Graeme Clark Collection
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ItemThe effects of electrode position and stimulus period on the hearing sensations in a multiple-channel cochlear implant patient [Abstract]( 1981)Abstract not available due to copyright.
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ItemPerceptual dissimilarity and discrimination studies using two-electrode stimulation with a multiple-channel cochlear implant patient [Abstract]( 1981)Abstract not available due to copyright.
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ItemPitch and loudness studies on a multiple-channel cochlear implant patient [Abstract]( 1981)Abstract not available due to copyright.
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ItemSignal processing for multichannel cochlear implants: past, present and future [Abstract]( 1994)Since the late 1970's, many groups have worked on developing effective signal processing for multichannel cochlear implants. The main aim of such schemes has been to provide the best possible speech perception for those using the device. Secondary aims of providing awareness and discrimination of environmental sounds and appreciation of music have also been considered. Early designs included some that attempted to simulate the normal cochlea. The application of such complex processing schemes was limited by the technology of the times. In some cases, researchers reverted to the use of single channel systems which could be controlled reliably with the existing technology. In other cases, as with the Australian implant, a simple multichannel processing scheme was devised that allowed a reliable implementation with available electronics. Over the next 15 years, largely due to the improvements in integrated circuit technology, the signal processors have slowly become more complex. Further psychophysical research has shown how additional information can be transferred effectively to implant users via electrical stimulation of the cochlea. This has lead to rapid improvement in the speech perception abilities of adults using cochlear implants. Some of the main developments in signal processing over the last 15 years will be discussed along with the latest speech perception results obtained with the new SPEAK processing scheme for the Australian 22-channel cochlear implant. Initial results for SPEAK show mean scores of 70% (equivalent to 85-90% phoneme scores) for open set monosyllabic word testing for experienced adult users. Although there remains a large range of performance for all users of cochlear implants, average speech perception scores for all implanted adults have also improved significantly with the developments in signal processing. It appears likely that multichannel cochlear implants will be a viable alternative for the treatment of severe hearing loss in the future.
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ItemA clinical report on vocabulary skills in cochlear implant users [Abstract]( 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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ItemBisensory and unisensory training of auditory-visual speech perception [Abstract]( 1994)The choice of strategy in auditory-visual training remains a controversial topic. Bisensory training involves exposing the subject to both of the main sources of information (auditory-visual). Unisensory training, on the other hand, focuses individually on each of the main modalities of sensory input (auditory, visual). Proponents of the bisensory training view suggest that auditory-visual training is most appropriate since this is the dominant mode of interaction in conventional communication settings. Those advocating unisensory training, suggest focussing on each modality separately prevents interference from one sense inhibiting training of the other sense. A training study is presented where three groups of four normally hearing subjects were given thirty-six sessions of analytic training using discrimination recognition and repetition tasks. Subjects were allocated to one of three groups based on their score on the CNC word test at the first evaluation; bisensory training (BS), bisensory input with unisensory training (BSUT) and unisensory training (US). Auditory stimuli were filtered (300Hz low-pass) and all stimuli were presented in the context of 50dB of white noise. Evaluations were conducted at five points (two pre-training and two post-training) to measure improvement of five phoneme, word and sentence tasks. The evaluations were conducted in all of the modalities of interest (auditory-visual, auditory, visual). In general there were no group differences across the training tasks, although the US group showed greater improvement that the BSUT and BS groups on vowel perception. Results of a phonetic feature analysis of word level performance will be presented. There is a tendency for bisensory training to result in better sentence level performance that unisensory training. Results are discussed in the light of current models of auditory-visual interaction.
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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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ItemCombined cochlear implant and speech processing hearing aid for implant users with a severe to profound hearing loss in the contralateral ear [Abstract]( 1994)The bimodal device was developed for cochlear implant users who simultaneously wear a hearing aid in the opposite ear having residual hearing of a severe to profound degree. The aim was to create a single device to provide both input signals in a more compatible manner and thus maximise use of the individual's total hearing capabilities. The acoustic component of the bimodal device is very flexible and can implement various speech processing strategies with speed, ease and precision. The Frequency Response Tailoring strategy utilises three filters to fit a frequency gain curve to within 1-2 dB of that desired. Modifications at discrete frequencies, ranges or slopes can be readily made. The Peak Sharpening or Spectral Enhancement strategy amplifies the formant peaks in speech for potential improvement of formant resolution and speech perception in the presence of background noise. The Resynthesis strategy presents specifically selected components of speech in selected combinations and includes the ability to transpose higher frequency information to lower frequency ranges for individuals with no aidable high frequency hearing levels. Different fits can be quickly and easily interchanged for comparison and evaluation and subsequent modifications indicated can be readily effected. Any combination of acoustic and implant speech processing strategy can be presented to optimise speech perception for the individual user.
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ItemA clinical report on speech production of cochlear implant users [Abstract]( 1994)Speech production results are reported for a group of 15 children, adolescents and prelinguistically deafened adults implanted with the 22-electrode cochlear implant. Age at implantation ranged from 5 years to 20 years and implant experience ranged from 1 year to 4 years, 7 months. On a speech intelligibility test using sentences seven implant users improved significantly over time. Mean group performance (n = 11) improved from 18% preoperatively to 43% postoperatively. Similarly on a test of articulation, eight implant users improved significantly over time and the group mean postoperative performance (n = 11) exceeded the preoperative performance (55% compared to 38%). This group effect was significant for consonants and blends but was nonsignificant for vowels. Improvements occurred for front, middle and back consonants, for stops, nasals, fricatives and glides and for voiceless and voiced consonants. Three implant users showed no significant gain on either test. The results suggest complex relationships between speech production performance and sensory information provided by a multichannel implant.
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ItemDesign fundamentals for a tactile speech processor: i) encoding of speech information, and ii) biomedical safety considerations [Abstract]( 1992)Approaches to providing speech information through the tactual modality have varied in: number and spatial location of transducers; method of interfacing with the skin's sensory apparatus; and content of speech information presented. Use of a multiple speech feature encoding approach to design of a tactile device was implemented in the wearable multichannel electrotactile speech processor or Tickle Talker developed at the University of Melbourne. Psychophysical studies established that subjects could discriminate salient electrical parameters in the tactual display, and that this information could be used to discriminate acoustic speech feature contrasts. Results with normally-hearing and hearing-impaired adults and children using an FOF2 encoding strategy showed improved discrimination scores for closed-set speech feature discrimination batteries, closed-set vowel and consonant identification tasks, as well as for open-set word and sentence comprehension. Based on analyses of tactual encoding of speech features, alternative speech processing strategies designed to increase the quality of speech information available were evaluated. Results for two hearing-impaired adults showed improved feature discrimination with the addition of a voicing signal to the FOF2 strategy. Biomedical safety investigations conducted concurrently have established that the electrical parameters of the stimulus waveform, electrode handset design, and electrical circuitry of the device are free from potential risks. Longer-term physiological assessments included measures of possible effects of electrical stimulation on tactual sensitivity, finger temperature, finger and hand blood flow, electrical thresholds and maximum comfortable levels, and on central nervous system, function as measured by EEG. Results of the kinesthetic, vascular and neurological assessments showed no significant contraindications which might limit application or long-term use of the device.