Music in the lives of deaf children with cochlear implants

Effect of Sound Coding Strategies on Music Perception with a Cochlear Implant

The goal of this study was to evaluate the music perception of cochlear implantees with two different sound processing strategies. Methods: Twenty-one patients with unilateral or bilateral cochlear implants (Oticon Medical®) were included. A music trial evaluated emotions (sad versus happy based on tempo and/or minor versus major modes) with three tests of increasing difficulty. This was followed by a test evaluating the perception of musical dissonances (marked out of 10). A novel sound processing strategy reducing spectral distortions (CrystalisXDP, Oticon Medical) was compared to the standard strategy (main peak interleaved sampling). Each strategy was used one week before the music trial. Results: Total music score was higher with CrystalisXDP than with the standard strategy. Nine patients (21%) categorized music above the random level (>5) on test 3 only based on mode with either of the strategies. In this group, CrystalisXDP improved the performances. For dissonance detection, 17 patients (40%) scored above random level with either of the strategies. In this group, CrystalisXDP did not improve the performances. Conclusions: CrystalisXDP, which enhances spectral cues, seemed to improve the categorization of happy versus sad music. Spectral cues could participate in musical emotions in cochlear implantees and improve the quality of musical perception.

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.

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

Purpose A growing body of evidence suggests that long-term music training provides benefits to auditory abilities for typical-hearing adults and children. The purpose of this study was to evaluate how music training may provide perceptual benefits (such as speech-in-noise, spectral resolution, and prosody) for children with hearing loss. Method Fourteen children aged 6-9 years with prelingual sensorineural hearing loss using bilateral cochlear implants, bilateral hearing aids, or bimodal configuration participated in a 12-week music training program, with nine participants completing the full testing requirements of the music training. Activities included weekly group-based music therapy and take-home music apps three times a week. The design was a pseudorandomized, longitudinal study (half the cohort was wait-listed, initially serving as a passive control group prior to music training). The test battery consisted of tasks related to music perception, music appreciation, and speech perception. As a comparison, 16 age-matched children with typical hearing also completed this test battery, but without participation in the music training. Results There were no changes for any outcomes for the passive control group. After music training, perception of speech-in-noise, question/statement prosody, musical timbre, and spectral resolution improved significantly, as did measures of music appreciation. There were no benefits for emotional prosody or pitch perception. Conclusion The findings suggest even a modest amount of music training has benefits for music and speech outcomes. These preliminary results provide further evidence that music training is a suitable complementary means of habilitation to improve the outcomes for children with hearing loss.

Beyond Technology: The Interaction of Perceptual Accuracy and Experiential Factors in Pediatric Music Engagement

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.

The Role of Music in Families of Children With Hearing Loss and Normal Hearing in Australia, Finland, and the UK

The primary aim of this current study was to compare the role, importance and value placed on music by families with normally hearing (NH) children, to those who had a child with a hearing loss (HL) who wore either hearing aids and/or cochlear implants. A secondary aim was to see whether this differed between the countries. Parents of children aged 2-6 years living in Australia, Finland, and the United Kingdom were invited to complete the Role of Music in Families Questionnaire (RMFQ). Two groups of participants were recruited from each country: (i) parents of NH children, and (ii) parents of children with a HL. The RMFQ had seven subsections covering topics such as music participation, attitudes to music, importance of music in the family, and future perspectives on music. Three hundred and twenty-two families of NH children, and 56 families of children with HL completed the questionnaire (Australia: 50 NH, 25 HL; Finland: 242 NH, 21 HL; United Kingdom: 30 NH, 10 HL). Analyses compared between NH and HL groups within each country, and between the three countries for the NH group, and the HL group, independently. Overall, there were few significant differences between the participation levels, role, or importance of music in families with NH children compared to those with a child who had a HL, regardless of whether the families lived in Australia, Finland or the United Kingdom. Children first started to respond to music at similar ages, and overall music participation frequency, and music enjoyment were relatively similar. The importance of music in the family was also similar between the NH and HL groups. In comparing between the countries, Finnish children had a tendency to have higher participation rates in musical activities, with few other differences noted. Overall, the results of this study indicate that children, regardless of hearing levels or country of residence, have similar levels of music engagement and enjoyment, and HL is not seen as a contraindication to music participation and involvement by the parents involved in this study.

