Electrical stimulation at the wrist as an aid for the profoundly deaf

Using haptic stimulation to enhance auditory perception in hearing-impaired listeners

INTRODUCTION

Hearing-assistive devices, such as hearing aids and cochlear implants, transform the lives of hearing-impaired people. However, users often struggle to locate and segregate sounds. This leads to impaired threat detection and an inability to understand speech in noisy environments. Recent evidence suggests that segregation and localization can be improved by providing missing sound-information through haptic stimulation.

AREAS COVERED

This article reviews the evidence that haptic stimulation can effectively provide sound information. It then discusses the research and development required for this approach to be implemented in a clinically viable device. This includes discussion of what sound information should be provided and how that information can be extracted and delivered.

EXPERT OPINION

Although this research area has only recently emerged, it builds on a significant body of work showing that sound information can be effectively transferred through haptic stimulation. Current evidence suggests that haptic stimulation is highly effective at providing missing sound-information to cochlear implant users. However, a great deal of work remains to implement this approach in an effective wearable device. If successful, such a device could offer an inexpensive, noninvasive means of improving educational, work, and social experiences for hearing-impaired individuals, including those without access to hearing-assistive devices.

Coding of acoustic features for a single-channel tactile aid

Measurements have been made on the discrimination of speech contrasts on the basis of single-channel vibrotactile presentation of a variety of speech-derived signals, coded as amplitude- and frequency-modulated pulse trains. Stimulation was at the index fingertip. The signals chosen for tactile presentation were the speech amplitude envelope, the voice fundamental frequency FO and the zero-crossing frequency in the 1.3-6.6 kHz band. "Two-feature' codings, which present two of these signals simultaneously (one coded as stimulus frequency and one coded as stimulus amplitude), were found to be no more effective than "single feature' codings which present only one signal (coded as both amplitude and frequency). Scores for consonant discrimination were highest for the single-feature coding of zero-crossing frequency, although differences between the codings were not, in general, significant. Scores for emphatic-stress discrimination were highest for the single-feature coding of F0, and this coding produced best results overall. A practical wrist-worn device, whose design is influenced by these experimental results is briefly described.

Coding strategies for a single-channel tactile aid

Measurements have been made on the ability of normally hearing subjects to identify the stressed word in simple sentences, using only tactile information. Vibrotactile stimuli were presented to the distal pad of the second finger via a single vibrator. A range of coding strategies was investigated, voice pitch or speech amplitude being represented as stimulus frequency and/or intensity. Test results show that, even without specific training, subjects can be quite successful in identifying stress patterns. The most effective coding strategies were (i) voice frequency presented as continuously variable stimulus frequency over the range 40-220 Hz, with a correlated modulation of stimulus amplitude, (ii) speech amplitude presented as two discrete levels of stimulus amplitude.