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Gfeller K, Mallalieu R. Psychosocial and auditory factors that influence successful music-based auditory training in pediatric cochlear implant recipients. Front Hum Neurosci 2023; 17:1308712. [PMID: 38178994 PMCID: PMC10764544 DOI: 10.3389/fnhum.2023.1308712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Cochlear implants (CIs), which are designed to support spoken communication of persons with severe to profound hearing loss, can provide improved hearing capability through passive exposure. However, auditory training may optimize perception of spectrally complex sounds such as music or speech. Reviews of music-based training for pediatric CI users have reported modest though variable benefits, as well as problems with attrition. It is presumed that more substantial changes may result from longer, more intensive training; however, the development of protocols sufficiently motivating for sustained intensity is challenging. This article examined the experiences of star pediatric CI users, whose years of music training have yielded exceptional auditory benefits. Greater understanding of their experiences and attitudes may suggest best practices for music-based training. Research aims included: (a) characterizing the musical behaviors and perceptual learning processes of music-centric (Music-centric, for purposes of this paper, refers to CI users who engage in sustained and successful music making such as music lessons and ensembles and focused music listening over a period of years, and who derive deep satisfaction from those experiences.) pediatric CI users, and (b) identifying psychosocial and auditory factors that motivated persistence in auditory training. Methods We used qualitative and patient-engaged research methodologies, gathering data through questionnaires with open-ended questions. The participants, six music-centric CI users and five parents, described their experiences and attitudes regarding music training, and factors that supported or undermined those experiences. Data were analyzed using reflexive thematic analysis. Results The codes were consolidated into five themes and organized into a Model of Music-Based Learning for Pediatric Cochlear Implant Recipients. Sustained participation in music training was perceived as a dynamic process including varied musical stimuli, and moderated by intrinsic (attitude, perceived behavioral control) and extrinsic (parents, teachers, peers) influences, hearing status, sound access and background factors. Discussion These themes highlighted motivational factors that pediatric CI users and parents considered important to sustained, intensive and successful music learning throughout childhood and adolescence. These factors should be considered in the development of music-based training for pediatric CI recipients.
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Affiliation(s)
- Kate Gfeller
- Department of Otolaryngology—Head and Neck Surgery, School of Music, Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, IA, United States
| | - Ruth Mallalieu
- Bodleian Libraries, The University of Oxford, Oxford, United Kingdom
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Camarena A, Manchala G, Papadopoulos J, O’Connell SR, Goldsworthy RL. Pleasantness Ratings of Musical Dyads in Cochlear Implant Users. Brain Sci 2021; 12:brainsci12010033. [PMID: 35053777 PMCID: PMC8773901 DOI: 10.3390/brainsci12010033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022] Open
Abstract
Cochlear implants have been used to restore hearing to more than half a million people around the world. The restored hearing allows most recipients to understand spoken speech without relying on visual cues. While speech comprehension in quiet is generally high for recipients, many complain about the sound of music. The present study examines consonance and dissonance perception in nine cochlear implant users and eight people with no known hearing loss. Participants completed web-based assessments to characterize low-level psychophysical sensitivities to modulation and pitch, as well as higher-level measures of musical pleasantness and speech comprehension in background noise. The underlying hypothesis is that sensitivity to modulation and pitch, in addition to higher levels of musical sophistication, relate to higher-level measures of music and speech perception. This hypothesis tested true with strong correlations observed between measures of modulation and pitch with measures of consonance ratings and speech recognition. Additionally, the cochlear implant users who were the most sensitive to modulations and pitch, and who had higher musical sophistication scores, had similar pleasantness ratings as those with no known hearing loss. The implication is that better coding and focused rehabilitation for modulation and pitch sensitivity will broadly improve perception of music and speech for cochlear implant users.
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Affiliation(s)
- Andres Camarena
- Auditory Research Center, Caruso Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.C.); (G.M.); (J.P.); (S.R.O.)
| | - Grace Manchala
- Auditory Research Center, Caruso Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.C.); (G.M.); (J.P.); (S.R.O.)
| | - Julianne Papadopoulos
- Auditory Research Center, Caruso Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.C.); (G.M.); (J.P.); (S.R.O.)
