Effects of auditory training on adult cochlear implant patients: a preliminary report

The process of learning new electrically stimulated speech patterns can be difficult for many cochlear implant users, especially congenitally deafened patients. Some implant users receive little benefit from the device, even after long-term experience. While many factors may influence individual patient outcomes, the paucity of auditory rehabilitation resources, especially for adult users, may contribute to some implant patients' poorer performance. The present study examined whether moderate auditory training, using speech stimuli, can improve the speech-recognition performance of adult cochlear implant patients. Ten cochlear implant patients with limited speech-recognition capabilities used a recently developed computer-based auditory rehabilitation tool to train at home for a period of one month or longer. Before training began, baseline speech-recognition performance was measured for each patient; baseline performance was measured for at least two weeks, until performance asymptoted. After baseline measures were complete, subjects were instructed to train themselves at home using novel monosyllable words one hour per day, five days per week. Subjects then returned to the lab every two weeks for retesting with the baseline speech materials. Preliminary results showed that there was significant improvement in all patients' speech perception performance after moderate training. While most patients did improve, the amount and time course of improvement was highly variable. Moderate training using a computer-based auditory rehabilitation tool can be an effective approach to improve cochlear implant patients' speech recognition, especially for poorer-performing implant users.

Rollo May on Existential Psychotherapy

This article is a lightly edited transcription of an interview conducted by Kirk Schneider, John Galvin, and Ilene Serlin with Rollo May at his retreat home in Holderness, New Hampshire, in the summer of 1987. Drawing from the influence of his forefathers, Freud, Jung, Fromm, Adler, Sullivan, and Rank as well as classical mythology, philosophy, and literature, May gives a passionate explanation of existential psychotherapy and why it is so urgent in today’s “quick fix,” “gimmick-oriented” society.

Effect of spectral normalization on different talker speech recognition by cochlear implant users

In cochlear implants (CIs), different talkers often produce different levels of speech understanding because of the spectrally distorted speech patterns provided by the implant device. A spectral normalization approach was used to transform the spectral characteristics of one talker to those of another talker. In Experiment 1, speech recognition with two talkers was measured in CI users, with and without spectral normalization. Results showed that the spectral normalization algorithm had small but significant effect on performance. In Experiment 2, the effects of spectral normalization were measured in CI users and normal-hearing (NH) subjects; a pitch-stretching technique was used to simulate six talkers with different fundamental frequencies and vocal tract configurations. NH baseline performance was nearly perfect with these pitch-shift transformations. For CI subjects, while there was considerable intersubject variability in performance with the different pitch-shift transformations, spectral normalization significantly improved the intelligibility of these simulated talkers. The results from Experiments 1 and 2 demonstrate that spectral normalization toward more-intelligible talkers significantly improved CI users' speech understanding with less-intelligible talkers. The results suggest that spectral normalization using optimal reference patterns for individual CI patients may compensate for some of the acoustic variability across talkers.

Asymptomatic schwannoma of the heart

We present a case of an asymptomatic right atrial mass detected on a screening ECHO. Pre-operative imaging and intraoperative frozen section suggested an atrial myxoma, but the extracardiac nature of the mass and its adherence to the right superior pulmonary vein and interatrial septum were inconsistent with this. Detailed histological assessment confirmed the diagnosis of atrial schwannoma. Limited case reports have shown complete resection is curative.