Graeme Clark Collection

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    Chronic electrical stimulation of the auditory nerve at high rates: I. Effect on residual hearing [Abstract]
    Xu, J. ; Shepherd, R. K. ; Clark, Graeme M. ( 1996)
    In addition to direct excitation of auditory nerve fibres, cochlear implant patients with small amounts of residual hearing may receive important additional auditory cues via electrophonic activation of hair cells 1. Before incorporating electrophonic hearing into speech processing strategies, the extent of hair cell survival following cochlear implantation must first be determined. We have recently demonstrated widespread survival of hair cells apical to electrode arrays implanted for periods of up to three years, the present report describes the effects of chronic electrical stimulation on hair cell survival.
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    Chronic electrical stimulation of the auditory nerve at high rates: II. Cochlear pathophysiology [Abstract]
    Shepherd, R. K. ; Xu, J. ; Clark, Graeme M. ( 1996)
    A major factor in the improved performance of cochlear implant patients has been the use of high stimulus rate speech processing strategies. While these strategies show clear clinical advantage, we know little of their long-term safety. Indeed, recent studies have indicated that high stimulus rates at intensities above clinical limits, can result in neural damage as a result of prolonged neuronal hyperactivity. The present study was designed to evaluate the effects of chronic electrical stimulation of the auditory nerve at high rates, using intensities within clinical limits.
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    Spatial representation of the cochlea within the inferior colliculus of neonatally deafened kittens following chronic electrical stimulation of the auditory nerve [Abstract]
    Shepherd, R. K. ; Martin, R. L. ; Brown, M. ; Clark, Graeme M. ( 1995)
    The orderly tonotopic representation of the cochlea is accurately reproduced within the central auditory system of normal hearing animals. Any degradation of this representation as a result of a neonatal hearing loss or chronic electrical stimulation during development could have important implications for the use of multichannel cochlear implants in young children. In the present study we have used 2-deoxyglucose autoradiography (2-00) to examine the topographic representation of the cochlea within the inferior colliculus (IC) of neonatally deafened kittens following periods of chronic intracochlear electrical stimulation.
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    Control strategies for neurons modelled by self-exciting point processes [Abstract]
    Irlicht, Laurence S. ; Clark, Graeme M. ( 1995)
    Abstract not available due to copyright.
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    Current trends in speech perception performance in adult cochlear implant patients [Abstract]
    Hollow, Rod ; Plant, Kerrie ; Whitford, Lesley ; Skok, Marisa ; DOWELL, RICHARD ; Clark, Graeme M. ( 1996)
    In 1994, Cochlear Pty. Ltd. (Now Cochlear Limited) released a new speech processor, the Spectra 22, for use with the Nucleus 22-channel cochlear implant. The Spectra 22 speech processor incorporates a new speech processing strategy called SPEAK, which is based upon research conducted by the University of Melbourne. This paper reports post-operative scores on open-set word and sentence materials for adult patients in the Melbourne Cochlear Implant Clinic who have been started up with the Spectra 22 speech processor.
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    The importance of different frequency bands to the speech perception of cochlear implantees [Abstract]
    Henry, Belinda A. ; McKay, Colette M. ; McDermott, Hugh J. ; Clark, Graeme M. ( 1996)
    It is well known that cochlear implantees exhibit a wide range of speech perception ability. Understanding the reason for this variability may lead to improved speech processors. This study investigates whether implantees rely on different areas of the speech spectrum for speech cues, compared to normally hearing listeners, and whether poor performers rely on different spectral areas than better performers. Six subjects with the Mini System 22 implant and using the SPEAK strategy participated in this experiment. Scores for monosyllabic words were obtained using the full speech spectrum and with selected frequency bands removed from the subjects’ speech processor maps. The Articulation Index (AI) is a measure of the proportion of speech information available to a listener, and the relative contribution to AI from different frequency bands is termed the Importance Function. The five frequency bands studied in this experiment were determined to be of equal importance to normally hearing listeners for the speech material used. The scores for each implantee were transformed into AI values, and hence the relative importance of the bands was determined. This relative importance was compared between the implantee group and normally hearing listeners to determine the way in which speech perception by electrical stimulation varies from that by acoustical stimulation. Comparisons were also made between individual implantees to determine whether correlations exist between their speech perception ability and their use of cues in different parts of the spectrum. Further research will determine whether the differences among implantees are correlated with their ability to perceive changes in stimulation place or temporal characteristics.