- Thornton School of Music, University of Southern California, Los Angeles, CA 90089, USA
| | - Samantha R. O’Connell
- Auditory Research Center, Caruso Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.C.); (G.M.); (J.P.); (S.R.O.)
| | - Raymond L. Goldsworthy
- Auditory Research Center, Caruso Department of Otolaryngology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.C.); (G.M.); (J.P.); (S.R.O.)
- Correspondence:
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Beyond Technology: The Interaction of Perceptual Accuracy and Experiential Factors in Pediatric Music Engagement. Otol Neurotol 2020; 40:e290-e297. [PMID: 30741909 DOI: 10.1097/mao.0000000000002123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Music engagement (the active making of music, e.g., music lessons and ensembles) is a common part of educational and community experiences. Music making typically involves listening to and production of rapidly changing combinations of pitch, timbre, and rhythm, which can be challenging for cochlear implant (CI) recipients, given that pitch and timbre are poorly conveyed through the CI. Pediatric CI users have variable patterns of music engagement, but some have achieved, sustained participation despite the degraded CI signal. What factors contribute to their persistence in these demanding listening situations? Our study examined a cohort of pediatric CI recipients from our center to better understand those perceptual and experiential factors most influential in relation to music engagement. METHOD Regressions and correlations were run for measures of pitch and speech perception, hearing history, familial involvement in music, personal importance of music, and extent of music engagement (years in music lessons; general involvement in music). RESULTS Pitch ranking accuracy was a significant predictor of sustained participation in music lessons (p = 0.0019), and sustained involvement in music (p = 0.0038), as well as performance on CNC words (p = -0.0060) and phonemes (p = -0.0174). Extent of familial involvement in music at the time of testing was significantly predictive of the user's musical engagement (p = 0.0007). Personal importance of music was not predicted by or significantly correlated with, any of the variables investigated. CONCLUSION Better pitch perception was associated with sustained involvement in music lessons as well as better speech perception. However, familial involvement in music was of greater impact for sustained music engagement. Judicious choice of musical instrument also influenced persistence. The positive impact of familial involvement indicates that perceptual limitations associated with CI processing do not present insurmountable barriers to music engagement. Because music engagement provides normalizing social involvement and challenging auditory practice, the impact of parental involvement has implications for counseling parents of CI users.
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Gfeller K, Mallalieu RM, Mansouri A, McCormick G, O'Connell RB, Spinowitz J, Gellinek Turner B. Practices and Attitudes That Enhance Music Engagement of Adult Cochlear Implant Users. Front Neurosci 2019. [PMID: 31920520 DOI: 10.3389/fnins/2019.01368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Cochlear implants (CIs) are auditory prostheses designed to support spoken communication in persons with severe to profound hearing loss. Many post-lingually deaf adult CI users achieve good speech recognition in quiet; unfortunately, CI technology conveys a degraded representation of pitch and timbre, essential components of music. Not surprisingly, most CI users achieve significantly poorer perception and enjoyment of music compared with normal hearing listeners. Anecdotal evidence indicates that this impacts music engagement, particularly singing and playing instruments requiring ongoing tuning to external pitches or producing intervallic ratios. Interestingly, a small cohort of adult CI users has shown remarkable success in recovering or developing musical skills, but their success is poorly understood. Greater understanding of their efforts and attitudes may suggest potential rehabilitative approaches for other CI users. PURPOSE This article documented personal characteristics and experiences perceived to contribute to high level musicianship. Research questions included: (1) What forms of practice/experience have most contributed to (re)establishing satisfying music making? (2) What situations or musical tasks are most frustrating or challenging? (3) What attitudes, motivational factors, or forms of support help CI users persist in working toward improved music engagement? METHODS Qualitative and patient-engaged research methodologies were used. Our study involved a unique collaboration of six CI users engaged in high levels of musicianship and a researcher whose scholarship focuses on music and CIs. The CI recipients conveyed their experiences and attitudes regarding music and CIs through open-ended narratives. These narratives were analyzed using an integrative approach of inductive and deductive coding methods. The codes and themes that emerged through inductive methods were then organized within the Dynamic Problem Solving Model for Management of Music Listening Environments (Gfeller et al., 2019a). OUTCOMES This paper provides reflections of six CI users who successfully engage in active music making, including on-going tuning to external pitches and ensemble participation. Their perspectives emphasize the importance of pre-CI music instruction, extensive practice and immersion in music listening and playing, persistence and self-efficacy, and problem solving skills that optimize music engagement, and suggest possible strategies useful to other CI users interested in improving music experiences.
