Music Training for Children With Sensorineural Hearing Loss Improves Speech-in-Noise Perception

Low-frequency pitch coding: relationships with speech-in-noise and music perception by pediatric populations with typical hearing and cochlear implants

PURPOSE

This study aimed to investigate the effects of low frequency (LF) pitch perception on speech-in-noise and music perception performance by children with cochlear implants (CIC) and typical hearing (THC). Moreover, the relationships between speech-in-noise and music perception as well as the effects of demographic and audiological factors on present research outcomes were studied.

METHODS

The sample consisted of 22 CIC and 20 THC (7-10 years). Harmonic intonation (HI) and disharmonic intonation (DI) tests were used to assess LF pitch perception. Speech perception in quiet (WRSq)/noise (WRSn + 10) were tested with the Italian bisyllabic words for pediatric populations. The Gordon test was used to evaluate music perception (rhythm, melody, harmony, and overall).

RESULTS

CIC/THC performance comparisons for LF pitch, speech-in-noise, and all music measures except harmony revealed statistically significant differences with large effect sizes. For the CI group, HI showed statistically significant correlations with melody discrimination. Melody/total Gordon scores were significantly correlated with WRSn + 10. For the overall group, HI/DI showed significant correlations with all music perception measures and WRSn + 10. Hearing thresholds showed significant effects on HI/DI scores. Hearing thresholds and WRSn + 10 scores were significantly correlated; both revealed significant effects on all music perception scores. CI age had significant effects on WRSn + 10, harmony, and total Gordon scores (p < 0.05).

CONCLUSION

Such findings confirmed the significant effects of LF pitch perception on complex listening performance. Significant speech-in-noise and music perception correlations were as promising as results from recent studies indicating significant positive effects of music training on speech-in-noise recognition in CIC.

Generalization of auditory expertise in audio engineers and instrumental musicians

From auditory perception to general cognition, the ability to play a musical instrument has been associated with skills both related and unrelated to music. However, it is unclear if these effects are bound to the specific characteristics of musical instrument training, as little attention has been paid to other populations such as audio engineers and designers whose auditory expertise may match or surpass that of musicians in specific auditory tasks or more naturalistic acoustic scenarios. We explored this possibility by comparing students of audio engineering (n = 20) to matched conservatory-trained instrumentalists (n = 24) and to naive controls (n = 20) on measures of auditory discrimination, auditory scene analysis, and speech in noise perception. We found that audio engineers and performing musicians had generally lower psychophysical thresholds than controls, with pitch perception showing the largest effect size. Compared to controls, audio engineers could better memorise and recall auditory scenes composed of non-musical sounds, whereas instrumental musicians performed best in a sustained selective attention task with two competing streams of tones. Finally, in a diotic speech-in-babble task, musicians showed lower signal-to-noise-ratio thresholds than both controls and engineers; however, a follow-up online study did not replicate this musician advantage. We also observed differences in personality that might account for group-based self-selection biases. Overall, we showed that investigating a wider range of forms of auditory expertise can help us corroborate (or challenge) the specificity of the advantages previously associated with musical instrument training.

Short- and long-term neuroplasticity interact during the perceptual learning of concurrent speech

Plasticity from auditory experience shapes the brain's encoding and perception of sound. However, whether such long-term plasticity alters the trajectory of short-term plasticity during speech processing has yet to be investigated. Here, we explored the neural mechanisms and interplay between short- and long-term neuroplasticity for rapid auditory perceptual learning of concurrent speech sounds in young, normal-hearing musicians and nonmusicians. Participants learned to identify double-vowel mixtures during ~ 45 min training sessions recorded simultaneously with high-density electroencephalography (EEG). We analyzed frequency-following responses (FFRs) and event-related potentials (ERPs) to investigate neural correlates of learning at subcortical and cortical levels, respectively. Although both groups showed rapid perceptual learning, musicians showed faster behavioral decisions than nonmusicians overall. Learning-related changes were not apparent in brainstem FFRs. However, plasticity was highly evident in cortex, where ERPs revealed unique hemispheric asymmetries between groups suggestive of different neural strategies (musicians: right hemisphere bias; nonmusicians: left hemisphere). Source reconstruction and the early (150-200 ms) time course of these effects localized learning-induced cortical plasticity to auditory-sensory brain areas. Our findings reinforce the domain-general benefits of musicianship but reveal that successful speech sound learning is driven by a critical interplay between long- and short-term mechanisms of auditory plasticity, which first emerge at a cortical level.

