Binaural sensitivity in children who use bilateral cochlear implants

Ehlers, Erica; Goupell, Matthew J.; Zheng, Yuankai; Godar, Shelly; Litovsky, Ruth Y.

doi:10.1121/1.4983824

Cited by 37 publications

(51 citation statements)

References 68 publications

(135 reference statements)

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“…Indeed, Gordon and colleagues initial impression was that ITD sensitivity was absent in most children with bilateral implants with similar findings from Litovsky and colleagues [26]. Weak detection of ITDs was recently reported by Gordon et al to emerge in children with over 4 years of bilateral implant experience [34].…”

Section: Direct Stimulation Of Binaural Hearingsupporting

confidence: 57%

“…In later work, Gordon and colleagues found that perception of ILDs was established at very early stages of bilateral implant use even for children who were older and heard through one implant for most of their lives [34]. This was consistent with findings that most children are able to discriminate stimuli containing ILD cues when tested after longer periods of bilateral implant use [26, 35]. More recently, ILD sensitivity in the envelope of short pulse trains was shown to be slightly reduced in children with long bilateral implant use (simultaneously and sequentially implanted) compared to normal hearing peers listening to clicks [34] (Figure 5A).…”

Section: Direct Stimulation Of Binaural Hearingsupporting

confidence: 52%

“…In a recent study, Litovsky and colleagues [26] used two types of stimuli to measure binaural sensitivity in 8–10 year old NH children. One stimulus was a transposed tone, which has high-rate carriers with amplitude modulations.…”

Section: Direct Stimulation Of Binaural Hearingmentioning

confidence: 99%

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Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception

Litovsky

Gordon

2016

Hearing Research

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Spatial hearing skills are essential for children as they grow, learn and play. They provide critical cues for determining the locations of sources in the environment, and enable segregation of important sources, such as speech, from background maskers or interferers. Spatial hearing depends on availability of monaural cues and binaural cues. The latter result from integration of inputs arriving at the two ears from sounds that vary in location. The binaural system has exquisite mechanisms for capturing differences between the ears in both time of arrival and intensity. The major cues that are thus referred to as being vital for binaural hearing are: interaural differences in time (ITDs) and interaural differences in levels (ILDs). In children with normal hearing (NH), spatial hearing abilities are fairly well developed by age 4–5 years. In contrast, children who are deaf and hear through cochlear implants (CIs) do not have an opportunity to experience normal, binaural acoustic hearing early in life. These children may function by having to utilize auditory cues that are degraded with regard to numerous stimulus features. In recent years there has been a notable increase in the number of children receiving bilateral CIs, and evidence suggests that while having two CIs helps them function better than when listening through a single CI, they generally perform worse than their NH peers. This paper reviews some of the recent work on bilaterally implanted children. The focus is on measures of spatial hearing, including sound localization, release from masking for speech understanding in noise and binaural sensitivity using research processors. Data from behavioral and electrophysiological studies are included, with a focus on the recent work of the authors and their collaborators. The effects of auditory plasticity and deprivation on the emergence of binaural and spatial hearing are discussed along with evidence for reorganized processing from both behavioral and electrophysiological studies. The consequences of both unilateral and bilateral auditory deprivation during development suggest that the relevant set of issues is highly complex with regard to successes and the limitations experienced by children receiving bilateral cochlear implants.

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Section: Direct Stimulation Of Binaural Hearingsupporting

confidence: 57%

Section: Direct Stimulation Of Binaural Hearingsupporting

confidence: 52%

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Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception

Litovsky

Gordon

2016

Hearing Research

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“…This relies on the brain's ability to process binaural spatial cues, including interaural level and interaural time differences (ILDs/ITDs) [2]. To benefit from binaural cues in everyday life, bilateral cochlear implantation is becoming increasingly common for deaf patients [3][4][5] . However, even binaural CI patients perform much below the level of normal listeners in sound localization or auditory scene analysis tasks, particularly when multiple sound sources are present [6,7].…”

mentioning

confidence: 99%

“…Under optimal conditions, normal human listeners may be able to detect ITDs not much larger than 10 μs [9]. In contrast, the ITD sensitivity of CI patients is highly variable and generally very poor, even when tested with experimental processors capable of delivering synchronized stimulus pulses with sub-millisecond resolution [3,[5][6][7]10,11].The binaural performance of CI patients depends to a fair extent on the patients' history. Importantly, pre-lingually deaf CI users invariably appear to exhibit no ITD sensitivity at all, whereas many post-lingually deaf CI users do exhibit at least some degree of ITD sensitivity [4,5,[11][12][13].…”

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confidence: 99%

Microsecond Interaural Time Difference Discrimination Restored by Cochlear Implants After Neonatal Deafness

Roßkothen-Kuhl

Buck

et al. 2018

Preprint

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Cochlear implants (CIs) can restore a high degree of functional hearing in deaf patients but enable only poor spatial hearing or hearing in noise. Early deaf CI users are essentially completely insensitive to interaural time differences (ITDs). A dearth of binaural experience during an early critical period is often blamed for these shortcomings. However, here we show that neonatally deafened rats which are fitted with binaural CIs in early adulthood are highly sensitive to ITDs immediately after implantation. Under binaural synchronized stimulation they can be trained to localize ITDs with essentially normal behavioral thresholds near 50 μs. This suggests that the deficits seen in human patients are unlikely to be caused by lack of experience during their period of deafness. It may instead be due to months or years of CI stimulation with inappropriate binaural parameters provided by CI processors which do not provide sub-millisecond temporal fine structure of sounds . 3 33 34 35 36 37 38 39 40 41 42 43 44 45 The World Health Organization reports that about 466 million people suffer from disabling hearing loss, making it the most common sensory impairment of our age. For people with severe to profound sensorineural hearing loss, cochlear implants (CIs) can be enormously beneficial, quite routinely allowing near normal spoken language acquisition, particularly when CI implantation takes place early in life [1]. Never the less the performance of CI users remains variable, and even in the best cases falls short of natural hearing.Good speech understanding in multi-sound environment requires the ability to separate speech from background, which relies in part on a phenomenon known as "spatial release from masking". This relies on the brain's ability to process binaural spatial cues, including interaural level and interaural time differences (ILDs/ITDs) [2]. To benefit from binaural cues in everyday life, bilateral cochlear implantation is becoming increasingly common for deaf patients [3][4][5] . However, even binaural CI patients perform much below the level of normal listeners in sound localization or auditory scene analysis tasks, particularly when multiple sound sources are present [6,7]. The parameters that would allow CI patients to derive maximum benefits from binaural spatial cues are still only partially understood. A number of technical problems (see [8], chapter 6) limit the fidelity with which CIs can encode binaural cues, particularly ITDs. The fact that contemporary CI speech processors were originally designed for monaural, rather than binaural, hearing likely contributes the observed deficits in ITD performance of bilateral CI users [3]. Standard CI processors provide pulsatile stimulation which is not locked to the temporal fine structure of the incoming sounds, and the timing of the electrical pulses is not synchronized between both ears, which makes these devices fundamentally incapable of encoding sub-millisecond binaural time structure. To be useful, ITDs as small as a few tens ...

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Binaural Hearing with Devices

Ricketts

Kan

2021

Springer Handbook of Auditory Research

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Binaural sensitivity in children who use bilateral cochlear implants

Cited by 37 publications

References 68 publications

Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception

Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception

Microsecond Interaural Time Difference Discrimination Restored by Cochlear Implants After Neonatal Deafness

Binaural Hearing with Devices

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