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Affiliation(s)
- Kate Gfeller
- School of Music, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA, United States.,Department of Communication Sciences and Disorders, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA, United States.,Iowa Cochlear Implant Clinical Research Center, Department of Otolaryngology-Head and Neck Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | | | | | - Gaelen McCormick
- Eastman School of Music, University of Rochester, Rochester, NY, United States
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Gfeller K, Mallalieu RM, Mansouri A, McCormick G, O’Connell RB, Spinowitz J, Gellinek Turner B. Practices and Attitudes That Enhance Music Engagement of Adult Cochlear Implant Users. Front Neurosci 2019; 13:1368. [PMID: 31920520 PMCID: PMC6937904 DOI: 10.3389/fnins.2019.01368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/04/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Cochlear implants (CIs) are auditory prostheses designed to support spoken communication in persons with severe to profound hearing loss. Many post-lingually deaf adult CI users achieve good speech recognition in quiet; unfortunately, CI technology conveys a degraded representation of pitch and timbre, essential components of music. Not surprisingly, most CI users achieve significantly poorer perception and enjoyment of music compared with normal hearing listeners. Anecdotal evidence indicates that this impacts music engagement, particularly singing and playing instruments requiring ongoing tuning to external pitches or producing intervallic ratios. Interestingly, a small cohort of adult CI users has shown remarkable success in recovering or developing musical skills, but their success is poorly understood. Greater understanding of their efforts and attitudes may suggest potential rehabilitative approaches for other CI users. PURPOSE This article documented personal characteristics and experiences perceived to contribute to high level musicianship. Research questions included: (1) What forms of practice/experience have most contributed to (re)establishing satisfying music making? (2) What situations or musical tasks are most frustrating or challenging? (3) What attitudes, motivational factors, or forms of support help CI users persist in working toward improved music engagement? METHODS Qualitative and patient-engaged research methodologies were used. Our study involved a unique collaboration of six CI users engaged in high levels of musicianship and a researcher whose scholarship focuses on music and CIs. The CI recipients conveyed their experiences and attitudes regarding music and CIs through open-ended narratives. These narratives were analyzed using an integrative approach of inductive and deductive coding methods. The codes and themes that emerged through inductive methods were then organized within the Dynamic Problem Solving Model for Management of Music Listening Environments (Gfeller et al., 2019a). OUTCOMES This paper provides reflections of six CI users who successfully engage in active music making, including on-going tuning to external pitches and ensemble participation. Their perspectives emphasize the importance of pre-CI music instruction, extensive practice and immersion in music listening and playing, persistence and self-efficacy, and problem solving skills that optimize music engagement, and suggest possible strategies useful to other CI users interested in improving music experiences.
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Affiliation(s)
- Kate Gfeller
- School of Music, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA, United States,Department of Communication Sciences and Disorders, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA, United States,Iowa Cochlear Implant Clinical Research Center, Department of Otolaryngology–Head and Neck Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United States,*Correspondence: Kate Gfeller,
| | | | | | - Gaelen McCormick
- Eastman School of Music, University of Rochester, Rochester, NY, United States
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Jorgensen EJ, Walker EA. Music Participation Among School-Aged Children Who Are Hard of Hearing. Am J Audiol 2019; 28:908-926. [PMID: 31721597 DOI: 10.1044/2019_aja-19-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Music is an important part of life for many people. Furthermore, music training has been shown to improve a variety of cognitive functions among children and adults. However, little research exists on how children who are hard of hearing (HH) perceive or participate in music. In particular, it is unknown whether hearing loss limits participation in music activities among school-aged children with mild-to-severe hearing loss. The purpose of this study was to determine whether hearing loss limits participation among children who are HH compared to children with normal hearing (NH). Method Participants were parents of 2 cohorts of children finishing 5th grade (approximately 11 years old). Parents were asked to complete a survey (online or paper) regarding the role of music in their child's life. A total of 88 surveys were completed (67 from parents of children who are HH and 21 from parents of children with NH, with an overall response rate of 74%). Results Hearing loss did not limit music participation among children. Children who are HH listened to recorded music, attended live concerts, and practiced an instrument at the same rates as children with NH. Listening to recorded and live music, practicing an instrument, and playing in an ensemble were equally as important to children who are HH as children with NH. Children who are HH were significantly more likely to regularly play in an ensemble than children with NH. Parent participation in music significantly influenced music participation for children who are HH but not children with NH. Descriptive data about music genres, instruments, and ensembles are also presented. Conclusions Children who are HH participate in music at the same or greater rates as children with NH. Parent participation in music may be particularly important for children who are HH. In light of this, music listening should be a consideration when fitting children with hearing aids.