Implicit Processing of Pitch in Postlingually Deafened Cochlear Implant Users

Cochlear implant (CI) users can only access limited pitch information through their device, which hinders music appreciation. Poor music perception may not only be due to CI technical limitations; lack of training or negative attitudes toward the electric sound might also contribute to it. Our study investigated with an implicit (indirect) investigation method whether poorly transmitted pitch information, presented as musical chords, can activate listeners’ knowledge about musical structures acquired prior to deafness. Seven postlingually deafened adult CI users participated in a musical priming paradigm investigating pitch processing without explicit judgments. Sequences made of eight sung-chords that ended on either a musically related (expected) target chord or a less-related (less-expected) target chord were presented. The use of a priming task based on linguistic features allowed CI patients to perform fast judgments on target chords in the sung music. If listeners’ musical knowledge is activated and allows for tonal expectations (as in normal-hearing listeners), faster response times were expected for related targets than less-related targets. However, if the pitch percept is too different and does not activate musical knowledge acquired prior to deafness, storing pitch information in a short-term memory buffer predicts the opposite pattern. If transmitted pitch information is too poor, no difference in response times should be observed. Results showed that CI patients were able to perform the linguistic task on the sung chords, but correct response times indicated sensory priming, with faster response times observed for the less-related targets: CI patients processed at least some of the pitch information of the musical sequences, which was stored in an auditory short-term memory and influenced chord processing. This finding suggests that the signal transmitted via electric hearing led to a pitch percept that was too different from that based on acoustic hearing, so that it did not automatically activate listeners’ previously acquired musical structure knowledge. However, the transmitted signal seems sufficiently informative to lead to sensory priming. These findings are encouraging for the development of pitch-related training programs for CI patients, despite the current technological limitations of the CI coding.

Singing Proficiency of Members of a Choir Formed by Prelingually Deafened Children With Cochlear Implants

Purpose A group of 10 prelingually deafened children with cochlear implants (CIs) formed a choir and received 21 months of formal music training. The purpose of this study was to evaluate the singing proficiency of these children. Method The participants included all choir members (7 girls and 3 boys, mean age of 9.5 years old) who were unilateral CI users. Meanwhile, 8 age-matched children with normal hearing were recruited as controls and were trained on 1 song for 2 weeks. Individual singing samples without instrument accompaniment were recorded from all participants. The singing samples were subject to acoustic analysis in which the fundamental frequency (F0) of each note was extracted and the duration was measured. Five metrics were developed and computed to quantify the accuracy of their pitch and rhythm performance. The 5 metrics included (a) percent correct of F0 contour direction of adjacent notes, (b) mean deviation of the normalized F0 across the notes, (c) mean deviation of the pitch intervals, (d) mean deviation of adjacent note duration ratio, and (e) mean absolute deviation of note duration. Results The choir members with CIs demonstrated high accuracy in both pitch and tempo measures and performed on par with the children with normal hearing. Early start of music training after implantation and use of bimodal hearing contributed to the development of better music ability in these children with CIs. Conclusion These findings indicated that rigorous music training could facilitate high singing proficiency in prelingually deafened children with CIs.

Benefits of Music Training for Perception of Emotional Speech Prosody in Deaf Children With Cochlear Implants

Objectives:

Children who use cochlear implants (CIs) have characteristic pitch processing deficits leading to impairments in music perception and in understanding emotional intention in spoken language. Music training for normal-hearing children has previously been shown to benefit perception of emotional prosody. The purpose of the present study was to assess whether deaf children who use CIs obtain similar benefits from music training. We hypothesized that music training would lead to gains in auditory processing and that these gains would transfer to emotional speech prosody perception.

Design:

Study participants were 18 child CI users (ages 6 to 15). Participants received either 6 months of music training (i.e., individualized piano lessons) or 6 months of visual art training (i.e., individualized painting lessons). Measures of music perception and emotional speech prosody perception were obtained pre-, mid-, and post-training. The Montreal Battery for Evaluation of Musical Abilities was used to measure five different aspects of music perception (scale, contour, interval, rhythm, and incidental memory). The emotional speech prosody task required participants to identify the emotional intention of a semantically neutral sentence under audio-only and audiovisual conditions.

Results:

Music training led to improved performance on tasks requiring the discrimination of melodic contour and rhythm, as well as incidental memory for melodies. These improvements were predominantly found from mid- to post-training. Critically, music training also improved emotional speech prosody perception. Music training was most advantageous in audio-only conditions. Art training did not lead to the same improvements.

Conclusions:

Music training can lead to improvements in perception of music and emotional speech prosody, and thus may be an effective supplementary technique for supporting auditory rehabilitation following cochlear implantation.