The Impact of Musical Rehabilitation on Complex Sound Perception in Cochlear Implant Users: A Systematic Review

OBJECTIVE

Musical rehabilitation has been used in clinical and nonclinical contexts to improve postimplantation auditory processing in implanted individuals. This systematic review aimed to evaluate the efficacy of music rehabilitation in controlled experimental and quasi-experimental studies on cochlear implant (CI) user speech and music perception.

DATABASES REVIEWED

PubMed/MEDLINE, EMBASE, Web of Science, PsycARTICLES, and PsycINFO databases through July 2022.

METHODS

Controlled experimental trials and prospective studies were included if they compared pretest and posttest data and excluded hearing aid-only users. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were then used to extract data from 11 included studies with a total of 206 pediatric and adult participants. Interventions included group music therapy, melodic contour identification training, auditory-motor instruction, or structured digital music training. Studies used heterogeneous outcome measures evaluating speech and music perception. Risk of bias was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool.

RESULTS

A total of 735 studies were screened, and 11 met the inclusion criteria. Six trials reported both speech and music outcomes, whereas five reported only music perception outcomes after the intervention relative to control. For music perception outcomes, significant findings included improvements in melodic contour identification (five studies, p < 0.05), timbre recognition (three studies, p < 0.05), and song appraisal (three studies, p < 0.05) in their respective trials. For speech prosody outcomes, only vocal emotion identification demonstrated significant improvements (two studies, p < 0.05).

CONCLUSION

Music rehabilitation improves performance on multiple measures of music perception, as well as tone-based characteristics of speech (i.e., emotional prosody). This suggests that rehabilitation may facilitate improvements in the discrimination of spectrally complex signals.

Short- and long-term experience-dependent neuroplasticity interact during the perceptual learning of concurrent speech

Plasticity from auditory experiences shapes brain encoding and perception of sound. However, whether such long-term plasticity alters the trajectory of short-term plasticity during speech processing has yet to be investigated. Here, we explored the neural mechanisms and interplay between short- and long-term neuroplasticity for rapid auditory perceptual learning of concurrent speech sounds in young, normal-hearing musicians and nonmusicians. Participants learned to identify double-vowel mixtures during ∼45 minute training sessions recorded simultaneously with high-density EEG. We analyzed frequency-following responses (FFRs) and event-related potentials (ERPs) to investigate neural correlates of learning at subcortical and cortical levels, respectively. While both groups showed rapid perceptual learning, musicians showed faster behavioral decisions than nonmusicians overall. Learning-related changes were not apparent in brainstem FFRs. However, plasticity was highly evident in cortex, where ERPs revealed unique hemispheric asymmetries between groups suggestive of different neural strategies (musicians: right hemisphere bias; nonmusicians: left hemisphere). Source reconstruction and the early (150-200 ms) time course of these effects localized learning-induced cortical plasticity to auditory-sensory brain areas. Our findings confirm domain-general benefits for musicianship but reveal successful speech sound learning is driven by a critical interplay between long- and short-term mechanisms of auditory plasticity that first emerge at a cortical level.

Sustainable Benefits of High Variability Phonetic Training in Mandarin-speaking Kindergarteners With Cochlear Implants: Evidence From Categorical Perception of Lexical Tones

OBJECTIVES

Although pitch reception poses a great challenge for individuals with cochlear implants (CIs), formal auditory training (e.g., high variability phonetic training [HVPT]) has been shown to provide direct benefits in pitch-related perceptual performances such as lexical tone recognition for CI users. As lexical tones in spoken language are expressed with a multitude of distinct spectral, temporal, and intensity cues, it is important to determine the sources of training benefits for CI users. The purpose of the present study was to conduct a rigorous fine-scale evaluation with the categorical perception (CP) paradigm to control the acoustic parameters and test the efficacy and sustainability of HVPT for Mandarin-speaking pediatric CI recipients. The main hypothesis was that HVPT-induced perceptual learning would greatly enhance CI users' ability to extract the primary pitch contours from spoken words for lexical tone identification and discrimination. Furthermore, individual differences in immediate and long-term gains from training would likely be attributable to baseline performance and duration of CI use.