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Affiliation(s)
- Erik J. Jorgensen
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Elizabeth A. Walker
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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A Randomized Controlled Crossover Study of the Impact of Online Music Training on Pitch and Timbre Perception in Cochlear Implant Users. J Assoc Res Otolaryngol 2019; 20:247-262. [PMID: 30815761 DOI: 10.1007/s10162-018-00704-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 10/17/2018] [Indexed: 10/27/2022] Open
Abstract
Cochlear implant (CI) biomechanical constraints result in impoverished spectral cues and poor frequency resolution, making it difficult for users to perceive pitch and timbre. There is emerging evidence that music training may improve CI-mediated music perception; however, much of the existing studies involve time-intensive and less readily accessible in-person music training paradigms, without rigorous experimental control paradigms. Online resources for auditory rehabilitation remain an untapped potential resource for CI users. Furthermore, establishing immediate value from an acute music training program may encourage CI users to adhere to post-implantation rehabilitation exercises. In this study, we evaluated the impact of an acute online music training program on pitch discrimination and timbre identification. Via a randomized controlled crossover study design, 20 CI users and 21 normal hearing (NH) adults were assigned to one of two arms. Arm-A underwent 1 month of online self-paced music training (intervention) followed by 1 month of audiobook listening (control). Arm-B underwent 1 month of audiobook listening followed by 1 month of music training. Pitch and timbre sensitivity scores were taken across three visits: (1) baseline, (2) after 1 month of intervention, and (3) after 1 month of control. We found that performance improved in pitch discrimination among CI users and NH listeners, with both online music training and audiobook listening. Music training, however, provided slightly greater benefit for instrument identification than audiobook listening. For both tasks, this improvement appears to be related to both fast stimulus learning as well as procedural learning. In conclusion, auditory training (with either acute participation in an online music training program or audiobook listening) may improve performance on untrained tasks of pitch discrimination and timbre identification. These findings demonstrate a potential role for music training in perceptual auditory appraisal of complex stimuli. Furthermore, this study highlights the importance and the need for more tightly controlled training studies in order to accurately evaluate the impact of rehabilitation training protocols on auditory processing.
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Dritsakis G, van Besouw RM, Kitterick P, Verschuur CA. A Music-Related Quality of Life Measure to Guide Music Rehabilitation for Adult Cochlear Implant Users. Am J Audiol 2017; 26:268-282. [PMID: 28614845 DOI: 10.1044/2017_aja-16-0120] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/10/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE A music-related quality of life (MuRQoL) questionnaire was developed for the evaluation of music rehabilitation for adult cochlear implant (CI) users. The present studies were aimed at refinement and validation. METHOD Twenty-four experts reviewed the MuRQoL items for face validity. A refined version was completed by 147 adult CI users, and psychometric techniques were used for item selection, assessment of reliability, and definition of the factor structure. The same participants completed the Short Form Health Survey for construct validation. MuRQoL responses from 68 CI users were compared with those of a matched group of adults with normal hearing. RESULTS Eighteen items measuring music perception and engagement and 18 items measuring their importance were selected; they grouped together into 2 domains. The final questionnaire has high internal consistency and repeatability. Significant differences between CI users and adults with normal hearing and a correlation between music engagement and quality of life support construct validity. Scores of music perception and engagement and importance for the 18 items can be combined to assess the impact of music on the quality of life. CONCLUSION The MuRQoL questionnaire is a reliable and valid measure of self-reported music perception, engagement, and their importance for adult CI users with potential to guide music aural rehabilitation.