Music perception improves in children with bilateral cochlear implants or bimodal devices

The objectives of this study were to determine if music perception by pediatric cochlear implant users can be improved by (1) providing access to bilateral hearing through two cochlear implants or a cochlear implant and a contralateral hearing aid (bimodal users) and (2) any history of music training. The Montreal Battery of Evaluation of Musical Ability test was presented via soundfield to 26 bilateral cochlear implant users, 8 bimodal users and 16 children with normal hearing. Response accuracy and reaction time were recorded via an iPad application. Bilateral cochlear implant and bimodal users perceived musical characteristics less accurately and more slowly than children with normal hearing. Children who had music training were faster and more accurate, regardless of their hearing status. Reaction time on specific subtests decreased with age, years of musical training and, for implant users, better residual hearing. Despite effects of these factors on reaction time, bimodal and bilateral cochlear implant users' responses were less accurate than those of their normal hearing peers. This means children using bilateral cochlear implants and bimodal devices continue to experience challenges perceiving music that are related to hearing impairment and/or device limitations during development.

Music Perception of Adolescents Using Electroacoustic Hearing

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.

Dance Movements Enhance Song Learning in Deaf Children with Cochlear Implants

Music perception of cochlear implants (CI) users is constrained by the absence of salient musical pitch cues crucial for melody identification, but is made possible by timing cues that are largely preserved by current devices. While musical timing cues, including beats and rhythms, are a potential route to music learning, it is not known what extent they are perceptible to CI users in complex sound scenes, especially when pitch and timbral features can co-occur and obscure these musical features. The task at hand, then, becomes one of optimizing the available timing cues for young CI users by exploring ways that they might be perceived and encoded simultaneously across multiple modalities. Accordingly, we examined whether training tasks that engage active music listening through dance might enhance the song identification skills of deaf children with CIs. Nine CI children learned new songs in two training conditions: (a) listening only (auditory learning), and (2) listening and dancing (auditory-motor learning). We examined children's ability to identify original song excerpts, as well as mistuned, and piano versions from a closed-set task. While CI children were less accurate than their normal hearing peers, they showed greater song identification accuracies in versions that preserved the original instrumental beats following learning that engaged active listening with dance. The observed performance advantage is further qualified by a medium effect size, indicating that the gains afforded by auditory-motor learning are practically meaningful. Furthermore, kinematic analyses of body movements showed that CI children synchronized to temporal structures in music in a manner that was comparable to normal hearing age-matched peers. Our findings are the first to indicate that input from CI devices enables good auditory-motor integration of timing cues in child CI users for the purposes of listening and dancing to music. Beyond the heightened arousal from active engagement with music, our findings indicate that a more robust representation or memory of musical timing features was made possible by multimodal processing. Methods that encourage CI children to entrain, or track musical timing with body movements, may be particularly effective in consolidating musical knowledge than methods that engage listening only.

Speech intonation and melodic contour recognition in children with cochlear implants and with normal hearing

BACKGROUND

Cochlear implant (CI) users have difficulty perceiving some intonation cues in speech and melodic contours because of poor frequency selectivity in the cochlear implant signal.

OBJECTIVES

To assess perceptual accuracy of normal hearing (NH) children and pediatric CI users on speech intonation (prosody), melodic contour, and pitch ranking, and to determine potential predictors of outcomes.

HYPOTHESIS

Does perceptual accuracy for speech intonation or melodic contour differ as a function of auditory status (NH, CI), perceptual category (falling versus rising intonation/contour), pitch perception, or individual differences (e.g., age, hearing history)?

METHOD

NH and CI groups were tested on recognition of falling intonation/contour versus rising intonation/contour presented in both spoken and melodic (sung) conditions. Pitch ranking was also tested. Outcomes were correlated with variables of age, hearing history, HINT, and CNC scores.

RESULTS

The CI group was significantly less accurate than the NH group in spoken (CI, M = 63.1%; NH, M = 82.1%) and melodic (CI, M = 61.6%; NH, M = 84.2%) conditions. The CI group was more accurate in recognizing rising contour in the melodic condition compared with rising intonation in the spoken condition. Pitch ranking was a significant predictor of outcome for both groups in falling intonation and rising melodic contour; age at testing and hearing history variables were not predictive of outcomes.

CONCLUSION

Children with CIs were less accurate than NH children in perception of speech intonation, melodic contour, and pitch ranking. However, the larger pitch excursions of the melodic condition may assist in recognition of the rising inflection associated with the interrogative form.

A cochlear implant user with exceptional musical hearing ability

Although the perception of music is generally poor in cochlear implant users, there are a few excellent performers.

OBJECTIVE

The aim of this study was the assessment of different aspects of music perception in one exceptional cochlear implant user.

DESIGN

The assessments included pitch direction discrimination, melody and timbre recognition, relative and absolute pitch judgment, and consonance rating of musical notes presented through the sound processor(s).

