Graeme Clark Collection
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ItemEducational assessment and management of children with multichannel cochlear implants( 1987)This paper describes the assessment and training program to evaluate speech, language, and communication skills of profoundly deaf children during and after training. Two sensory aids/prostheses are used: hearing aids and the Nucleus multichannel cochlear implant. Using a single-subject time-series experimental design, children's speech, language, and communication skills are assessed. For speech skills, assessment includes formal tests of articulation and intelligibility, syllable stress and process analyses, analyses of suprasegmental features, and voice quality. For general communication abilities, conversational skills with different speakers, story production skills, comprehension and expression of procedural information, discourse skills, and a measure of conversational interaction skills (pragmatics) are analyzed at regular intervals. Regular observations also sample the subjects' mode and frequency of interactions with individuals and groups in the school and home setting. Normative tests and formal analyses of language samples are also used to assess the overall language age of the child, vocabulary size, and kinds of expressive and receptive, syntactic, and semantic ability.
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ItemPreliminary results for the Cochlear Corporation multielectrode intracochlear implant in six prelingually deaf patients( 1987)The preliminary results from this study indicate that some prelingually deaf patients may get worthwhile help from a multiple-electrode cochlear implant that uses a formant-based speech processing strategy. It is encouraging that these improvements can occur in young adults and teenagers. The results for two children are also encouraging. A 10-year-old child obtained significant improvement on some speech perception tests. It was easy to set thresholds and comfortable listening levels on a 5-year-old child, and he is now a regular user of the device. There are, however, considerable variations in performance among the prelingual patients, which may be related to the following factors: whether they have had some hearing after birth, the method of education used, the motivation of the patient, and age at implantation.
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ItemProsthetic devices for the management of patients with severe sensorineural deafness( 1977)It is estimated that 5-10% of patients with significant hearing loss do not get satisfactory help with a hearing aid. This means that in Australia there are about 5,000-10,000 people who need further treatment. Furthermore, a large number of these patients are born deaf and their proper management is critical if they are going to develop adequate speech and language. If these patients are going 10 perceive speech, the speech must be broken down into signals that can be used 10 stimulate the residual hearing, excite the auditory nerve fibres by electrical stimulation or stimulate another sensory system such as vision or the skin senses. These alternatives offer real hope for the patient with severe sensori-neural deafness as there is a great deal of redundancy in the speech signal. This is illustrated in Fig. 1 which shows the raw signal obtained on a cathode ray oscilloscope for the word "ear". It can be seen that there is an overall waveform envelope which is now thought to be quite important in speech perception. Inside the speech waveform there are waves of many shapes and sizes. Far too many for your eye to detect at a glance, and indeed too many for your ear to perceive. In fact, when you hear phonemes and words your brain only picks up key signals.
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ItemA neurophysiological assessment of the surgical treatment of perceptive deafness( 1970)The results of treating patients with middle ear disease are now good, but the situation is not as satisfactory with perceptive deafness, and this is one of the major problems facing otologists today.
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ItemHearing due to electrical stimulation of the auditory system( 1969)One of the major problems facing otologists today is the treatment of perceptive deafness. The results of treating patients with deafness due to middle-ear disease are now good, but this is not the case when there is damage to the inner ear or central auditory pathways. A hearing aid will assist a great many people, but there are a number of patients with very severe or total deafness who cannot be helped in this way. Consequently, a different approach to the problem must be made, and for this reason, electrical stimulation of the cochlea or auditory pathways to reproduce the natural stimulus may provide a solution.
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ItemClinical results for profoundly deaf patients using the 22-elctrode cochlear prosthesis [Abstract]( 1987)The 22-electrode cochlear prosthesis developed in Australia by the University of Melbourne and Cochlear Pty. Limited has been in clinical use in Melbourne for five years. Results for 40 postlingually deaf adults have shown significant communication benefit for 90% of patients. Twenty patients (50%) have demonstrated the ability to understand conversational speech without lipreading or visual cues. No electronic or mechanical failures have been observed in any of the implanted devices. There have been no serious medical complications, but psychological disturbance has occurred in two cases. Experience with prelingually deaf adults has indicated that initial hearing responses for this group are not as good as for the postlingually deaf patients. However, improvement over time has been evident with consistent use of the device. Long-term benefit for these patients will depend to a large extent on motivational and social factors. Results for a small number of young deaf children have been encouraging. The age at onset of profound deafness, intelligence, educational management and family support are all important factors affecting the potential benefit of a cochlear implant for a child.
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ItemThe histopathology of the human temporal bone following cochlear implantation in a patient: a summary( 1987)The macroscopic and microscopic evaluation of the implanted and unimplanted temporal bones in a patient who had a cochlear prosthesis for 27 months prior to his death from cardiac disease has shown that the device is biocompatible, and does not lead to any significant adverse effects. The cause of deafness was meningitis.
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ItemSpeech perception and the development of language in deaf children( 1976)This study has been undertaken to help determine how the perception of phonemes is important in the development of language and speech in deaf children. It is generally accepted that a pure tone audiogram is not a reliable indication of future language development, and consequently it is necessary to look for other prognostic tests. The development of these tests would be of great value not only in the prognosis but also in helping to reveal the basic underlying mechanisms in speech perception and production. This could in turn lead to a more definitive approach to the aural rehabilitation of the patient.