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Affiliation(s)
- Giorgos Dritsakis
- Institute of Sound and Vibration Research, University of Southampton, UK
| | | | - Pádraig Kitterick
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, UK
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Sjoberg KM, Driscoll VD, Gfeller K, Welhaven AE, Kirk KI, Prusick L. The impact of electric hearing on children's timbre and pitch perception and talker discrimination. Cochlear Implants Int 2017; 18:36-48. [PMID: 28098512 DOI: 10.1080/14670100.2016.1263406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Virginia D Driscoll
- b Department of Otolaryngology , Iowa Cochlear Implant Clinical Research Center , Iowa City , IA , USA
| | - Kate Gfeller
- c Department of Communication Sciences and Disorders , School of Music, Iowa Cochlear Implant Clinical Research Center , Iowa City , IA , USA
| | - Anne E Welhaven
- d Department of Biostatistics , The University of Iowa , Iowa City , IA , USA
| | - Karen Iler Kirk
- e Department of Speech and Hearing Science , University of Illinois Urbana-Champaign , Champaign , IL , USA
| | - Lindsay Prusick
- f Department of Otolaryngology , The University of Iowa, Iowa Cochlear Implant Clinical Research Center , Iowa City , IA , USA
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Gfeller K, Guthe E, Driscoll V, Brown CJ. A preliminary report of music-based training for adult cochlear implant users: Rationales and development. Cochlear Implants Int 2016; 16 Suppl 3:S22-31. [PMID: 26561884 DOI: 10.1179/1467010015z.000000000269] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components. METHODS Prior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for CI recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This informed the development of a computer-based music training program designed specifically for adult CI users. RESULTS Principles and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented. CONCLUSIONS Music training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users is required.
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Abstract
BACKGROUND Preserved residual hearing in adult recipients of short electrode cochlear implants (CIs) contributes to improve perception of speech in noise as well as music. Recently, children and adolescents with sufficient low-frequency hearing but profound loss at higher frequencies enrolled in a FDA trial intended to evaluate the benefit of a short electrode device on the maintenance of residual hearing. This article reports on the perception of several music listening tasks by adolescents using electroacoustic hearing. METHODS Five adolescents (13-18 yr) with 18-24 months of electroacoustic experience, 73 children (LEC) and adolescents (LEA) who use traditional implants, and 87 children with normal hearing (NH) tested on 3 measures of music perception: Complex Pitch Ranking (PR-C); Melodic Error Detection (MED); Melody Recognition X Information Cue (MRIC). The participants with ipsilateral residual hearing were tested preoperatively at intervals up to 24 months. RESULTS Pitch ranking scores for the electroacoustic group were significantly better than the LEC and LEA (p < 0.0002 and p = 0.0076, respectively) and were not significantly different from the NH group. On the MED, although scores were more accurate than those of the LEC and LEA groups, they were not significantly better. For the MRIC, the electroacoustic group was significantly better than both LEA and LEC on melody with and without rhythm. NH subjects were significantly better than both LE groups, but not the electroacoustic group. CONCLUSION Low-frequency information available to electroacoustic users was associated with more accurate perception on three pitch-based music listening tasks. Greater residual hearing during auditory development may also contribute to more "normal" mental representation of musical elements.
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Abstract
Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly hearing-impaired people to perceive sounds. Many CI users find language comprehension satisfactory, but music perception is generally considered difficult. However, music contains different dimensions which might be accessible in different ways. We aimed to highlight three main dimensions of music processing in CI users which rely on different processing mechanisms: (1) musical discrimination abilities, (2) access to meaning in music, and (3) subjective music appreciation. All three dimensions were investigated in two CI user groups (post- and prelingually deafened CI users, all implanted as adults) and a matched normal hearing control group. The meaning of music was studied by using event-related potentials (with the N400 component as marker) during a music-word priming task while music appreciation was gathered by a questionnaire. The results reveal a double dissociation between the three dimensions of music processing. Despite impaired discrimination abilities of both CI user groups compared to the control group, appreciation was reduced only in postlingual CI users. While musical meaning processing was restorable in postlingual CI users, as shown by a N400 effect, data of prelingual CI users lack the N400 effect and indicate previous dysfunctional concept building.
