Two Ears and Two (or More?) Devices: A Pediatric Case Study of Bilateral Profound Hearing Loss

Uchanski, Rosalie M.; Davidson, Lisa; Quadrizius, Sharon; Reeder, Ruth M.; Cadieux, Jamie; Kettel, Jerrica; Chole, Richard A.

doi:10.1177/1084713809336423

Cited by 10 publications

(7 citation statements)

References 46 publications

(77 reference statements)

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“…We will only know the answer to that question after we follow the children tested here, and other children, for longer periods of time. Finally, choices regarding stimulation for children with HL are sure to be affected by emerging technologies, particularly those that will allow combined electric and acoustic stimulation to the same ear (e.g., Uchanski et al, 2009). In the future we may find ways to match our methods of auditory stimulation to children’s hearing loss and learning needs more precisely, and make adjustments to those settings throughout childhood as hearing loss and needs change.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Bilateral Electric and Bimodal Electric—Acoustic Stimulation on Language Development

Nittrouer

Chapman

2009

Trends in Amplification

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There is no doubt that cochlear implants have improved the spoken language abilities of children with hearing loss, but delays persist. Consequently it is imperative that new treatment options be explored. This study evaluated one aspect of treatment that might be modified, that having to do with bilateral implants and bimodal stimulation. Fifty-eight children with at least one implant were tested at 42 months of age on four language measures spanning a continuum from basic to generative in nature. When children were grouped by the kind of stimulation they had at 42 months (one implant, bilateral implants, or bimodal stimulation), no differences across groups were observed. That was true even when groups were constrained to only children who had at least twelve months to acclimatize to their stimulation configuration. However, when children were grouped according to whether or not they had spent any time with bimodal stimulation (either consistently since their first implant or as an interlude to receiving a second) advantages were found for children who had some bimodal experience, but those advantages were restricted to language abilities that are generative in nature. Thus, previously reported benefits of simultaneous bilateral implantation early in a child’s life may not extend to generative language. In fact, children may benefit from a period of bimodal stimulation early in childhood because low-frequency speech signals provide prosody and serve as an aid in learning how to perceptually organize the signal that is received through a cochlear implant.

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Section: Discussionmentioning

confidence: 99%

The Effects of Bilateral Electric and Bimodal Electric—Acoustic Stimulation on Language Development

Nittrouer

Chapman

2009

Trends in Amplification

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“…Three semantically-neutral sentences with simple vocabulary were recorded multiple times with each emotion (Uchanski et al 2009). In the Emotion Discrimination task, 24 pairs of sentences were presented and the child made a touch-screen response indicating whether the sentences were spoken with the same feeling or with different feelings.…”

Section: Methodsmentioning

confidence: 99%

Interdependence of Linguistic and Indexical Speech Perception Skills in School-Age Children With Early Cochlear Implantation

et al. 2013

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Objectives This study documented the ability of experienced pediatric cochlear implant (CI) users to perceive linguistic properties (what is said) and indexical attributes (emotional intent and talker identity) of speech, and examined the extent to which linguistic (LSP) and indexical (ISP) perception skills are related. Pre-implant aided hearing, age at implantation, speech processor technology, CI-aided thresholds, sequential bilateral cochlear implantation, and academic integration with hearing age-mates were examined for their possible relationships to both LSP and ISP skills. Design Sixty 9–12 year olds, first implanted at an early age (12–38 months), participated in a comprehensive test battery that included the following LSP skills: 1) recognition of monosyllabic words at loud and soft levels, 2) repetition of phonemes and suprasegmental features from non-words, and 3) recognition of keywords from sentences presented within a noise background, and the following ISP skills: 1) discrimination of male from female and female from female talkers and 2) identification and discrimination of emotional content from spoken sentences. A group of 30 age-matched children without hearing loss completed the non-word repetition, and talker- and emotion-perception tasks for comparison. Results Word recognition scores decreased with signal level from a mean of 77% correct at 70 dB SPL to 52% at 50 dB SPL. On average, CI users recognized 50% of keywords presented in sentences that were 9.8 dB above background noise. Phonetic properties were repeated from non-word stimuli at about the same level of accuracy as suprasegmental attributes (70% and 75%, respectively). The majority of CI users identified emotional content and differentiated talkers significantly above chance levels. Scores on LSP and ISP measures were combined into separate principal component scores and these components were highly correlated (r = .76). Both LSP and ISP component scores were higher for children who received a CI at the youngest ages, upgraded to more recent CI technology and had lower CI-aided thresholds. Higher scores, for both LSP and ISP components, were also associated with higher language levels and mainstreaming at younger ages. Higher ISP scores were associated with better social skills. Conclusions Results strongly support a link between indexical and linguistic properties in perceptual analysis of speech. These two channels of information appear to be processed together in parallel by the auditory system and are inseparable in perception. Better speech performance, for both linguistic and indexical perception, is associated with younger age at implantation and use of more recent speech processor technology. Children with better speech perception demonstrated better spoken language, earlier academic mainstreaming, and placement in more typically-sized classrooms (i.e., >20 students). Well-developed social skills were more highly associated with the ability to discriminate the nuances of talker identity and emotion than with the ab...

