Graeme Clark Collection
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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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ItemFricative perception by cochlear implant users( 1992)Three implant users were tested with 45 syllables consisting of[v, f, �, ?, z, s, ?, ?, d?, t ?, ?, , d, n, 1] before the vowels [I ,a,u] with three wearable speech processors. The WSP3 processor coded first and second formant frequencies and amplitudes. The MSP1 processor used a similar scheme with improved measurement and coding of the formants. The MSP2 processor added amplitude information from three higher frequency bands. Average scores were 42% for WSP3, 54% for MSP1, and 57% for MSP2. Perception of voicing, manner, and place of articulation of the consonants was significantly greater for the MSP processors than the WSP3 processor. Place perception was slightly higher for MSP2 than MSP1. The listeners used three perceptual dimensions which were highly correlated with the frequencies and amplitudes of peaks in the low frequency region of the frication spectrum, amplitudes of high frequency peaks, and duration of the frication noise.