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Gfeller K. Music-based training for pediatric CI recipients: A systematic analysis of published studies. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S50-6. [PMID: 27246744 PMCID: PMC4916033 DOI: 10.1016/j.anorl.2016.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/11/2016] [Indexed: 11/16/2022]
Abstract
In recent years, there has been growing interest in the use of music-based training to enhance speech and language development in children with normal hearing and some forms of communication disorders, including pediatric CI users. The use of music training for CI users may initially seem incongruous given that signal processing for CIs presents a degraded version of pitch and timbre, both key elements in music. Furthermore, empirical data of systematic studies of music training, particularly in relation to transfer to speech skills are limited. This study describes the rationale for music training of CI users, describes key features of published studies of music training with CI users, and highlights some developmental and logistical issues that should be taken into account when interpreting or planning studies of music training and speech outcomes with pediatric CI recipients.
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Affiliation(s)
- K Gfeller
- Department of Otolaryngology-Head and Neck Surgery, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, 52242 IA, United States.
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van Besouw RM, Oliver BR, Hodkinson SM, Polfreman R, Grasmeder ML. Participatory design of a music aural rehabilitation programme. Cochlear Implants Int 2015; 16 Suppl 3:S39-50. [DOI: 10.1179/1467010015z.000000000264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Whipple CM, Gfeller K, Driscoll V, Oleson J, McGregor K. Do communication disorders extend to musical messages? An answer from children with hearing loss or autism spectrum disorders. J Music Ther 2015; 52:78-116. [PMID: 25691513 PMCID: PMC4414659 DOI: 10.1093/jmt/thu039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Effective musical communication requires conveyance of the intended message in a manner perceptible to the receiver. Communication disorders that impair transmitting or decoding of structural features of music (e.g., pitch, timbre) and/or symbolic representation may result in atypical musical communication, which can have a negative impact on music therapy interventions. OBJECTIVE This study compared recognition of symbolic representation of emotions or movements in music by two groups of children with different communicative characteristics: severe to profound hearing loss (using cochlear implants [CI]) and autism spectrum disorder (ASD). Their responses were compared to those of children with typical-development and normal hearing (TD-NH). Accuracy was examined as a function of communicative status, emotional or movement category, and individual characteristics. METHODS Participants listened to recorded musical excerpts conveying emotions or movements and matched them with labels. Measures relevant to auditory and/or language function were also gathered. RESULTS There was no significant difference between the ASD and TD-NH groups in identification of musical emotions or movements. However, the CI group was significantly less accurate than the other two groups in identification of both emotions and movements. Mixed effects logistic regression revealed different patterns of accuracy for specific emotions as a function of group. CONCLUSION Conveyance of emotions or movements through music may be decoded differently by persons with different types of communication disorders. Because music is the primary therapeutic tool in music therapy sessions, clinicians should consider these differential abilities when selecting music for clinical interventions focusing on emotions or movement.
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Affiliation(s)
- Christina M Whipple
- School of Music, The University of Iowa School of Music, Department of Communication Sciences and Disorders, The University of Iowa Iowa Cochlear Implant Clinical Research Center, University of Iowa Hospitals and Clinics Department of Biostatistics, The University of Iowa Department of Communication Sciences and Disorders, The DeLTA Center, The University of Iowa
| | - Kate Gfeller
- School of Music, The University of Iowa School of Music, Department of Communication Sciences and Disorders, The University of Iowa Iowa Cochlear Implant Clinical Research Center, University of Iowa Hospitals and Clinics Department of Biostatistics, The University of Iowa Department of Communication Sciences and Disorders, The DeLTA Center, The University of Iowa
| | - Virginia Driscoll
- School of Music, The University of Iowa School of Music, Department of Communication Sciences and Disorders, The University of Iowa Iowa Cochlear Implant Clinical Research Center, University of Iowa Hospitals and Clinics Department of Biostatistics, The University of Iowa Department of Communication Sciences and Disorders, The DeLTA Center, The University of Iowa
| | - Jacob Oleson
- School of Music, The University of Iowa School of Music, Department of Communication Sciences and Disorders, The University of Iowa Iowa Cochlear Implant Clinical Research Center, University of Iowa Hospitals and Clinics Department of Biostatistics, The University of Iowa Department of Communication Sciences and Disorders, The DeLTA Center, The University of Iowa
| | - Karla McGregor