STUDY SAMPLE

An adult cochlear implant user with musical background who lost her hearing postlingually, and five normally-hearing listeners with musical training participated in the study.

RESULTS

The CI user discriminated pitch direction for sounds differing by one semitone and recognized melody with nearly 100% accuracy. Her results in timbre recognition were better than average published data for cochlear implant users. Her consonance rating, and relative and absolute pitch perception were comparable to normally-hearing listeners with musical training.

CONCLUSION

The results in this study showed that excellent performance is possible on musical perception tasks including pitch perception using present day cochlear implant technologies. Factors that may explain this user's exceptional performance are short duration of deafness, pre- and post-deafness musical training, and perfect pitch abilities before the onset of deafness.

MUSIC APPRECIATION AND TRAINING FOR COCHLEAR IMPLANT RECIPIENTS: A REVIEW

In recent years, there has been increasing interest in music perception of cochlear implant (CI) recipients, and a growing body of research conducted in this area. The majority of these studies have examined perceptual accuracy for pitch, rhythm, and timbre. Another important, but less commonly studied aspect of music listening is appreciation, or appraisal. Despite the ongoing research into potential technological improvements that may improve music perception for recipients, both perceptual accuracy and appreciation generally remain poor for most recipients. Whilst perceptual accuracy for music is important, appreciation and enjoyment also warrants research as it also contributes to clinical outcomes and perceived benefits. Music training is being shown to offer excellent potential for improving music perception and appreciation for recipients.Therefore, the primary topics of this review are music appreciation and training. However, a brief overview of the psychoacoustic, technical, and physiological factors associated with a recipient's perception of music is provided, as these are important factors in understanding the listening experience for CI recipients. The purpose of this review is to summarize key papers that have investigated these issues, in order to demonstrate that i) music enjoyment and appraisal is an important and valid consideration in evaluating music outcomes for recipients, and ii) that music training can improve music listening for many recipients, and is something that can be offered to persons using current technology.

The Music Experiences and Attitudes Of A First Cohort of Prelingually-Deaf Adolescents and Young Adults CI Recipients

The purpose of this study was to examine the musical engagement (participation and attitude) of pediatric CI recipients who were implanted during early childhood and who have reached age 15 or older. A questionnaire was administered to a group of 31 prelingually deaf CI users who receive annual follow up services and assessment in a clinical research center. The questionnaire was used to examine involvement in and attitudes toward music in school, the community, and in the home; social affiliation (hearing, Deaf, both) and mode of communication (oral, manual, both) were also examined. Despite the technical limitations of cochlear implants in transmitting pitch, melody, and tone quality, over two thirds of this sample described music as being important or very important in their lives. A high level of past and present familial involvement in music was associated with higher levels of current involvement and importance of music in the lives of adolescent and young adult CI users. Comparisons were noted with data from prior studies of persons with hearing loss who were non-CI users.

Children using cochlear implants capitalize on acoustical hearing for music perception

Cochlear implants (CIs) electrically stimulate the auditory nerve providing children who are deaf with access to speech and music. Because of device limitations, it was hypothesized that children using CIs develop abnormal perception of musical cues. Perception of pitch and rhythm as well as memory for music was measured by the children’s version of the Montreal Battery of Evaluation of Amusia (MBEA) in 23 unilateral CI users and 22 age-matched children with normal hearing. Children with CIs were less accurate than their normal hearing peers (p < 0.05). CI users were best able to discern rhythm changes (p < 0.01) and to remember musical pieces (p < 0.01). Contrary to expectations, abilities to hear cues in music improved as the age at implantation increased (p < 0.01). Because the children implanted at older ages also had better low frequency hearing prior to cochlear implantation and were able to use this hearing by wearing hearing aids. Access to early acoustical hearing in the lower frequency ranges appears to establish a base for music perception, which can be accessed with later electrical CI hearing.

Investigation on the music perception skills of Italian children with cochlear implants

OBJECTIVE

To compare the music perception skills of a group of Italian-speaking children with cochlear implants to those of a group of normal hearing children; to analyze possible correlations between implanted children's musical skills and their demographics, clinical characteristics, phonological perception, and speech recognition and production abilities.

METHODS

18 implanted children aged 5-12 years and a reference group of 23 normal-hearing subjects with typical language development were enrolled. Both groups received a melody identification test and a song (i.e. original version) identification test. The implanted children also received a test battery aimed at assessing speech recognition, speech production and phoneme discrimination.

RESULTS

The implanted children scored significantly worse than the normal hearing subjects in both musical tests. In the cochlear implant group, phoneme discrimination abilities were significantly correlated with both melody and song identification skills, and length of device use was significantly correlated with song identification skills.