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“…Furthermore, these low-frequency acoustic cues may transmit pitch cues that improve perception of music (McDermott, 2011). The ability to localize sound, hear in the presence of background noise, and perceive music are among the outcomes that may be improved when listening bimodally compared to a unilateral CI (Ching, Hill, et al, 2005; Kong et al, 2005; Ching et al, 2007; Gifford et al, 2007a; Dorman et al, 2008; Uchanski et al, 2009). In addition, some period of bimodal device use prior to children receiving bilateral sequential CIs may have benefits for language development (Nittrouer and Chapman, 2009) and localization abilities (Grieco-Calub and Litovsky, 2010).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Hearing Aid Frequency Response Fittings in Pediatric and Young Adult Bimodal Recipients

et al. 2015

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Background A coordinated fitting of a cochlear implant (CI) and contralateral hearing aid (HA) for bimodal device use should emphasize balanced audibility and loudness across devices. However, guidelines for allocating frequency information to the CI and HA are not well established for the growing population of bimodal recipients. Purpose The study aim was to compare the effects of three different HA frequency responses, when fitting a CI and an HA for bimodal use, on speech recognition and localization in children/young adults. Specifically, the three frequency responses were wideband, restricted high frequency, and nonlinear frequency compression (NLFC), which were compared with measures of word recognition in quiet, sentence recognition in noise, talker discrimination, and sound localization. Research Design The HA frequency responses were evaluated using an A B1 A B2 test design: wideband frequency response (baseline-A), restricted high-frequency response (experimental-B1), and NLFC-activated (experimental-B2). All participants were allowed 3–4 weeks between each test session for acclimatization to each new HA setting. Bimodal benefit was determined by comparing the bimodal score to the CI-alone score. Study Sample Participants were 14 children and young adults (ages 7–21 yr) who were experienced users of bimodal devices. All had been unilaterally implanted with a Nucleus CI24 internal system and used either a Freedom or CP810 speech processor. All received a Phonak Naida IX UP behind-the-ear HA at the beginning of the study. Data Collection and Analysis Group results for the three bimodal conditions (HA frequency response with wideband, restricted high frequency, and NLFC) on each outcome measure were analyzed using a repeated measures analysis of variance. Group results using the individual “best bimodal” score were analyzed and confirmed using a resampling procedure. Correlation analyses examined the effects of audibility (aided and unaided hearing) in each bimodal condition for each outcome measure. Individual data were analyzed for word recognition in quiet, sentence recognition in noise, and localization. Individual preference for the three bimodal conditions was also assessed. Results Group data revealed no significant difference between the three bimodal conditions for word recognition in quiet, sentence recognition in noise, and talker discrimination. However, group data for the localization measure revealed that both wideband and NLFC resulted in significantly improved bimodal performance. The condition that yielded the “best bimodal” score varied across participants. Because of this individual variability, the “best bimodal” score was chosen for each participant to reassess group data within word recognition in quiet, sentence recognition in noise, and talker discrimination. This method revealed a bimodal benefit for word recognition in quiet after a randomization test was used to confirm significance. The majority of the participants preferred NLFC at the conclusion of the study, altho...

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Two Ears and Two (or More?) Devices: A Pediatric Case Study of Bilateral Profound Hearing Loss

Cited by 10 publications

References 46 publications

The Effects of Bilateral Electric and Bimodal Electric—Acoustic Stimulation on Language Development

The Effects of Bilateral Electric and Bimodal Electric—Acoustic Stimulation on Language Development

Interdependence of Linguistic and Indexical Speech Perception Skills in School-Age Children With Early Cochlear Implantation

Evaluation of Hearing Aid Frequency Response Fittings in Pediatric and Young Adult Bimodal Recipients

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