Music-based training for pediatric CI recipients: A systematic analysis of published studies.

In recent years, there has been growing interest in the use of music-based training to enhance speech and language development in children with normal hearing and some forms of communication disorders, including pediatric CI users. The use of music training for CI users may initially seem incongruous given that signal processing for CIs presents a degraded version of pitch and timbre, both key elements in music. Furthermore, empirical data of systematic studies of music training, particularly in relation to transfer to speech skills are limited. This study describes the rationale for music training of CI users, describes key features of published studies of music training with CI users, and highlights some developmental and logistical issues that should be taken into account when interpreting or planning studies of music training and speech outcomes with pediatric CI recipients.

Musical backgrounds, listening habits, and aesthetic enjoyment of adult cochlear implant recipients.

This paper describes the listening habits and musical enjoyment of postlingually deafened adults who use cochlear implants. Sixty-five implant recipients (35 females, 30 males) participated in a survey containing questions about musical background, prior involvement in music, and audiologic success with the implant in various listening circumstances. Responses were correlated with measures of cognition and speech recognition. Sixty-seven implant recipients completed daily diaries (7 consecutive days) in which they reported hours spent in specific music activities. Results indicate a wide range of success with music. In general, people enjoy music less postimplantation than prior to hearing loss. Musical enjoyment is influenced by the listening environment (e.g., a quiet room) and features of the music.

A preliminary investigation comparing one and eight channels at fast and slow rates on music appraisal in adults with cochlear implants.

Music perception is important to cochlear implant patients, but little effort has been devoted to improving signal processing for music. In this preliminary investigation, we probed the importance of number of channels and stimulus rate. We asked eight users of the Clarion cochlear implant to rate music quality on a scale from 0 to 100 on three different types of music (country and western, pop and classical). Patients rated eight- and one-channel processors running at a fast and slow rate. The stimulus rate was 200 pps for the slow rate. For the eight-channel condition, the fast rate varied from 394 to 765 pps. For the one-channel condition, the fast rate varied from 2601 to 4335 pps. Results indicated that the eight-channel condition was uniformly rated higher than the one-channel condition. However, the results for stimulus rate were less clear. No patients assigned higher ratings with the slow rate, but only three subjects assigned higher ratings with the fast rate. We conclude that music perception can be influenced and probably improved by signal processing. The number of channels, or perhaps spectral representation, is critical for music appreciation by cochlear implant recipients.

Timbral recognition and appraisal by adult cochlear implant users and normal-hearing adults.

The purpose of this study was to examine the appraisal and recognition of timbre (four different musical instruments) by recipients of Clarion cochlear implants (CIS strategy, 75- or 150-microsec pulse widths) and to compare their performance with that of normal-hearing listeners. Twenty-eight Clarion cochlear implant users and 41 normal-hearing listeners were asked to give a subjective assessment of the pleasantness of each instrument using a visual analog scale with anchors of "like very much" to "dislike very much," and to match each sound with a picture of the instrument they believed had produced it. No significant differences were found between the two different pulse widths for either appreciation or recognition; thus, data from the two pulse widths following 12 months of Clarion implant use were collapsed for further analyses. Significant differences in appraisal were found between normal-hearing listeners and implant recipients for two of the four instruments sampled. Normal-hearing adults were able to recognize all of the instruments with significantly greater accuracy than implant recipients. Performance on timbre perception tasks was correlated with speech perception and cognitive tasks.

Perception of rhythmic and sequential pitch patterns by normally hearing adults and adult cochlear implant users.

OBJECTIVE: This study compares the musical perception of 17 adult recipients of the Nucleus cochlear implant using two different formant extraction processing strategies (F0F1F2 and MPEAK). DESIGN: Over a 12 mo period, participants were alternately switched between two strategies every 3 mo. Performance was evaluated using three measures of rhythmic and sequential pitch perception. RESULTS: Three individuals performed significantly better with the MPEAK strategy on one particular rhythm task, 11 participants performed better with the MPEAK strategy on another rhythm task, and no significant differences were found between the two strategies on a sequential pitch pattern task. CONCLUSIONS: Neither strategy seems clearly superior for perception of either sequential pitch or rhythmic patterns.

Melodic, rhythmic, and timbral perception of adult cochlear implant users.

The purpose of this pilot study was to investigate adult Ineraid and Nucleus cochlear implant (CI) users' perceptual accuracy for melodic and rhythmic patterns, and quality ratings for different musical instruments. Subjects were 18 postlingually deafened adults with CI experience. Evaluative measures included the Primary Measures of Music Audiation (PMMA) and a Musical Instrument Quality Rating. Performance scores on the PMMA were correlated with speech perception measures, music background, and subject characteristics. Results demonstrated a broad range of perceptual accuracy and quality ratings across subjects. On these measures, performance for temporal contrasts was better than for melodic contrasts independent of CI device. Trends in the patterns of correlations between speech and music perception suggest that particular structural elements of music are differentially accessible to cochlear implant users. Additionally, notable qualitative differences for ratings of musical instruments were observed between Nucleus and Ineraid users.

Clinical experience with the oral antidiabetic compound, tolazamide.

In clinical experience totalling 82 patient-years with the sulfonylurea tolazamide, satisfactory control of glycemia was obtained in 70% of diabetics. The preponderance of elderly and newly diagnosed diabetics in the group probably increased the percentage of successes, because when tolazamide was compared with tolbutamide in the same patients the frequency of clinical effectiveness was similar. The ratio of effectiveness by weight for tolbutamide/tolazamide was 6.6/1.0. No toxic effects were detected, side effects were minimal and there appeared to be little tendency to induce unwarranted hypoglycemia.