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Browsing by Subject "Cochlear implants"

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    Age-related changes in prosodic features of maternal speech to prelingually deaf infants with cochlear implants
    (Wiley, 2013) Kondaurova, Maria V.; Bergeson, Tonya R.; Xu, Huipuing; Otolaryngology -- Head and Neck Surgery, School of Medicine
    This study investigated prosodic and structural characteristics of infant-directed speech to hearing-impaired infants as they gain hearing experience with a cochlear implant over a 12-month period of time. Mothers were recorded during a play interaction with their HI infants (N = 27, mean age 18.4 months) at 3, 6, and 12 months post-implantation. Two separate control groups of mothers with age-matched normal-hearing infants (NH-AM) (N = 21, mean age 18.1 months) and hearing experience-matched normal-hearing infants (NH-EM) (N = 24, mean age 3.1 months) were recorded at three testing sessions. Mothers produced less exaggerated pitch characteristics, a larger number of syllables per utterance, and faster speaking rate when interacting with NH-AM as compared to HI infants. Mothers also produced more syllables and demonstrated a trend suggesting faster speaking rate in speech to NH-EM relative to HI infants. Age-related modifications included decreased pitch standard deviation and increased number of syllables in speech to NH-AM infants and increased number of syllables in speech to HI and NH-EM infants across the 12-month period. These results suggest that mothers are sensitive to the hearing status of their infants and modify characteristics of infant-direct speech over time.
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    An analysis of hearing aid fittings in adults using cochlear implants and contralateral hearing aids
    (Wiley, 2010-12) Harris, Michael S.; Hay-McCutcheon, Marcia; Otolaryngology -- Head and Neck Surgery, School of Medicine
    OBJECTIVES/HYPOTHESIS: The objective of this study was to assess the appropriateness of hearing aid fittings within a sample of adult cochlear implant recipients who use a hearing aid in the contralateral ear (i.e., bimodal stimulation). METHODS: The hearing aid gain was measured using real ear testing for 14 postlingually deaf English-speaking adults who use a cochlear implant in the contralateral ear. Unaided and aided audiometric testing assessed the degree of functional gain derived from hearing aid use. RESULTS: On average, the target to actual output level difference was within 10 dB only at frequencies of 750 Hz and 1,000 Hz. Only 1 of the 14 study participants had a hearing aid for which the majority of the tested frequencies were within 10 dB of the target gain. In addition, a greater amount of functional gain (i.e., the increase in unaided behavioral thresholds after amplification) was provided for lower frequencies than higher frequencies. CONCLUSIONS: Hearing aid settings in our sample were suboptimal and may be regarded as a contributing factor to the variability in bimodal benefit. Refining hearing aid fitting strategies tailored to the needs of the concurrent cochlear implant and hearing aid user is recommended.
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    Contribution of Verbal Learning & Memory and Spectro-Temporal Discrimination to Speech Recognition in Cochlear Implant Users
    (Wiley, 2023) Harris, Michael S.; Hamel, Benjamin L.; Wichert, Kristin; Kozlowski, Kristin; Mleziva, Sarah; Ray, Christin; Pisoni, David B.; Kronenberger, William G.; Moberly, Aaron C.; Psychiatry, School of Medicine
    Objectives: Existing cochlear implant (CI) outcomes research demonstrates a high degree of variability in device effectiveness among experienced CI users. Increasing evidence suggests that verbal learning and memory (VL&M) may have an influence on speech recognition with CIs. This study examined the relations in CI users between visual measures of VL&M and speech recognition in a series of models that also incorporated spectro-temporal discrimination. Predictions were that (1) speech recognition would be associated with VL&M abilities and (2) VL&M would contribute to speech recognition outcomes above and beyond spectro-temporal discrimination in multivariable models of speech recognition. Methods: This cross-sectional study included 30 adult postlingually deaf experienced CI users who completed a nonauditory visual version of the California Verbal Learning Test-Second Edition (v-CVLT-II) to assess VL&M, and the Spectral-Temporally Modulated Ripple Test (SMRT), an auditory measure of spectro-temporal processing. Participants also completed a battery of word and sentence recognition tasks. Results: CI users showed significant correlations between some v-CVLT-II measures (short-delay free- and cued-recall, retroactive interference, and "subjective" organizational recall strategies) and speech recognition measures. Performance on the SMRT was correlated with all speech recognition measures. Hierarchical multivariable linear regression analyses showed that SMRT performance accounted for a significant degree of speech recognition outcome variance. Moreover, for all speech recognition measures, VL&M scores contributed independently in addition to SMRT. Conclusion: Measures of spectro-temporal discrimination and VL&M were associated with speech recognition in CI users. After accounting for spectro-temporal discrimination, VL&M contributed independently to performance on measures of speech recognition for words and sentences produced by single and multiple talkers.
