Graeme Clark Collection
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ItemSpeech perception and spoken language in children with impaired hearing( 1998)Fifty seven children with impaired hearing aged 4-12 years were evaluated with speech perception and language measures as the first stage of a longitudinal study. The Clinical Evaluation of Language Fundamentals (CELF) and Peabody Picture Vocabulary Test (PPVT) were used to evaluate the children's spoken language. Regression analyses indicated that scores on both tests were significantly correlated with chronological age, but delayed relative to children with normal hearing. Performance increased at 45% of the rate expected for children with normal hearing for the CELF, and 62% for the PPVT. Perception scores were not significantly correlated with chronological age, but were highly correlated with results on the PPVT and CELF. The data suggest a complex relationship whereby hearing impairment reduces speech perception, which slows language development, which has a further adverse effect on speech perception.
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ItemRehabilitation strategies for adult cochlear implant users(Monduzzi Editore, 1997)This paper summarizes open-set speech perception results using audition alone for a large group of adult Nucleus cochlear implant users in Melbourne. The results show wide variation in performance but significant improvement over the years from 1982 to 1995. Analysis of these results shows that speech processor developments have made the major contribution to this improvement over this time. Recent results for patients using the SPECTRA-SPEAK processor show !hat most subjects obtain good speech perception within six months of implantation and the need for intensive auditory training is minimal for many of these patients. Postoperative care should encourage consistent device use by providing opportunities for success and providing long term technical support for implant users. In some cases, including elderly patients, those with long term profound deafness, and those with special needs, there will still be a need for additional rehabilitation and auditory training support.
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ItemFactors affecting outcomes in children with cochlear implants(Monduzzi Editore, 1997)Open-set speech perception tests were completed for a group of 52 children and adolescents who were long-term users of the Nucleus multiple channel cochlear prosthesis. Results showed mean scores for the group of 32.4% for open-set BKE sentences and 48.1% for phonemes in open-set monosyllabic words. Over 80% of the group performed significantly on these tas1cs. Age at implantation was identified as a significant factor affecting speech perception performance with improved scores for children implanted early. This factor was evident in the results at least down to the age of three years. Duration.. of profound hearing loss, progressive hearing loss, educational program and preoperative residual hearing were also identified as significant factors that may affect speech perception performance.
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ItemThe effect of language knowledge on speech perception in children with impaired hearing( 1996)Open-set words and sentences were used to assess auditory speech perception of three hearing-impaired children aged 9 to 15 years using the Nucleus 22channel cochlear implant. Vocabulary and syntax used in the tests were assessed following the initial perception tests. Remediation was given in specific vocabulary and syntactic areas, chosen separately for each child, and the children were reassessed. Two children showed a significant post-remediation improvement in their overall scores on the syntactic test and both perception measures. The third child who was older, had the best language knowledge and the lowest auditory speech perception scores, showed no significant change on any of the measures. Language remediation in specific areas of weakness may be the quickest way to enhance speech perception for some children with impaired hearing in this age range.
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ItemHabilitation issues in the management of children using the cochlear multiple-channel cochlear prosthesis( 1993)Since 1985, a significant proportion of patients seen In the Melbourne cochlear Implant clinic have been children. The children represent a diverse population, with both congenital and acquired hearing-impairment, a wide-range or hearing levels pre-Implant, and an age range from 2 years to 18 years. The habilitation programme developed for the overall group must be flexible enough to be tailored to the Individual needs of each child, and to adapt to the changing needs or children as they progress. Long-term data shows that children are continuing to show Improvements after 5-7 years of device use, particularly In their perception of open-set words and sentences. Habilitation programs must therefore be geared to the long-term needs of children and their families. Both speech perception and speech production need to be addressed In the specific content of the habilitation program for any Individual child. In addition, for young children, the benefits or Improved speech perception should have an Impact on development of speech and language, and the focus of the programme for this age child will reflect this difference In emphasis. Specific materials and approaches will vary for very young children, school-age and teenage children. In addition, educational selling will have a bearing on the Integration of listening and device use Into the classroom environment.
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ItemSpeech perception, production and language results in a group of children using the 22-electrode cochlear implant( 1989)Paper presented at the 118th Meeting of the Acoustical Society of America
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ItemSpeech processing strategies in an electrotactile aid for hearing-impaired adults and children(Australian Speech Science and Technology Association, 1990)An electrotactile speech processor (Tickle Talker) for hearing-impaired children and adults has been developed and tested. Estimates of second format frequency, fundamental frequency and speech amplitude are extracted from the speech input, electrically encoded and presented to the user through eight electrodes located over the digital nerve bundles on the fingers of the non-dominant hand. Clinical results with children and adults confirm that tactually-encoded speech features can be recognized, and combined with input from vision or residual audition to improve recognition of words in isolation or in sentences. Psychophysical testing suggests that alternative encoding strategies using multiple-electrode stimuli are feasible. Preliminary results comparing encoding of consonant voiced/voiceless contrasts with new encoding schemes are discussed.
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ItemCombining tactile, auditory and visual information for speech perception( 1988)Four normally hearing subjects were trained and tested with all combinations of a highly degraded auditory input, a visual input via lipreading, and a tactile input using a multichannel electrotactile speech processor. When the visual input was added to any combination of other inputs, a significant improvement occurred for every test. Similarly, the auditory input produced a significant improvement for all tests except closed-set vowel recognition. The tactile input produced scores that were significantly greater than chance in isolation, but combined less effectively with the other modalities. The less effective combination might be due to lack of training with the tactile input, or to more fundamental limitations in the processing of multimodal stimuli.
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ItemResults of multiple-electrode cochlear implants in children( 1987)Children in Australia and United States of America are now being implanted with the Nucleus 22 electrode intracochlear prosthesis utilizing the F0/F1F2 coding strategy. A total of 32 adolescents (10-17 years) and 24 preadolescents (2-9 years) have been implanted as of 31 August, 1987. No significant postoperative complications were recorded, the speech processors were successfully programmed, and all are users of the device. For the 56 children, the average length of postoperative stimulation time is 2.8 months. Because the majority of children have such short experience with the device we report herein two children from the University of Melbourne (A) and two children from the United States (U) who have been using the Nucleus system for 12 months or more. Child 1A has only 10 electrodes in the cochlea; therefore, the number of channels programmed for the children is 10, 17, 18 and 18, respectively. Child Al and A2 were deafened by meningitis at 3-3 and 3 years of age, respectively. Child U3 became profoundly deafened from a progressive sensorineural loss at age 11 and Child U4 was deafened by recurrent cochlear hydrops at age 13 years.
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ItemSignal processing in quiet and noise( 1987)It has been shown that many profoundly deaf patients using multichannel cochlear implants are able to understand significant amounts of conversational speech using the prosthesis without the aid of lipreading. These results are usually obtained under ideal acoustic conditions but, unfortunately, the environments in which the prostheses are most often used are rarely perfect. Some form of competing signal is always present in the urban setting, from other conversations, radio and television, appliances, traffic noise and so on. As might be expected, implant users in general find background noise to be the largest detrimental factor in their understanding of speech, both with and without the aid of lipreading. Recently, some assessment of implant patient performance with competing noise has been attempted using a four-alternative forced-choice spondee test (1) at Iowa University. Similar testing has been carried out at the University of Melbourne with a group of patients using the Nucleus multichannel cochlear prosthesis. This study formed part of an assessment of a two formant (F0/FI/F2) speech coding strategy (2). Results suggested that the new scheme provided improved speech recognition both in quiet and with competing noise. This paper reports on some more detailed investigations into the effects of background noise on speech recognition for multichannel cochlear implant users.