Maximizing cochlear implant patients’ performance with advanced speech training procedures

Abstract

Advances in implant technology and speech processing have provided great benefit to many cochlear implant patients. However, some patients receive little benefit from the latest technology, even after many years' experience with the device. Moreover, even the best cochlear implant performers have great difficulty understanding speech in background noise, and music perception and appreciation remain major challenges. Recent studies have shown that targeted auditory training can significantly improve cochlear implant patients' speech recognition performance. Such benefits are not only observed in poorly performing patients, but also in good performers under difficult listening conditions (e.g., speech noise, telephone speech, music, etc.). Targeted auditory training has also been shown to enhance performance gains provided by new implant devices and/or speech processing strategies. These studies suggest that cochlear implantation alone may not fully meet the needs of many patients, and that additional auditory rehabilitation may be needed to maximize the benefits of the implant device. Continuing research will aid in the development of efficient and effective training protocols and materials, thereby minimizing the costs (in terms of time, effort and resources) associated with auditory rehabilitation while maximizing the benefits of cochlear implantation for all recipients.

Masking Release and Modulation Interference in Cochlear Implant and Simulation Listeners

“…One of the common findings from the studies of CI users is individual variability in their speech recognition scores regardless of speech materials or noise conditions (e.g., Fu & Galvin, 2008;Gifford, Shallop, & Peterson, 2008;Kwon et al, 2012), which was also found in the current study. Table 6 shows the performance of individual CI listeners in several conditions: quiet with full-spectrum speech and low-pass filtered speech, remote noise for the three AM conditions, and embedded noise for the same AM conditions.…”

“…If this is true, then peripheral manipulations on the current commercial CI devices such as developments in signal processing algorithms or mapping strategies might not be enough to reduce the negative effect of background noise on speech perception of CI listeners. Perhaps, specific auditory training such as speech-in-noise training or targeted speech training in modulated maskers could be recommended based on listeners' individual needs (Fu & Galvin, 2008).…”

“…Previous studies reported that auditory training was helpful for listeners with hearing impairment to detect/ recognize simple stimuli such as musical tones (Galvin et al, 2007;Gfeller et al, 2002) and to understand speech recognition in difficult listening conditions (Fu & Galvin, 2008). Furthermore, behavioral changes due to auditory training seem to be correlated with training-related neurophysiological changes (Tremblay et al, 1998).…”

Cued Speech for Enhancing Speech Perception and First Language Development of Children With Cochlear Implants

“…These authors emphasize that speech perception of implant users can be improved by more formalized auditory training consisting of repetitive exercises focused on the speech perception skill to be learned, such as hearing through the telephone. Positive results have been found with only a small amount of training and transfer of learning to untrained speech tests (Fu & Galvin, 2008;Moore, Ferguson, Halliday, & Riley, 2008). These studies suggest that, despite the fact that the implant signal may limit the speech perception performance level, most individuals can benefit from training, indicating that they have not extracted all the information available from the signal before the training.…”

Desenvolvendo as habilidades auditivas em crianças usuárias de implante coclear: estratégias terapêuticas

“…Por esse motivo, é ressaltada a importância da atenção do fonoaudiólogo durante as situações terapêuticas, para que aproveite os indícios da criança de que está apta a ser desafiada com tarefas de maior complexidade; ou de que necessita de retomada de habilidades mais iniciais -como a discriminação auditiva, que em quase todos os casos precisa ser trabalhada durante todo o processo de terapia fonoaudiológica aurioral, mesmo quando a criança já está no nível da compreensão auditiva. Isso porque, apesar de ela ser capaz de reconhecer ou compreender conteúdos no contexto, informações específicas podem ser perdidas, como os traços distintivos dos fonemas e os traços supra-segmentais (FU; GALVIN, 2008).…”