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    Developmental Effects of Family Environment on Outcomes in Pediatric Cochlear Implant Recipients
    (Wolters Kluwer, 2013) Frush Holt, Rachael; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: To examine and compare the family environment of preschool- and school-age children with cochlear implants and assess its influence on children's executive function and spoken language skills. Study design: Retrospective between-subjects design. Setting: Outpatient research laboratory. Patients: Prelingually deaf children with cochlear implants and no additional disabilities and their families. Intervention(s): Cochlear implantation and speech-language therapy. Main outcome measures: Parents completed the Family Environment Scale and the Behavior Rating Inventory of Executive Function (or the preschool version). Children were tested using the Peabody Picture Vocabulary Test-4 and either the Preschool Language Scales-4 or the Clinical Evaluation of Language Fundamentals-4. Results: The family environments of children with cochlear implants differed from normative data obtained from hearing children, but average scores were within 1 standard deviation of norms on all subscales. Families of school-age children reported higher levels of control than those of preschool-age children. Preschool-age children had fewer problems with emotional control when families reported higher levels of support and lower levels of conflict. School-age children had fewer problems with inhibition but more problems with shifting of attention when families reported lower levels of conflict. School-age children's receptive vocabularies were enhanced by families with lower levels of control and higher levels of organization. Conclusion: Family environment and its relation to language skills and executive function development differed across the age groups in this sample of children with cochlear implants. Because family dynamics is one developmental/environmental factor that can be altered with therapy and education, the present results have important clinical implications for family-based interventions for deaf children with cochlear implants.
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    Executive functioning and spoken language skills in young children with hearing aids and cochlear implants: Longitudinal findings
    (Frontiers Media, 2022-09-23) Jamsek, Izabela A.; Kronenberger, William G.; Pisoni, David B.; Holt, Rachael Frush; Psychiatry, School of Medicine
    Deaf or hard-of-hearing (DHH) children who use auditory-oral communication display considerable variability in spoken language and executive functioning outcomes. Furthermore, language and executive functioning skills are strongly associated with each other in DHH children, which may be relevant for explaining this variability in outcomes. However, longitudinal investigations of language and executive functioning during the important preschool period of development in DHH children are rare. This study examined the predictive, reciprocal associations between executive functioning and spoken language over a 1-year period in samples of 53 DHH and 59 typically hearing (TH) children between ages 3-8 years at baseline. Participants were assessed on measures of receptive spoken language (vocabulary, sentence comprehension, and following spoken directions) and caregiver-completed executive functioning child behavior checklists during two in-person home visits separated by 1 year. In the sample of DHH children, better executive functioning at baseline (Time 1) was associated with better performance on the higher-order language measures (sentence comprehension and following spoken directions) 1 year later (Time 2). In contrast, none of the Time 1 language measures were associated with better executive functioning in Time 2 in the DHH sample. TH children showed no significant language-executive functioning correlations over the 1-year study period. In regression analyses controlling for Time 1 language scores, Time 1 executive functioning predicted Time 2 language outcomes in the combined DHH and TH samples, and for vocabulary, that association was stronger in the DHH than in the TH sample. In contrast, after controlling for Time 1 executive functioning, none of the regression analyses predicting Time 2 executive functioning from Time 1 language were statistically significant. These results are the first findings to demonstrate that everyday parent-rated executive functioning behaviors predict basic (vocabulary) and higher-order (comprehension, following directions) spoken language development 1 year later in young (3-8 year old) DHH children, even after accounting for initial baseline language skills.
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    Identification of Acoustically Similar and Dissimilar Vowels in Profoundly Deaf Adults Who Use Hearing Aids and/or Cochlear Implants: Some Preliminary Findings
    (ASHA, 2014) Hay-McCutcheon, Marcia J.; Peterson, Nathaniel R.; Rosado, Christian A.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Purpose: In this study, the authors examined the effects of aging and residual hearing on the identification of acoustically similar and dissimilar vowels in adults with postlingual deafness who use hearing aids (HAs) and/or cochlear implants (CIs). Method: The authors used two groups of acoustically similar and dissimilar vowels to assess vowel identification. Also, the Consonant-Nucleus-Consonant Word Recognition Test (Peterson & Lehiste, 1962) and sentences from the Hearing in Noise Test (Nilsson, Soli, & Sullivan, 1994) were administered. Forty CI recipients with postlingual deafness (ages 31-81 years) participated in the study. Results: Acoustically similar vowels were more difficult to identify than acoustically dissimilar vowels. With increasing age, performance deteriorated when identifying acoustically similar vowels. Vowel identification was also affected by the use of a contralateral HA and the degree of residual hearing prior to implantation. Moderate correlations were found between speech perception and vowel identification performance. Conclusions: Identification performance was affected by the acoustic similarity of the vowels. Older adults experienced more difficulty identifying acoustically similar confusable vowels than did younger adults. The findings might lend support to the ease of language understanding model (Ronnberg, Rudner, Foo, & Lunner, 2008), which proposes that the quality and perceptual robustness of acoustic input affects speech perception.
