Graeme Clark Collection

Permanent URI for this collection

Search Results

Now showing 1 - 10 of 41
  • Item
    Thumbnail Image
    Training place pitch perception in cochlear implant users [Abstract]
    Dawson, Pam ; Clark, Graeme M. ( 1997)
    The study has aimed at determining whether the ability to use place coded vowel formant information could be enhanced with analytical vowel training in a group of -congenitally deafened patients, who showed limited speech perception skills after cochlear implant experience ranging from 1y8m to 6y11m. It has investigated whether improvements in vowel perception after training can carry over to word recognition. A further objective was to see whether poorer vowel perception was associated with poorer electrode position difference limens. Three children, one adolescent and one young adult were assessed with synthesized versions of the words /hid, head, had, hud, hod, hood/ and a natural version of these words as well as with a closed-set monosyllabic word task. The change in performance after 10 training sessions was compared to the change in performance during a non-training period. Four of the five patients showed a significant gain in synthetic vowel perception post-training on at least one assessment, but only two patients showed gains across a number of tests post-training. For one of these 2 children improvements in vowel perception generalized to word perception. Patients’ electrode limens ranged from 1 to 3 electrodes except for 1 adolescent whose minimal progress post-training could be partly explained by poorer apical electrode discrimination. The findings are discussed with reference to a number of factors, including the notion of a "critical period" for neural plasticity.
  • Item
    Thumbnail Image
    Factors affecting speech perception outcomes for older children using multichannel cochlear implants
    Dowell, Richard C. ; Dettman, Shani J. ; Hill, Katie ; Winton, Elizabeth ; Hollow, Rod ; Clark, Graeme M. ( 2002)
    Experience with cochlear implantation in early-deafened teenagers or young adults has been somewhat disappointing, however, in recent years a proportion of older children have demonstrated excellent speech perception performance. There appears to be a wide gap between the good and poor performers within this group. It is important to investigate the possible factors influencing performance so that adolescents and their families are able to make informed decisions regarding cochlear implant surgery. This study considered a number of factors in a group of 25 children implanted in Melbourne between the ages of 8 and 18 years. Each subject completed open set speech perception testing using BKB sentences before and after implantation and pre-operative language testing using the Peabody Picture Vocabulary Test. Data were collected regarding the type of hearing loss, age at implant, age at hearing aid fitting, audiometric details, and the pre-and postoperative communication mode. Multivariate analysis suggested that three factors have a significant predictive value for post-implant speech perception: pre-operative open-set sentence score, duration of profound hearing loss and equivalent language age. These three factors accounted for 66% of the variance in this group. The results of this study suggest that children who have useful pre-implant speech perception, and higher age-equivalent scores on language measures, would be expected to do well with a cochlear implant. A shorter duration of profound hearing loss is also advantageous. Mean speech perception scores for the older group were not significantly different from younger children.
  • Item
    Thumbnail Image
    Predicting speech perception outcomes for children using multichannel cochlear implants [Abstract]
    Dowell, Richard C. ; Dettman, Shani J. ; WILLIAMS, SARAH ; Hill, Katie ; TOMOV, ALEXANDRA ; Clark, Graeme M. ( 2002)
    The ability to predict outcomes for children who are cochlear implant candidates is most helpful in counselling families and making clinical recommendations. Open-set speech perception results have been collected for all children implanted with the Nucleus device in Melbourne. Speech perception as assessed at six month intervals following implantation. Information wascollected for each child regarding type of hearing loss, duration and age at onset of profound hearing loss, age at implantation, pre and post-implant communication mode, developmental delay, speech coding scheme and implant experience.
  • Item
    Thumbnail Image
    Inhibition underlies the encoding of short voice onset times in the ventral cochlear nucleus
    Paolini, A. G. ; Clarey, J. C. ; Clark, Graeme M. ( 2001)
    Recent experiments in our laboratory have shown that voice onset time (VOT), the time between consonant release and the first glottal pulse of an ensuing vowel, is effectively encoded by neurons within the ventral cochlear nucleus (VCN). In this investigation we examined the possible neural mechanisms which may underlie this VOT encoding. In male rats anaesthetised with urethane (2.5g1kg i.p), microelectrodes containing 1M potassium acetate, were inserted into the VCN. Speech stimuli consisting of 3 syllables spoken naturally by a male and female were presented at double rate and 3 intensities (/bεt/, /dεt/, and /gεt/ at 45, 65 and 75 dB SPL). Intracellular recordings were made in 12 neurons, eight of which had a response to pure tones typical of spherical bushy neurons, responding in a primary-like (PL) fashion. The remaining cells were classified as either globular bushy (n=2) or stellate cells (n=2). In PL neurons, the VOT period was associated with hyperpolarisation. The duration and amplitude of this hyperpolarising influence was greater for female speech. These PL units showed better encoding of VOT than other cell types in which hyperpolarisation was less evident and action > potentials were often evoked during this period at the highest intensity level. We propose that this hyperpolarisation is due to stimulation of inhibitory sidebands by the high frequency frication noise within the VOT period. This inhibition reduces the probability of action potential generation during the VOT period and enhances the salience of the voice onset enabling more effective encoding of VOT than seen in the auditory nerve.