- School of Music, The University of Iowa School of Music, Department of Communication Sciences and Disorders, The University of Iowa Iowa Cochlear Implant Clinical Research Center, University of Iowa Hospitals and Clinics Department of Biostatistics, The University of Iowa Department of Communication Sciences and Disorders, The DeLTA Center, The University of Iowa
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Petersen B, Weed E, Sandmann P, Brattico E, Hansen M, Sørensen SD, Vuust P. Brain responses to musical feature changes in adolescent cochlear implant users. Front Hum Neurosci 2015; 9:7. [PMID: 25705185 PMCID: PMC4319402 DOI: 10.3389/fnhum.2015.00007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 01/07/2015] [Indexed: 11/13/2022] Open
Abstract
Cochlear implants (CIs) are primarily designed to assist deaf individuals in perception of speech, although possibilities for music fruition have also been documented. Previous studies have indicated the existence of neural correlates of residual music skills in postlingually deaf adults and children. However, little is known about the behavioral and neural correlates of music perception in the new generation of prelingually deaf adolescents who grew up with CIs. With electroencephalography (EEG), we recorded the mismatch negativity (MMN) of the auditory event-related potential to changes in musical features in adolescent CI users and in normal-hearing (NH) age mates. EEG recordings and behavioral testing were carried out before (T1) and after (T2) a 2-week music training program for the CI users and in two sessions equally separated in time for NH controls. We found significant MMNs in adolescent CI users for deviations in timbre, intensity, and rhythm, indicating residual neural prerequisites for musical feature processing. By contrast, only one of the two pitch deviants elicited an MMN in CI users. This pitch discrimination deficit was supported by behavioral measures, in which CI users scored significantly below the NH level. Overall, MMN amplitudes were significantly smaller in CI users than in NH controls, suggesting poorer music discrimination ability. Despite compliance from the CI participants, we found no effect of the music training, likely resulting from the brevity of the program. This is the first study showing significant brain responses to musical feature changes in prelingually deaf adolescent CI users and their associations with behavioral measures, implying neural predispositions for at least some aspects of music processing. Future studies should test any beneficial effects of a longer lasting music intervention in adolescent CI users.
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Affiliation(s)
- Bjørn Petersen
- Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- Royal Academy of Music, Aarhus, Denmark
| | - Ethan Weed
- Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- Department of Aesthetics and Communication – Linguistics, Aarhus University, Aarhus, Denmark
| | - Pascale Sandmann
- Central Auditory Diagnostics Lab, Department of Neurology, Cluster of Excellence “Hearing4all”, Hannover Medical School, Hannover, Germany
| | - Elvira Brattico
- Brain and Mind Laboratory, Department of Biomedical Engineering and Computational Science, Aalto University, Aalto, Finland
- Cognitive Brain Research Unit, Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Mads Hansen
- Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Stine Derdau Sørensen
- Department of Aesthetics and Communication – Linguistics, Aarhus University, Aarhus, Denmark
| | - Peter Vuust
- Center for Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- Royal Academy of Music, Aarhus, Denmark
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Driscoll V, Gfeller K, Tan X, See RL, Cheng HY, Kanemitsu M. Family involvement in music impacts participation of children with cochlear implants in music education and music activities. Cochlear Implants Int 2014; 16:137-46. [PMID: 25431978 DOI: 10.1179/1754762814y.0000000103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Objective Children with cochlear implants (CIs) participate in musical activities in school and daily lives. Considerable variability exists regarding the amount of music involvement and enjoyment. Using the Music Engagement Questionnaire-Preschool/Elementary (MEQ-P/E), we wanted to determine patterns of musical participation and the impact of familial factors on engagement. Methods Parents of 32 children with CIs (16 preschool and 16 elementary) completed a questionnaire regarding the musical involvement of their child with an implant and a normal-hearing (NH) sibling (if one existed). We compared CI children's involvement to that of their NH siblings as well as across groups of children with and without CIs. Correlations between parent ratings of music importance, demographic factors, and involvement of CI and NH children were conducted within and across groups. Results No significant differences were found between children with CIs and NH siblings, meaning children from the same family showed similar levels of musical involvement. When compared at the same developmental stage, no significant differences were found between preschool children with and without CIs. Parents who rated the importance of music as 'low' or 'middle' had children (NH and CI) who were less involved in music activities. Children whose parents rated music importance as 'high' were involved in monthly to weekly music activities with 81.25% reporting daily music listening. Conclusion Despite a less-than-ideal auditory signal for music, preschool and school-aged CI children enjoy and are involved in musical experiences. Families who enjoy and spend a greater amount of time involved in music tend to have children who also engage more actively in music.
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