DESIGN

Twenty-eight prelingually deaf Mandarin-speaking kindergarteners with CIs were tested. Half of them received five sessions of HVPT within a period of 3 weeks. The other half served as control who did not receive the formal training. Two classical CP tasks on a tonal continuum from Mandarin tone 1 (high-flat in pitch) to tone 2 (mid-rising in pitch) with fixed acoustic features of duration and intensity were administered before (pretest), immediately after (posttest), and 10 weeks posttraining termination (follow-up test). Participants were instructed to either label a speech stimulus along the continuum (i.e., identification task) or determine whether a pair of stimuli separated by zero or two steps from the continuum was the same or different (i.e., discrimination task). Identification function measures (i.e., boundary position and boundary width) and discrimination function scores (i.e., between-category score, within-category score, and peakedness score) were assessed for each child participant across the three test sessions.

RESULTS

Linear mixed-effects (LME) models showed significant training-induced enhancement in lexical tone categorization with significantly narrower boundary width and better between-category discrimination in the immediate posttest over pretest for the trainees. Furthermore, training-induced gains were reliably retained in the follow-up test 10 weeks after training. By contrast, no significant changes were found in the control group across sessions. Regression analysis confirmed that baseline performance (i.e., boundary width in the pretest session) and duration of CI use were significant predictors for the magnitude of training-induced benefits.

CONCLUSIONS

The stringent CP tests with synthesized stimuli that excluded acoustic cues other than the pitch contour and were never used in training showed strong evidence for the efficacy of HVPT in yielding immediate and sustained improvement in lexical tone categorization for Mandarin-speaking children with CIs. The training results and individual differences have remarkable implications for developing personalized computer-based short-term HVPT protocols that may have sustainable long-term benefits for aural rehabilitation in this clinical population.

Hearing Assistive Technology Facilitates Sentence-in-Noise Recognition in Chinese Children With Autism Spectrum Disorder

PURPOSE

Hearing assistive technology (HAT) has been shown to be a viable solution to the speech-in-noise perception (SPIN) issue in children with autism spectrum disorder (ASD); however, little is known about its efficacy in tonal language speakers. This study compared sentence-level SPIN performance between Chinese children with ASD and neurotypical (NT) children and evaluated HAT use in improving SPIN performance and easing SPIN difficulty.

METHOD

Children with ASD (n = 26) and NT children (n = 19) aged 6-12 years performed two adaptive tests in steady-state noise and three fixed-level tests in quiet and steady-state noise with and without using HAT. Speech recognition thresholds (SRTs) and accuracy rates were assessed using adaptive and fixed-level tests, respectively. Parents or teachers of the ASD group completed a questionnaire regarding children's listening difficulty under six circumstances before and after a 10-day trial period of HAT use.

RESULTS

Although the two groups of children had comparable SRTs, the ASD group showed a significantly lower SPIN accuracy rate than the NT group. Also, a significant impact of noise was found in the ASD group's accuracy rate but not in that of the NT group. There was a general improvement in the ASD group's SPIN performance with HAT and a decrease in their listening difficulty ratings across all conditions after the device trial.

CONCLUSIONS

The findings indicated inadequate SPIN in the ASD group using a relatively sensitive measure to gauge SPIN performance among children. The markedly increased accuracy rate in noise during HAT-on sessions for the ASD group confirmed the feasibility of HAT for improving SPIN performance in controlled laboratory settings, and the reduced post-use ratings of listening difficulty further confirmed the benefits of HAT use in daily scenarios.

Effectiveness of rhythmic training on linguistics skill development in deaf children and adolescents with cochlear implants: A systematic review

OBJECTIVE

This review compiles the scientific evidence to date on the effectiveness of musical/rhythmic training for improving and/or enhancing the development of language skills in deaf children aged 6-16 years with cochlear implants.

METHODS

PubMed, ScienceDirect, and Web of Science were used for the research following the PRISMA protocol.

RESULTS

The reviewed studies indicate that rhythmic training can improve language skills (perception, production, and comprehension) in this population, as well as in other cognitive skills.

CONCLUSION

Although further research is still needed, the current evidence can help identify new and more effective early intervention methods for deaf children.

