Auditory, Speech and Language Development in Cochlear Implant Children: A One Year Longitudinal Study

The advent of Cochlear Implants (CI) has bought with it, the goal of spoken language performance for severe-profound sensori-neural hearing loss (SNHL) as par with the normal hearing listeners. The aim of this study was to evaluate the outcome of paediatric cochlear implantation in auditory and speech skills below the age of 5 years. The present study consisted of 50 childrens. Auditory skills were assessed in terms of audiometric thresholds and localization abilities. Speech - Language skills were measured using; Categories of Auditory Performance -CAP; Meaningful Use of Speech Scale - MUSS; Meaningful Auditory Integration Scale - MAIS and Speech intelligibility Rating - SIR. Hearing thresholds obtained from all the subjects for pre implant and post implant conditions of 3rd, 6th, 9th, 12th month conditions, evidenced a high significant (p < 0.001) improvement across all test frequencies 500, 1000, 2000 and 4000 Hz. There was also a statistically significant difference across successive measurements of auditory and speech skills, as determined by ANOVA (F (4, 245) = 151.33, p < 0.001 for CAP; F (4, 245) = 89.636, p < 0.001 for SIR; F (4, 245) = 812.282 p < 0.001 for MAIS and F(4, 245) = 435.677 p < 0.001 for MUSS). Auditory localization abilities were also improved considerably over a period of one year. The present study added the evidence to the literature that cochlear implants significantly improved the hearing ability of children with severe-to-profound hearing loss. This study also demonstrated that, children were better able to make use of the auditory information perceived through the implant.

Spectrotemporal window of binaural integration in auditory object formation

Binaural integration of interaural temporal information is essential for sound source localization and segregation. Current models of binaural interaction have shown that accurate sound localization in the horizontal plane depends on the resolution of phase ambiguous information by across-frequency integration. However, as such models are mostly static, it is not clear how proximate in time binaural events in different frequency channels should occur to form an auditory object with a unique lateral position. The present study examined the spectrotemporal window required for effective integration of binaural cues across frequency to form the perception of a stationary position. In Experiment 1, listeners judged whether dichotic frequency-modulated (FM) sweeps with a constant large nominal interaural delay (1500 μs), whose perceived laterality was ambiguous depending on the sweep rate (1500, 3000, 6000, and 12,000 Hz/s), produced a percept of continuous motion or a stationary image. Motion detection performance, indexed by d-prime (d') values, showed a clear effect of sweep rate, with auditory motion effects most pronounced for low sweep rates, and a punctate stationary image at high rates. Experiment 2 examined the effect of modulation rate (0.5, 3, 20, and 50 Hz) on lateralizing sinusoidally frequency-modulated (SFM) tones to confirm the effect of sweep rate on motion detection, independent of signal duration. Lateralization accuracy increased with increasing modulation rate up to 20 Hz and saturated at 50 Hz, with poorest performance occurring below 3 Hz depending on modulator phase. Using the transition point where percepts changed from motion to stationary images, we estimated a spectrotemporal integration window of approximately 150 ms per octave required for effective integration of interaural temporal cues across frequency channels. A Monte Carlo simulation based on a cross-correlation model of binaural interaction predicted 90% of the variance on perceptual motion detection performance as a function of FM sweep rate. Findings suggest that the rate of frequency channel convergence of binaural cues is essential to binaural lateralization.

Comparison of congruence judgment and auditory localization tasks for assessing the spatial limits of visual capture

Vision typically has better spatial accuracy and precision than audition and as a result often captures auditory spatial perception when visual and auditory cues are presented together. One determinant of visual capture is the amount of spatial disparity between auditory and visual cues: when disparity is small, visual capture is likely to occur, and when disparity is large, visual capture is unlikely. Previous experiments have used two methods to probe how visual capture varies with spatial disparity. First, congruence judgment assesses perceived unity between cues by having subjects report whether or not auditory and visual targets came from the same location. Second, auditory localization assesses the graded influence of vision on auditory spatial perception by having subjects point to the remembered location of an auditory target presented with a visual target. Previous research has shown that when both tasks are performed concurrently they produce similar measures of visual capture, but this may not hold when tasks are performed independently. Here, subjects alternated between tasks independently across three sessions. A Bayesian inference model of visual capture was used to estimate perceptual parameters for each session, which were compared across tasks. Results demonstrated that the range of audiovisual disparities over which visual capture was likely to occur was narrower in auditory localization than in congruence judgment, which the model indicates was caused by subjects adjusting their prior expectation that targets originated from the same location in a task-dependent manner.

