Virginia Driscoll

Clinical evaluation of music perception, appraisal and experience in cochlear implant users

Abstract Objectives: The objectives were to evaluate the relationships among music perception, appraisal, and experience in cochlear implant users in multiple clinical settings and to examine the viability of two assessments designed for clinical use. Design: Background questionnaires (IMBQ) were administered by audiologists in 14 clinics in the United States and Canada. The CAMP included tests of pitch-direction discrimination, and melody and timbre recognition. The IMBQ queried users on prior musical involvement, music listening habits pre and post implant, and music appraisals. Study sample: One-hundred forty-five users of Advanced Bionics and Cochlear Ltd cochlear implants. Results: Performance on pitch direction discrimination, melody recognition, and timbre recognition tests were consistent with previous studies with smaller cohorts, as well as with more extensive protocols conducted in other centers. Relationships between perceptual accuracy and music enjoyment were weak, suggesting that perception and appraisal are relatively independent for CI users. Conclusions: Perceptual abilities as measured by the CAMP had little to no relationship with music appraisals and little relationship with musical experience. The CAMP and IMBQ are feasible for routine clinical use, providing results consistent with previous thorough laboratory-based investigations.

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.

Accuracy of Cochlear Implant Recipients in Speech Reception in the Presence of Background Music

Objectives: This study examined speech recognition abilities of cochlear implant (CI) recipients in the spectrally complex listening condition of 3 contrasting types of background music, and compared performance based upon listener groups: CI recipients using conventional long-electrode devices, Hybrid CI recipients (acoustic plus electric stimulation), and normal-hearing adults. Methods: We tested 154 long-electrode CI recipients using varied devices and strategies, 21 Hybrid CI recipients, and 49 normal-hearing adults on closed-set recognition of spondees presented in 3 contrasting forms of background music (piano solo, large symphony orchestra, vocal solo with small combo accompaniment) in an adaptive test. Outcomes: Signal-to-noise ratio thresholds for speech in music were examined in relation to measures of speech recognition in background noise and multitalker babble, pitch perception, and music experience. Results: The signal-to-noise ratio thresholds for speech in music varied as a function of category of background music, group membership (long-electrode, Hybrid, normal-hearing), and age. The thresholds for speech in background music were significantly correlated with measures of pitch perception and thresholds for speech in background noise; auditory status was an important predictor. Conclusions: Evidence suggests that speech reception thresholds in background music change as a function of listener age (with more advanced age being detrimental), structural characteristics of different types of music, and hearing status (residual hearing). These findings have implications for everyday listening conditions such as communicating in social or commercial situations in which there is background music.

Do Communication Disorders Extend to Musical Messages? An Answer from Children with Hearing Loss or Autism Spectrum Disorders

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.

Effects of Long-Term Musical Training on Cortical Auditory Evoked Potentials

Objective: Evidence suggests that musicians, as a group, have superior frequency resolution abilities when compared with nonmusicians. It is possible to assess auditory discrimination using either behavioral or electrophysiologic methods. The purpose of this study was to determine if the acoustic change complex (ACC) is sensitive enough to reflect the differences in spectral processing exhibited by musicians and nonmusicians. Design: Twenty individuals (10 musicians and 10 nonmusicians) participated in this study. Pitch and spectral ripple discrimination were assessed using both behavioral and electrophysiologic methods. Behavioral measures were obtained using a standard three interval, forced choice procedure. The ACC was recorded and used as an objective (i.e., nonbehavioral) measure of discrimination between two auditory signals. The same stimuli were used for both psychophysical and electrophysiologic testing. Results: As a group, musicians were able to detect smaller changes in pitch than nonmusician. They also were able to detect a shift in the position of the peaks and valleys in a ripple noise stimulus at higher ripple densities than non-musicians. ACC responses recorded from musicians were larger than those recorded from non-musicians when the amplitude of the ACC response was normalized to the amplitude of the onset response in each stimulus pair. Visual detection thresholds derived from the evoked potential data were better for musicians than non-musicians regardless of whether the task was discrimination of musical pitch or detection of a change in the frequency spectrum of the ripple noise stimuli. Behavioral measures of discrimination were generally more sensitive than the electrophysiologic measures; however, the two metrics were correlated. Conclusions: Perhaps as a result of extensive training, musicians are better able to discriminate spectrally complex acoustic signals than nonmusicians. Those differences are evident not only in perceptual/behavioral tests but also in electrophysiologic measures of neural response at the level of the auditory cortex. While these results are based on observations made from normal-hearing listeners, they suggest that the ACC may provide a non-behavioral method of assessing auditory discrimination and as a result might prove useful in future studies that explore the efficacy of participation in a musically based, auditory training program perhaps geared toward pediatric or hearing-impaired listeners.

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.

Family involvement in music impacts participation of children with cochlear implants in music education and music activities

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 childrens 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.