Perception of Prosody in Hearing-Impaired Individuals and Users of Hearing Assistive Devices: An Overview of Recent Advances

PURPOSE

Prosody perception is an essential component of speech communication and social interaction through which both linguistic and emotional information are conveyed. Considering the importance of the auditory system in processing prosody-related acoustic features, the aim of this review article is to review the effects of hearing impairment on prosody perception in children and adults. It also assesses the performance of hearing assistive devices in restoring prosodic perception.

METHOD

Following a comprehensive online database search, two lines of inquiry were targeted. The first summarizes recent attempts toward determining the effects of hearing loss and interacting factors such as age and cognitive resources on prosody perception. The second analyzes studies reporting beneficial or detrimental impacts of hearing aids, cochlear implants, and bimodal stimulation on prosodic abilities in people with hearing loss.

RESULTS

The reviewed studies indicate that hearing-impaired individuals vary widely in perceiving affective and linguistic prosody, depending on factors such as hearing loss severity, chronological age, and cognitive status. In addition, most of the emerging information points to limitations of hearing assistive devices in processing and transmitting the acoustic features of prosody.

CONCLUSIONS

The existing literature is incomplete in several respects, including the lack of a consensus on how and to what extent hearing prostheses affect prosody perception, especially the linguistic function of prosody, and a gap in assessing prosody under challenging listening situations such as noise. This review article proposes directions that future research could follow to provide a better understanding of prosody processing in those with hearing impairment, which may help health care professionals and designers of assistive technology to develop innovative diagnostic and rehabilitation tools.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809772.

Perception of timbre in adult Cochlear implant users: Comparison of Iranian and Western musical instruments

OBJECTIVES

Cochlear implants (CI) have dramatically improved speech perception for patients with sensorineural hearing impairment. However, listening to music is a great challenge for them. This study examined the perception and appraisal of Iranian musical instruments comparing with similar Western instruments.

METHODS

Eleven adult CI users and 25 normal hearing (NH) individuals participated in this study. Musical stimuli of three commonly heard instrument pairs were prepared. Participants were asked to identify the instruments and rate their appraisal on a ten-point Likert scale (0 = dislike very much, 10 = like very much).

RESULTS

The instrument recognition rate was 40.6% among the CI users, and the mean appraisal score was 5.2 ± 2.7. NH listeners had none significant higher scores on both tasks with a recognition rate of 50.0% and the mean appraisal score of 6.9 ± 1.5. Iranian instruments were more recognized in both groups. Regarding their appraisal, the mean score for both types was almost equal in the NH group, while CI users more appraised Iranian instruments.

CONCLUSION

In addition to better recognition of Iranian instruments, they were particularly better appraised in the CI group. Iranian instruments provide suitable musical pieces for CI recipients that can be considered in rehabilitation programs.

The development of cortical processing of speech differs between children with cochlear implants and normal hearing and changes with parental singing

Objective

The aim of the present study was to investigate speech processing development in children with normal hearing (NH) and cochlear implants (CI) groups using a multifeature event-related potential (ERP) paradigm. Singing is associated to enhanced attention and speech perception. Therefore, its connection to ERPs was investigated in the CI group.

Methods

The paradigm included five change types in a pseudoword: two easy- (duration, gap) and three difficult-to-detect (vowel, pitch, intensity) with CIs. The positive mismatch responses (pMMR), mismatch negativity (MMN), P3a and late differentiating negativity (LDN) responses of preschoolers (below 6 years 9 months) and schoolchildren (above 6 years 9 months) with NH or CIs at two time points (T1, T2) were investigated with Linear Mixed Modeling (LMM). For the CI group, the association of singing at home and ERP development was modeled with LMM.

Results

Overall, responses elicited by the easy- and difficult to detect changes differed between the CI and NH groups. Compared to the NH group, the CI group had smaller MMNs to vowel duration changes and gaps, larger P3a responses to gaps, and larger pMMRs and smaller LDNs to vowel identity changes. Preschoolers had smaller P3a responses and larger LDNs to gaps, and larger pMMRs to vowel identity changes than schoolchildren. In addition, the pMMRs to gaps increased from T1 to T2 in preschoolers. More parental singing in the CI group was associated with increasing pMMR and less parental singing with decreasing P3a amplitudes from T1 to T2.

