials along the auditory nerve for the coding of frequency and intensity. As a result, a hearing aid which amplifies sound is of little or no use. Our early research (Clark, 1969) emphasized that with electrical stimulation there was an electro-neural "bottle-neck" restricting the amount of speech and other acoustic information that could be presented to the nervous system. It also showed the need to use multiple-channel stimulation presented non-simultaneously, to minimize channel interaction (Clark, 1987).
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ItemAdvances in cochlear implant speech processing [Abstract]( 1997)Our early research emphasized there was a restriction on the amount of speech and other acoustic information that could be transmitted to the nervous system by electrical stimulation of the auditory nerve. It also showed the need to use multiple-channel stimulation, and minimize channel interaction. As a result our research over the last 30 years has been directed towards optimizing the information presented to the auditory nervous system. This has involved extracting the energy of the first and second formants (FO/F2-WSP II; FO/FI/F2-WSP III; Multipeak-MSP) as well as the outputs of high band pass fixed filters (Multipeak - MSP) and coding these outputs as cochlear place of stimulation. The voicing frequency was coded as rate of stimulation. Our most recent speech processing strategy (SPEAK) extracts a specified number of .maximal outputs from a series of band pass filters, rather than selecting the peaks of energy which was the case with the other strategies. The voltages from the maximal outputs are used to stimulate appropriate electrodes on a place coding basis. The stimuli are presented at a constant stimulus rate to reduce channel interaction. Voicing is conveyed as amplitude variations.
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ItemA stimulation of spatio-temporal firing across auditory nerve fibres( 1997)Present cochlear implant speech processing strategies give recipients a perception of sound inferior to that of the normal hearing population. Since it is beyond current technology to achieve an electrically evoked auditory-nerve output identical to that of normal hearing, stimulation strategies are limited to approximating certain features of the neural firing patterns. The importance of the spatio-temporal firing patterns of an ensemble of auditory nerve fibres to speech perception has been stated in previous studies (1,2). This paper utilises a composite model of the cochlea and hair-cell/auditory nerve transduction using artificial and speech signals as input to produce a spatio-temporal excitation pattern which represents the fluctuating firing probability of the auditory neurons. A model of electrical stimulation of the auditory nerve is then used to show how stimulation strategies currently used produce neural firing patterns qualitatively different to those produced by normal hearing. Our investigations indicate that it is possible to generate electrical stimulation parameters that cause the spatio-temporal responses of the neural population to better approximate normal hearing. These responses enable us to identify stimulation parameters required to obtain the chosen neural firing patterns. A number of examples illustrate the utility of this method, revealing the spatio-temporal responses for varying numbers of neurons and electrode displacements.
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ItemTemporal coding in auditory neurons to electrical stimulation [Abstract]( 1997)The temporal response of the auditory pathway following intracochlear electrical stimulation will reflect the level of encoded temporal information, which is important for the further developmentof cochlear implant speech processing strategies, and in tum lead to a better understanding of temporal coding of acoustic stimuli Temporal coding of sound frequencies is based on the phase or time locked neural response seen to low frequency acoustic stimuli. The ability of neurons to respond in a time locked manner may determine the degree of encoded temporal frequency information. Electrophysiological studies have shown that the degree of response synchrony to charge balanced biphasic electrical stimuli is far greater than that seen to acoustic stimuli. We have investigated the temporal response properties of single units in the anteroventral cochlear nucleus (AVCN) in the cat to rates of electrical stimulation up to 800 pulses/s.