Crucial Music Components Needed for Speech Perception Enhancement of Pediatric Cochlear Implant Users: A Systematic Review and Meta-Analysis

Interventions for Developmental Language Delay and Disorders

BACKGROUND

Approximately 9.9 % of children present with difficulties in language development (DLD), 7.6 % without serious additional impairments and 2.3 % associated with languagerelevant comorbidities, e.g., hearing loss. Notably, in a consensus statement by experts in German-speaking countries, in the guideline presented here, and further in this article, all of these disorders are referred to as "developmental language disorders" (DLD), whereas the international consortium CATALISE only refers to those without comorbidities as DLD. DLDs are among the most commonly treated childhood disorders and, if persistent, often reduce educational and socio-economic outcome. Children in their third year of life with developmental language delay (late talkers, LT) are at risk of a later DLD.

METHODS

This German interdisciplinary clinical practice guideline reflects current knowledge regarding evidence-based interventions for developmental language delay and disorders. A systematic literature review was conducted on the effectiveness of interventions for DLD.

RESULTS

The guideline recommends parent training (Hedges g = 0.38 to 0.82) for LTs with expressive language delay, language therapy (Cohen's d = -0.20 to 0.90) for LTs with additional receptive language delay or further DLD risk factors, phonological or integrated phonological treatment methods (Cohen's d = 0.89 to 1.04) for phonological speech sound disorders (SSDs), a motor approach for isolated phonetic SSDs (non-DLD), and for lexical-semantic and morpho-syntactic impairments combinations of implicit and explicit intervention approaches (including input enrichment, modeling techniques, elicitation methods, creation of production opportunities, metalinguistic- approaches, visualizations; Cohen's d = 0.89-1.04). Recom mendations were also made for DLD associated with pragmatic-communicative impairment, bi-/ multilingualism, hearing loss, intellectual disability, autism-spectrum disorders, selective mutism, language- relevant syndromes or multiple disabilities, and for intensive inpatient language rehabilitation.

CONCLUSION

Early parent- and child-centered speech and language intervention implementing evidence-based intervention approaches, frequency, and settings, combined with educational language support, can improve the effectiveness of management of developmental language delay and disorders.

Meludia platform as a tool to evaluate music perception in pediatric and adult cochlear implant users

PURPOSE

Music perception is one of the greatest challenges for cochlear implant (CI) users. The aims of this study were: (i) to evaluate the music perception of CI users using the online Meludia music training program as music testing platform, (ii) to compare performance among three age groups, and (iii) to compare CI users with their normal hearing (NH) peers.

METHODS

138 individuals participated, divided between children (6-10 y), adolescents (11-16 y), and adults (≥ 17 y). Five music perception tasks were evaluated: Rhythm, Spatialization, Stable/unstable, Melody, and Density. We also administered the music related quality of life (MuRQoL) questionnaire for adults, and a music questionnaire for pediatric population (6-16 y) (MuQPP).

RESULTS

A significantly higher percentage of the adolescent CI users completed the five tasks compared to the other age groups. Both pediatric and adolescent CI users had similar performance to their NH peers in most categories. On the MuRQoL, adult NH listeners reported more music exposure than CI users (3.8 ± 0.6 vs 3.0 ± 0.6, p < 0.01), but both groups reported similar levels of perceived music importance (3.4 ± 0.7 vs 3.2 ± 1.1, p = 0.340). On the MuQPP, pediatric CI users who scored highly on music perception also had higher reported questionnaire scores (54.2 ± 12.9 vs 40.9 ± 12.1, p = 0.009).

CONCLUSIONS

Meludia can be used to evaluate music perception and to use for music training in CI users of all ages. Adolescents had the highest performance in most musical tasks. Pediatric CI users were more similar to their NH peers. The importance of music in adult CI users was comparable to their NH peers.

Meta-Analysis Exploring the Effects of Music Training in Cochlear Implant Users by Age

BACKGROUND AND OBJECTIVES

The present study aimed to explore meaningful change in the musical performance of cochlear implant (CI) users according to age after receiving music training compared to the other CI users who did not receive any music training and normal hearing (NH) listeners. Materials and.

METHODS

Article search was conducted from five journal databases. In accordance with PICOS criteria, 29 articles and 15 articles were included for the CI and NH groups, respectively. A total of 44 articles consisting of 407 CI users and 486 NH participants were then analyzed. Using the data gathered from pre- and post-training, meta-analysis was applied by the random-effects model, and then piecewise meta-regression was employed.

RESULTS

CI users with music training showed better performance than those without the training across all ages. The curve change in musical performance when training showed that the CI users was similar to the general pattern of NH performance, indicating that the CI users gained benefits from music training and developed perceptual ability, even though it was not as high as the level of NH counterparts.

CONCLUSIONS

This finding supports the benefits of active engagement with music for both CI users and NH listeners, while noting the important role of music as one of the primary aural rehabilitation approaches.

Tone perception development in Mandarin-speaking children with cochlear implants

OBJECTIVE

The purpose of this study was to examine the longer-term effects of cochlear implant (CI) use on tone perception by evaluating improvement in Mandarin tone recognition in children with CIs 2 and 3 years post CI activation, and to explore the effects of implant age, chronological age and duration of CI use on the development of tone perception.

METHODS

Tone perception was assessed in 29 bilateral profound hearing impaired children (mean chronological age = 4.6 years, SD = 0.7 years) with unilateral CIs at 24 and 36 months after CI activation using the tone perception subtest in the Mandarin Early Speech Perception (MESP-T) test.

RESULTS

Children's tone recognition for tone pairs and individual tones improved significantly between 2 and 3 years post CI use, showing an increase in average tone recognition score from 73.2% to 81.8%, which was significantly higher than chance level (i.e. 50%). There was no significant correlation between tone recognition ability and either implant age or chronological age at two evaluation points. Further analysis revealed that the tone recognition score for tone pair 2-3 was significantly lower than that for other tone pairs except for tone pair 2-4.

CONCLUSIONS

Longer CI experience can significantly improve tone recognition ability in CI children between 2 and 3 years post CI activation.

Musical Training Enhances Categorical Perception of Speech in Preschoolers: Training Duration and Musical Program Matter

PURPOSE

Previous research has indicated the beneficial effects of musical training on speech perception in children. However, little has been known about whether musical training exerts transfer effects on fine-grained perception of linguistic pitch and time information. This study aimed to investigate the effects of different musical training programs and training duration on preschoolers' categorical perception (CP) of lexical tones and voice onset time (VOT) in Mandarin Chinese, which utilize pitch and time changes, respectively, to convey phonemic contrasts.

METHOD

Sixty-one Mandarin-speaking children aged 4 years were randomly assigned to pitch-based musical training (carillon group), rhythm-based musical training (drum group), or handcraft learning (control group). Children completed the tests designed to assess their musical abilities, CP of lexical tones and VOT, IQ, and working memory at three time-points. Repeated-measures analyses of variance were conducted to evaluate the training-related effects in various tasks. Correlation analyses were used to infer the relationships between musical abilities and CP performance of speech.

RESULTS

The carillon group demonstrated advantages over the drum and control groups in music pitch processing and CP of lexical tones; besides, the drum group performed better in the music time processing and CP of VOT than the control group. Moreover, positive correlations were found between musical gains and improvements on CP of speech.

CONCLUSIONS

These results provide evidence that transfer effects occur in CP of lexical tones and VOT in preschoolers. Our findings highlight the selectivity of musical advantages driven by different components of training programs and suggest that long-term musical training could be a means of early speech rehabilitation in children with communication disorders.