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    A training program for use with multichannel speech perception/production tactile devices [Abstract]
    GALVIN, KARYN ; COWAN, ROBERT ; Mavrias, Gina ; Moore, Alessandra ; SARANT, JULIA ; Clark, Graeme M. ( 1996)
    Over the past ten years, there have been remarkable improvements in both conventional hearing aid technology and in the use of multichannel cochlear prostheses. These developments have resulted in improved speech perception for severely and profoundly hearing impaired adults and children. However, a small number of adults and children remain unable to benefit from either of these prosthetic approaches. This may occur as a result of medical/surgical issues, which render implantation unfeasible, or from a decision by the patient or parents that the device is inappropriate for the individual person. In these cases, use of a supplemental speech perception device employing the intact tactile modality has been advocated. A number of single and multichannel devices have been developed, both commercially and in the laboratory. One of these, the Tickle Talker, a multichannel electrotactile speech processor, has been developed and thoroughly evaluated with both adults and children at the University of Melbourne. Benefits to speech perception have been noted on both closed-set phonemic discrimination tests, and on open-set word and sentence scores, where the device was used to supplement lipreading and/or aided residual hearing. Benefits to articulation have also been noted. Recently, improved speech processing and the design of a new electrode handset have been implemented. While these factors are important to device acceptance, the critical factor in improving speech perception and production appears to be the training program which is employed with the device. The program must be based on the information available through the device, but organised to emphasize the integration of tactually-encoded speech information into open-set understanding of words and sentences if communication is to be improved. The important elements of the program will be discussed. At present, no tactile device is able to provide sufficient information for open-set speech understanding using only the tactile input. While this may be an ultimate goal, significant periods of training may be required to achieve this outcome.
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    Speech perception in people with a severe hearing loss: preliminary results [Abstract]
    Flynn, Mark C. ; Dowell, Richard C. ; Clark, Graeme M. ( 1996)
    Recent improvements in multichannel cochlear implants have led to improved speech perception for people with profound hearing impairments. Given this improvement, it has been suggested that some people with severe hearing impairments would be more successful with a cochlear implant than a hearing aid. Unfortunately little research exists to support the suitability of cochlear implants for these individuals. In order to determine this, a detailed investigation of the aided performance of people with severe hearing losses is being conducted at The University of Melbourne (School of Audiology). Severe hearing loss was defined as a pure tone average of greater than 60dBHL, but no worse that 100dBSPL in the better ear. At present, 15 participants have taken part in this study and their results will be discussed. Each participant took part in a standard audiometric assessment which included an audiogram, AB words, tympanometry with acoustic reflexes and an ABR. Each participant’s hearing aids were assessed to make sure that they were optimally aided. Following the hearing aid evaluation the participants took part in a series of traditional speech perception tests which included 24 consonant recognition, 11 vowel recognition, CNC words, CUNY sentences, and the Connected Speech Test (CSTv2). Other tests of speech perception were conducted which looked at the effects of different types of background noise, amounts of reverberation, rates of speech and amount of available context. The aim of this was to better simulate “real-life” listening conditions. Consequently, a range of results for both traditional assessments of speech perception and simulated listening conditions will be presented and compared.
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    Speech perception for hearing aid users versus cochlear implantees [Abstract]
    Flynn, Mark C. ; Dowell, Richard C. ; Clark, Graeme M. ( 1996)
    Abstract not available due to copyright.
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    A clinical report on receptive vocabulary skills in cochlear implant users
    Dawson, P. W. ; Blamey, P. J. ; Dettman, S. J. ; Barker, E. J. ; Clark, Graeme M. ( 1995)
    Objective: The aim was to measure the rate of vocabulary acquisition for cochlear implant users and compare the pre- and postoperative rates with published data for other groups with normal or impaired hearing. The hypothesis was that the postoperative rate would be greater than the preoperative rate. Design: The Peabody Picture Vocabulary Test (PPVT) was administered to 32 children, adolescents, and prelinguistically deafened adults implanted with the 22-electrode cochlear implant. Age at implantation ranged from 2 y r 6 mo to 20 yr and implant use ranged from 6 mo to 7 yr 8 mo. Results: The group mean postoperative performance at various postoperative intervals was significantly higher than mean preoperative performance. Single-subject data indicated statistically significant gains over time on this test for 13 of the subjects. The mean postoperative rate of vocabulary acquisition of 1.06 times the rate for normally hearing children was significantly greater than the mean preoperative rate of 0.43. Conclusions: These rates of improvement were in accord with previous reports on smaller numbers of implant users, but could not be attributed unambiguously to use of the implant because no control group was used for this clinical work. Variables such as age at implantation, duration of profound deafness, communication mode, and speech perception skill failed to significantly predict rate of improvement on the PPVT.