Graeme Clark Collection
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ItemIssues in the development of multichannel tactile devices for hearing-impaired children and adults( 1995)Levitt, Pickett and Houde (1980), in their landmark monograph, noted that the history of tactile aid development has been characterized by periodic bursts of enthusiasm and research, often culminating in identification of new avenues to be explored for improving tactile perception of speech. While several research groups have maintained long-term interest in tactile research (Boothroyd, 1985; Oller, Payne, & Gavin, 1980; Saunders, 1985), there was a marked increase in reports of new multichannel tactile devices during the 1980s (reviewed in McGarr, 1989). This upsurge may have been spurred in part by the rapid increase world-wide in the number of hearing-impaired children and adults using cochlear implants as everyday communication devices, and the perceived need for a non-surgical approach to assisting hearing-impaired children. Despite this increase in tactile research, no tactile device has yet achieved widespread commercial use by the hearing-impaired community. It is, therefore, of interest to question why cochlear implants have been more widely accepted than tactile devices.
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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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ItemCochlear implants for congenitally deaf adolescents: is open-set speech perception a realistic expectation?( 1994)The prognosis for benefit from use of cochlear implants in congenitally deaf adolescents, who have a long duration of profound deafness prior to implantation, has typically been low. Speech perception results for two congenitally deaf patients implanted as adolescents at the University of Melbourne/Royal Victorian Eye and Ear Hospital Clinic show that, after 12 months of experience, both patients had significant open-set speech discrimination scores without lipreading. These results suggest that although benefits may in general be low for congenitally deaf adolescents, individuals may attain significant benefits to speech perception after a short period of experience. Prospective patients from this group should therefore be considered on an individual basis with regard to prognosis for benefit from cochlear implantation.