Conclusion

The multifeature paradigm is suitable for assessing cortical speech processing development in children. In children with CIs, cortical discrimination is often reflected in pMMR and P3a responses, and in MMN and LDN responses in children with NH. Moreover, the cortical speech discrimination of children with CIs develops late, and over time and age, their speech sound change processing changes as does the processing of children with NH. Importantly, multisensory activities such as parental singing can lead to improvement in the discrimination and attention shifting toward speech changes in children with CIs. These novel results should be taken into account in future research and rehabilitation.

Evidence for a Musician Speech-Perception-in-Noise Advantage in School-Age Children

PURPOSE

The objective of this study was to evaluate whether child musicians are better at listening to speech in noise (SPIN) than nonmusicians of the same age. In addition, we aimed to explore whether the musician SPIN advantage in children was related to general intelligence (IQ).

METHOD

Fifty-one children aged 8.2-11.8 years and with different levels of music training participated in the study. A between-group design and correlational analyses were used to determine differences in SPIN skills as they relate to music training. IQ was used as a covariate to explore the relationship between intelligence and SPIN ability.

RESULTS

More years of music training were associated with better SPIN skills than fewer years of music training. Furthermore, this difference in SPIN skills remained even when accounting for IQ. These results were found at the group level and also when years of instrument training was treated as a continuous variable (i.e., correlational analyses).

CONCLUSIONS

We confirmed results from previous studies in which child musicians outperformed nonmusicians in SPIN skills. We also showed that this effect was not related to differences in IQ between the musicians and nonmusicians for this cohort of children. However, confirmation of this finding with a cohort of children from more diverse socioeconomic statuses and cognitive profiles is warranted.

Improved Speech in Noise Perception in the Elderly After 6 Months of Musical Instruction

Understanding speech in background noise poses a challenge in daily communication, which is a particular problem among the elderly. Although musical expertise has often been suggested to be a contributor to speech intelligibility, the associations are mostly correlative. In the present multisite study conducted in Germany and Switzerland, 156 healthy, normal-hearing elderly were randomly assigned to either piano playing or music listening/musical culture groups. The speech reception threshold was assessed using the International Matrix Test before and after a 6 month intervention. Bayesian multilevel modeling revealed an improvement of both groups over time under binaural conditions. Additionally, the speech reception threshold of the piano group decreased during stimuli presentation to the left ear. A right ear improvement only occurred in the German piano group. Furthermore, improvements were predominantly found in women. These findings are discussed in the light of current neuroscientific theories on hemispheric lateralization and biological sex differences. The study indicates a positive transfer from musical training to speech processing, probably supported by the enhancement of auditory processing and improvement of general cognitive functions.

Beyond Audition: Psychosocial Benefits of Music Training for Children With Hearing Loss

OBJECTIVES

Children with hearing loss tend to have poorer psychosocial and quality of life outcomes than their typical-hearing (TH) peers-particularly in the areas of peer relationships and school functioning. A small number of studies for TH children have suggested that group-based music activities are beneficial for prosocial outcomes and help develop a sense of belonging. While one might question whether perceptual limitations would impede satisfactory participation in musical activities, findings from a few studies have suggested that group music activities may have similar benefits for children with hearing loss as well. It is important to note that the effect of music on psychosocial outcomes has primarily been investigated at an anecdotal level. The objective of this study was to explore the effect of a music training program on psychosocial and quality of life outcomes for children with hearing loss. It was hypothesized that music training would provide benefits for domains centered upon peer relationships and prosocial measures.

DESIGN

Fourteen children aged 6 to 9 years with prelingual sensorineural hearing loss (SNHL) participated in a 12-week music training program that consisted of group-based face-to-face music therapy supplemented by online music apps. The design was a pseudorandomized, longitudinal study (9 participants were waitlisted, initially serving as a passive control group). Psychosocial wellbeing and quality of life were assessed using a questionnaire battery comprised of the Strengths and Difficulty Questionnaire (SDQ), the Pediatric Quality of Life Inventory, the Hearing Environments and Reflection on Quality of Life (HEAR-QL), and the Glasgow Children's Benefit Inventory. For comparative purposes, responses were measured from 16 TH children that ranged in age from 6 to 9 years.