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    Information-processing skills of deaf children with cochlear implants: some new process measures of performance
    (Elsevier, 2004) Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Recent findings on learning, memory and cognitive processes in deaf children following cochlear implantation are reviewed. The contribution of demographic factors is discussed and the results of several studies using "process" measures of performance are presented. In the first study, results from an investigation of the "Stars" showed that the exceptionally good implant users differed from the low performers in several important ways reflecting their ability to rapidly encode sound patterns into phonological representations. In the second set of studies, several new measures of information-processing performance are reported. Speaking rate, a measure shown in other populations to correlate well with an individual's verbal rehearsal speed for items in immediate memory was found to be strongly correlated with measures of a child's immediate memory capacity as well as open-set spoken word recognition scores. Additional evidence revealed atypical reproductive memory spans for auditory as well as visual sequences. Deaf children with cochlear implants also showed less benefit from simple repetition of a familiar sequence than age-matched normal-hearing children. Variation in children's success with cochlear implants reflects differences in the operation of elementary information-processing skills used in a wide range of language-processing tasks that draw on phonological coding and verbal rehearsal processes.
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    Language Processing in Children with Cochlear Implants: A Preliminary Report on Lexical Access for Production and Comprehension
    (Taylor & Francis, 2013) Schwartz, Richard G.; Steinman, Susan; Ying, Elizabeth; Ying Mystal, Elana; Houston, Derek M.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    In this plenary paper, we present a review of language research in children with cochlear implants along with an outline of a 5-year project designed to examine the lexical access for production and recognition. The project will use auditory priming, picture naming with auditory or visual interfering stimuli (Picture-Word Interference and Picture-Picture Interference, respectively) and eye tracking paradigms to examine the roles of semantic and various phonological factors. Preliminary data are presented from auditory priming, picture-word interference and picture-picture interference tasks. The emergence of group difference is briefly discussed.
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    Lexical Effects on Spoken Word Recognition by Pediatric Cochlear Implant Users
    (Wolters Kluwer, 1995) Kirk, Karen Iler; Pisoni, David B.; Osberger, Mary Joe; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: The purposes of this study were 1) to examine the effect of lexical characteristics on the spoken word recognition performance of children who use a multichannel cochlear implant (CI), and 2) to compare their performance on lexically controlled word lists with their performance on a traditional test of word recognition, the PB-K. Design: In two different experiments, 14 to 19 pediatric CI users who demonstrated at least some open-set speech recognition served as subjects. Based on computational analyses, word lists were constructed to allow systematic examination of the effects of word frequency, lexical density (i.e., the number of phonemically similar words, or neighbors), and word length. The subjects' performance on these new tests and the PB-K also was compared. Results: The percentage of words correctly identified was significantly higher for lexically "easy" words (high frequency words with few neighbors) than for "hard" words (low frequency words with many neighbors), but there was no lexical effect on phoneme recognition scores. Word recognition performance was consistently higher on the lexically controlled lists than on the PB-K. In addition, word recognition was better for multisyllabic than for momosyllabic stimuli. Conclusions: These results demonstrate that pediatric cochlear implant users are sensitive to the acoustic-phonetic similarities among words, that they organize words into similarity neighborhoods in long-term memory, and they use this structural information in recognizing isolated words. The results further suggest that the PB-K underestimates these subjects' spoken words recognition.
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    List Equivalency of PRESTO for the Evaluation of Speech Recognition
    (American Academy of Audiology, 2015-06) Faulkner, Kathleen F.; Tamati, Terrin N.; Gilbert, Jaimie L.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    BACKGROUND: There is a pressing clinical need for the development of ecologically valid and robust assessment measures of speech recognition. Perceptually Robust English Sentence Test Open-set (PRESTO) is a new high-variability sentence recognition test that is sensitive to individual differences and was designed for use with several different clinical populations. PRESTO differs from other sentence recognition tests because the target sentences differ in talker, gender, and regional dialect. Increasing interest in using PRESTO as a clinical test of spoken word recognition dictates the need to establish equivalence across test lists. PURPOSE: The purpose of this study was to establish list equivalency of PRESTO for clinical use. RESEARCH DESIGN: PRESTO sentence lists were presented to three groups of normal-hearing listeners in noise (multitalker babble [MTB] at 0 dB signal-to-noise ratio) or under eight-channel cochlear implant simulation (CI-Sim). STUDY SAMPLE: Ninety-one young native speakers of English who were undergraduate students from the Indiana University community participated in this study. DATA COLLECTION AND ANALYSIS: Participants completed a sentence recognition task using different PRESTO sentence lists. They listened to sentences presented over headphones and typed in the words they heard on a computer. Keyword scoring was completed offline. Equivalency for sentence lists was determined based on the list intelligibility (mean keyword accuracy for each list compared with all other lists) and listener consistency (the relation between mean keyword accuracy on each list for each listener). RESULTS: Based on measures of list equivalency and listener consistency, ten PRESTO lists were found to be equivalent in the MTB condition, nine lists were equivalent in the CI-Sim condition, and six PRESTO lists were equivalent in both conditions. CONCLUSIONS: PRESTO is a valuable addition to the clinical toolbox for assessing sentence recognition across different populations. Because the test condition influenced the overall intelligibility of lists, researchers and clinicians should take the presentation conditions into consideration when selecting the best PRESTO lists for their research or clinical protocols.
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