CONCLUSIONS

Experience with device use and phonological perception had a moderate-to-strong correlation to implanted children's music perception abilities. In the light of these findings, it is reasonable to assume that a rehabilitation program specifically aimed at improving phonological perception could help pediatric cochlear implant recipients better understand the basic elements of music; moreover, a training aimed at improving the comprehension of the spectral elements of music could enhance implanted children's phonological skills.

The music perception abilities of prelingually deaf children with cochlear implants

OBJECTIVE

To investigate the music perception abilities of prelingually deaf children with cochlear implants, in comparison to a group of normal-hearing children, and to consider the factors that contribute to music perception.

METHODS

The music perception abilities of 39 prelingually deaf children with unilateral cochlear implants were compared to the abilities of 39 normal hearing children. To assess the music listening abilities, the MuSIC perception test was adopted. The influence of the child's age, age at implantation, device experience and type of sound-processing strategy on the music perception were evaluated. The effects of auditory performance, nonverbal intellectual abilities, as well as the child's additional musical education on music perception were also considered.

RESULTS

Children with cochlear implants and normal hearing children performed significantly differently with respect to rhythm discrimination (55% vs. 82%, p<0.001), instrument identification (57% vs. 88%, p<0.001) and emotion rating (p=0.022). However we found no significant difference in terms of melody discrimination and dissonance rating between the two groups. There was a positive correlation between auditory performance and melody discrimination (r=0.27; p=0.031), between auditory performance and instrument identification (r=0.20; p=0.059) and between the child's grade (mark) in school music classes and melody discrimination (r=0.34; p=0.030). In children with cochlear implant only, the music perception ability assessed by the emotion rating test was negatively correlated to the child's age (r(S)=-0.38; p=0.001), age at implantation (r(S)=-0.34; p=0.032), and device experience (r(S)=-0.38; p=0.019). The child's grade in school music classes showed a positive correlation to music perception abilities assessed by rhythm discrimination test (r(S)=0.46; p<0.001), melody discrimination test (r(S)=0.28; p=0.018), and instrument identification test (r(S)=0.23; p=0.05).

CONCLUSIONS

As expected, there was a marked difference in the music perception abilities of prelingually deaf children with cochlear implants in comparison to the group of normal hearing children, but not for all the tests of music perception. Additional multi-centre studies, including a larger number of participants and a broader spectrum of music subtests, considering as many as possible of the factors that may contribute to music perception, seem reasonable.

Current research on music perception in cochlear implant users

The authors present a comprehensive review of the state of music perception with cochlear implant (CI) users. They discuss methods of assessment and results of studies of the aspects of music perception, melody, timbre, rhythm, and so forth in individuals with cochlear implants. They discuss neural mechanisms of music perception and the anticipation of broader acceptance of standardized tests for music perception in CI users.

Developing a music programme for preschool children with cochlear implants

Although music perception is especially challenging for cochlear implant (CI) users, young CI users' musical perception abilities are improved by participation in structured musical activities.

OBJECTIVES

To design, implement, evaluate, and publish a music training programme with a monitoring tool for preschool CI users, for use in family-centred habilitation programmes.

METHODS

We devised a programme of musical activities, Musical EARS®, and a curriculum-related hierarchical Evaluation Form to represent performance. The programme included sections on singing; recognizing songs, tunes, and timbre; and responding appropriately to music and rhythm. It was implemented over 18 months at Ilkses Rehabilitation Centre, with 25 paediatric MED-EL CI users split into three groups of varying age, duration of CI use, and ability.

RESULTS

Mean total scores increased significantly for all groups. Scores increased unevenly across subscales. Participation in and enjoyment of musical activities increased for both children and parents. Significant correlations were found between scores and length of CI use.

DISCUSSION

The training programme effectively enriches child CI users' musical experience. To varying degrees, children learned to perform the Musical EARS® activities. The study allowed us to validate the lesson content and the hierarchical nature of the Evaluation Form. We conclude that prelingually deafened CI users should be systematically involved in musical activities to help them acquire skills acquired more easily by hearing peers.

Music Therapy for Preschool Cochlear Implant Recipients

This paper provides research and clinical information relevant to music therapy for preschool children who use cochlear implants (CI). It consolidates information from various disciplinary sources regarding (a) cochlear implantation of young prelingually-deaf children (~age 2-5), (b) patterns of auditory and speech-language development, and (c) research regarding music perception of children with CIs. This information serves as a foundation for the final portion of the article, which describes typical music therapy goals and examples of interventions suitable for preschool children.