RESULTS

At baseline, children with SNHL had poorer outcomes for internalizing problems, and all measures of the HEAR-QL compared with the TH children. There were no differences for general psychosocial and physical health. After music training, SDQ internalizing problems such as peer relationships and emotional regulation were significantly reduced for the children with SNHL. There were no changes for any outcomes for the passive control group. Additional benefits were noted for emotional and learning factors on the Glasgow Children's Benefit Inventory. However, there were no significant changes for any psychosocial and quality of life outcomes as measured by the Pediatric Quality of Life Inventory or HEAR-QL instruments.

CONCLUSIONS

The present study provides initial evidence that music training has a positive effect on at least some psychosocial and quality of life outcomes for children with hearing loss. As they are at a greater risk of poorer psychosocial and quality of life outcomes, these findings are cause for cautious optimism. Children with hearing loss should be encouraged to participate in group-based musical activities.

High-Variability Phonetic Training Benefits Lexical Tone Perception: An Investigation on Mandarin-Speaking Pediatric Cochlear Implant Users

Purpose Lexical tone perception is known to be persistently difficult for individuals with cochlear implants (CIs). The purpose of this study was to evaluate the efficacy of high-variability phonetic training (HVPT) in improving Mandarin tone perception for native-speaking children with CIs. Method A total of 28 Mandarin-speaking pediatric CI recipients participated in the study. Half of the children with CIs received a five-session HVPT within a period of 3 weeks. Identification and discrimination of lexical tones produced by familiar talkers (used during training) and novel talkers (not used during training) were measured before, immediately after, and 10 weeks after training termination. The other half untrained children served as control for the identical pre- and posttests. Results Lexical tone perception significantly improved in both trained identification task and untrained discrimination task for the trainees. There was also a significant effect in transfer of learning to perceiving tones produced by novel talkers. Moreover, training-induced gains were retained for up to 10 weeks after training. By comparison, no significant pre-post changes were observed in the control group. Conclusion The results provide the first systematical assessment for the efficacy of the HVPT protocol for Mandarin-speaking pediatric CI users with congenital hearing loss, which supports the clinical utility of intensive short-term HVPT in these children's rehabilitative regimens.

No Evidence That Music Training Benefits Speech Perception in Hearing-Impaired Listeners: A Systematic Review

As musicians have been shown to have a range of superior auditory skills to non-musicians (e.g., pitch discrimination ability), it has been hypothesized by many researchers that music training can have a beneficial effect on speech perception in populations with hearing impairment. This hypothesis relies on an assumption that the benefits seen in musicians are due to their training and not due to innate skills that may support successful musicianship. This systematic review examined the evidence from 13 longitudinal training studies that tested the hypothesis that music training has a causal effect on speech perception ability in hearing-impaired listeners. The papers were evaluated for quality of research design and appropriate analysis techniques. Only 4 of the 13 papers used a research design that allowed a causal relation between music training and outcome benefits to be validly tested, and none of those 4 papers with a better quality study design demonstrated a benefit of music training for speech perception. In spite of the lack of valid evidence in support of the hypothesis, 10 of the 13 papers made claims of benefits of music training, showing a propensity for confirmation bias in this area of research. It is recommended that future studies that aim to evaluate the association of speech perception ability and music training use a study design that differentiates the effects of training from those of innate perceptual and cognitive skills in the participants.

Neurophysiological improvements in speech-in-noise task after short-term choir training in older adults

Perceiving speech in noise (SIN) is important for health and well-being and decreases with age. Musicians show improved speech-in-noise abilities and reduced age-related auditory decline, yet it is unclear whether short term music engagement has similar effects. In this randomized control trial we used a pre-post design to investigate whether a 12-week music intervention in adults aged 50-65 without prior music training and with subjective hearing loss improves well-being, speech-in-noise abilities, and auditory encoding and voluntary attention as indexed by auditory evoked potentials (AEPs) in a syllable-in-noise task, and later AEPs in an oddball task. Age and gender-matched adults were randomized to a choir or control group. Choir participants sang in a 2-hr ensemble with 1-hr home vocal training weekly; controls listened to a 3-hr playlist weekly, attended concerts, and socialized online with fellow participants. From pre- to post-intervention, no differences between groups were observed on quantitative measures of well-being or behavioral speech-in-noise abilities. In the choir group, but not the control group, changes in the N1 component were observed for the syllable-in-noise task, with increased N1 amplitude in the passive condition and decreased N1 latency in the active condition. During the oddball task, larger N1 amplitudes to the frequent standard stimuli were also observed in the choir but not control group from pre to post intervention. Findings have implications for the potential role of music training to improve sound encoding in individuals who are in the vulnerable age range and at risk of auditory decline.