Auditory spatial localization: Developmental delay in children with visual impairments

For individuals with visual impairments, auditory spatial localization is one of the most important features to navigate in the environment. Many works suggest that blind adults show similar or even enhanced performance for localization of auditory cues compared to sighted adults (Collignon, Voss, Lassonde, & Lepore, 2009). To date, the investigation of auditory spatial localization in children with visual impairments has provided contrasting results. Here we report, for the first time, that contrary to visually impaired adults, children with low vision or total blindness show a significant impairment in the localization of static sounds. These results suggest that simple auditory spatial tasks are compromised in children, and that this capacity recovers over time.

Auditory and visual localization accuracy in young children and adults

OBJECTIVE

This study aimed to measure and compare sound and light source localization ability in young children and adults who have normal hearing and normal/corrected vision in order to determine the extent to which age, type of stimuli, and stimulus order affects sound localization accuracy.

METHODS

Two experiments were conducted. The first involved a group of adults only. The second involved a group of 30 children aged 3 to 5 years. Testing occurred in a sound-treated booth containing a semi-circular array of 15 loudspeakers set at 10° intervals from -70° to 70° azimuth. Each loudspeaker had a tiny light bulb and a small picture fastened underneath. Seven of the loudspeakers were used to randomly test sound and light source identification. The sound stimulus was the word "baseball". The light stimulus was a flashing of a light bulb triggered by the digital signal of the word "baseball". Each participant was asked to face 0° azimuth, and identify the location of the test stimulus upon presentation. Adults used a computer mouse to click on an icon; children responded by verbally naming or walking toward the picture underneath the corresponding loudspeaker or light. A mixed experimental design using repeated measures was used to determine the effect of age and stimulus type on localization accuracy in children and adults. A mixed experimental design was used to compare the effect of stimulus order (light first/last) and varying or fixed intensity sound on localization accuracy in children and adults.

RESULTS

Localization accuracy was significantly better for light stimuli than sound stimuli for children and adults. Children, compared to adults, showed significantly greater localization errors for audition. Three-year-old children had significantly greater sound localization errors compared to 4- and 5-year olds. Adults performed better on the sound localization task when the light localization task occurred first.

CONCLUSIONS

Young children can understand and attend to localization tasks, but show poorer localization accuracy than adults in sound localization. This may be a reflection of differences in sensory modality development and/or central processes in young children, compared to adults.

Enhanced auditory spatial localization in blind echolocators

Echolocation is the extraordinary ability to represent the external environment by using reflected sound waves from self-generated auditory pulses. Blind human expert echolocators show extremely precise spatial acuity and high accuracy in determining the shape and motion of objects by using echoes. In the current study, we investigated whether or not the use of echolocation would improve the representation of auditory space, which is severely compromised in congenitally blind individuals (Gori et al., 2014). The performance of three blind expert echolocators was compared to that of 6 blind non-echolocators and 11 sighted participants. Two tasks were performed: (1) a space bisection task in which participants judged whether the second of a sequence of three sounds was closer in space to the first or the third sound and (2) a minimum audible angle task in which participants reported which of two sounds presented successively was located more to the right. The blind non-echolocating group showed a severe impairment only in the space bisection task compared to the sighted group. Remarkably, the three blind expert echolocators performed both spatial tasks with similar or even better precision and accuracy than the sighted group. These results suggest that echolocation may improve the general sense of auditory space, most likely through a process of sensory calibration.