  • Item
    Thumbnail Image
    Short-term auditory memory in children using cochlear implants
    Dawson, Pam W. ; Busby, Peter A. ; McKay, Colette M. ; Clark, Graeme M. ( 2001)
    There are many factors contributing to the variance in language performance of children using cochlear implants. Typically studies have investigated the predictive value of demographic factors such as duration of profound deafness. It is possible that profound auditory deprivation prior to implantation may have caused auditory processing deficits at a cortical level and, in particular, a deficit in short-term, sequential auditory memory. The aim of the study was to assess short-term sequential auditory memory ability in young children using cochlear implants and to investigate the relationship of this ability to receptive language performance.
  • Item
    Thumbnail Image
    What factors contribute to successful outcomes for children using cochlear implants
    Cowan, Robert C. ; Clark, Graeme M. ; Dowell, Richard C. ; Dettman, Shani J ; Barker, Elizabeth ; Latus, Katie ; Hollow, Rod ; Blamey, Peter J. ( 2000)
    Long term speech perception data has been collected for 100 children using the Nucleus multichannel cochlear prosthesis in Melbourne. Scores on a number of different assessments are available at approximately six month intervals following implantation for these children. The group represents an unselected sample of cochlear implant users, as all children were included if they had sufficient developmental skills to perform formal speech perception tests. Information was also collected on each child regarding type of hearing loss, age of onset of profound hearing loss, duration of profound hearing loss, age at implantation, pre and post-implant communication mode, developmental delay, speech processing strategy and length of experience with implant use.
  • Item
    Thumbnail Image
    Latest results for adults & children using cochlear implants & future implications
    Cowan, Robert C. ; Clark, Graeme M. ; Dowell, Richard C. ; Dettman, Shani J ; Barker, Elizabeth ; Latus, Katie ; Hollow, Rod ; Blamey, Peter J. ( 2000)
    The overall success of a cochlear implant procedure is most often quantified by assessing how well implantees can understand speech. This is because a primary aim of the application of cochlear implants is to improve communication, and it is relatively straightforward to obtain accurate measures of speech recognition. The quality of cochlear implant hearing is not well described by measuring an audiogram, as the detection of sound is similar across all implantees if the device is functioning correctly. A commonly used measure of speech understanding is the CID everyday sentence test where the number of correctly identified words within sentences is assessed. In the early days of cochlear implants, subjects could only recognize a few words without lipreading but the most recent results show average scores of 80% without lipreading for this sentence test, after 6 months of experience with the device.
  • Item
    Thumbnail Image
    Hearing levels and speech perception prior to cochlear implantation - are they predictive of outcomes for adult implant users?
    Dowell, Richard C. ; Winton, Elizabeth ; Ling, Caroline ; Hollow, Rod ; COWAN, ROBERT ; Clark, Graeme M. ( 2000)
    As the speech perception results obtained for adults using multichannel cochlear implants have improved, people with a wider range of hearing losses are now considering implantation. In the mid-1980s, most adults undergoing cochlear implantation had little or no residual hearing. This made selection and counselling relatively straightforward as any level of hearing obtained through use of the cochlear implant could be considered as a benefit in such cases. Most patients evaluated for implantation today have some degree of useful residual hearing, and may be reliant on this hearing to varying degrees in their everyday life. In essence, they have something to lose if their postoperative performance is poor. In counselling these patients, it would be most helpful to have reliable predictors of postoperative performance. A number of factors such as duration of profound hearing loss, congenital profound hearing loss, and certain aetiologies (eg, head injury) have shown significant links with outcomes in previous studies.
  • Item
    Thumbnail Image
    Application of the cochlear implant to profoundly hearing impaired adolescents: re-visiting the inclusion criterion for older children
    DETTMAN, SHANI ; Latus, Katie ; Cosson, Liz ; Dowell, Richard C. ; Clark, Graeme M. ( 2000)
    Objective: The purpose of this study is to examine the range of outcomes for older children receiving the multi-channel cochlear implant. Recent improvements in the speech perception performance for profoundly hearing impaired children and adults have lead to expanded selection criterion for cochlear implant inclusion. That is, the efficacy of cochlear implants for adults with acquired hearing loss is well documented. In addition, the application of the cochlear implant to young children has lead to improvements in open set speech perception, speech production and language acquisition. In contrast, congenitally deaf and prelingually deafened children who are implanted after the age of 8 years have performed poorer than children implanted at a younger age on speech perception, speech production and psychophysical performance measures.
  • Item
    Thumbnail Image
    Speech perception in noise with cochlear implant and hearing aid for implanted adolescents
    DETTMAN, SHANI ; Latus, Katie ; Cosson, Liz ; Dowell, Richard C. ; Clark, Graeme M. ( 2000)
    Objective. To describe the open set speech perception performance for 8 congenitally deaf adolescents who use a multichannel cochlear implant and behind-the ear hearing aid as their 'everyday listening' condition. Expanded indication for cochlear implant inclusion has lead to the implantation of a number of persons with severe to profound hearing loss. It has been suggested that persons who have some residual bearing are good candidates for the cochlear implant due to: the presence of more ganglion cells, prior auditory experience, pre-patterning of the auditory cortex or other factors, as yet unknown, such as language experience.