Assessment of music experience after cochlear implantation: A review of current tools and their utilization

Objective

To provide an overview of the current available music assessment tools after cochlear implantation (CI); to report on the utilization of music assessments in the literature; to propose potential future directions in music assessment after CI.

Methods

A thorough search was performed in PubMed, Embase, and The Cochrane Library through October 31, 2020. MeSH search terms, keywords, and phrases included “cochlear implant,” “cochlear prosthesis,” “auditory prosthesis,” “music,” “music assessment,” “music questionnaire,” “music perception,” “music enjoyment, and “music experience.” Potentially relevant studies were reviewed for inclusion, with particular focus on assessments developed specifically for the cochlear implant population and intended for widespread use.

Results/conclusions

Six hundred and forty-three studies were screened for relevance to assessment of music experience among cochlear implantees. Eighty-one studies ultimately met criteria for inclusion. There are multiple validated tools for assessment of music experience after cochlear implantation, each of which provide slightly differing insights into the patients’ subjective and/or objective post-activation experience. However, no single assessment tool has been adopted into widespread use and thus, much of the literature pertaining to this topic evaluates outcomes non-uniformly, including single-use assessments designed specifically for the study at hand. The lack of a widely accepted universal tool for assessment of music limits our collective understanding the contributory and mitigating factors applicable to current music experience of cochlear implantees, and limits our ability to uniformly evaluate the success of new implant technologies or music training paradigms.

Music perception and training for pediatric cochlear implant users

INTRODUCTION

Cochlear implants (CIs) are biomedical devices that restore sound perception for people with severe-to-profound sensorineural hearing loss. Most postlingually deafened CI users are able to achieve excellent speech recognition in quiet environments. However, current CI sound processors remain limited in their ability to deliver fine spectrotemporal information, making it difficult for CI users to perceive complex sounds. Limited access to complex acoustic cues such as music, environmental sounds, lexical tones, and voice emotion may have significant ramifications on quality of life, social development, and community interactions.

AREAS COVERED

The purpose of this review article is to summarize the literature on CIs and music perception, with an emphasis on music training in pediatric CI recipients. The findings have implications on our understanding of noninvasive, accessible methods for improving auditory processing and may help advance our ability to improve sound quality and performance for implantees.

EXPERT OPINION

Music training, particularly in the pediatric population, may be able to continue to enhance auditory processing even after performance plateaus. The effects of these training programs appear generalizable to non-trained musical tasks, speech prosody and, emotion perception. Future studies should employ rigorous control groups involving a non-musical acoustic intervention, standardized auditory stimuli, and the provision of feedback.

Musicians Show Improved Speech Segregation in Competitive, Multi-Talker Cocktail Party Scenarios

Studies suggest that long-term music experience enhances the brain’s ability to segregate speech from noise. Musicians’ “speech-in-noise (SIN) benefit” is based largely on perception from simple figure-ground tasks rather than competitive, multi-talker scenarios that offer realistic spatial cues for segregation and engage binaural processing. We aimed to investigate whether musicians show perceptual advantages in cocktail party speech segregation in a competitive, multi-talker environment. We used the coordinate response measure (CRM) paradigm to measure speech recognition and localization performance in musicians vs. non-musicians in a simulated 3D cocktail party environment conducted in an anechoic chamber. Speech was delivered through a 16-channel speaker array distributed around the horizontal soundfield surrounding the listener. Participants recalled the color, number, and perceived location of target callsign sentences. We manipulated task difficulty by varying the number of additional maskers presented at other spatial locations in the horizontal soundfield (0–1–2–3–4–6–8 multi-talkers). Musicians obtained faster and better speech recognition amidst up to around eight simultaneous talkers and showed less noise-related decline in performance with increasing interferers than their non-musician peers. Correlations revealed associations between listeners’ years of musical training and CRM recognition and working memory. However, better working memory correlated with better speech streaming. Basic (QuickSIN) but not more complex (speech streaming) SIN processing was still predicted by music training after controlling for working memory. Our findings confirm a relationship between musicianship and naturalistic cocktail party speech streaming but also suggest that cognitive factors at least partially drive musicians’ SIN advantage.