American Cochlear Implant Alliance Task Force: Recommendations for Determining Cochlear Implant Candidacy in Adults.

The indications for cochlear implantation have expanded over time due to evidence demonstrating identification and implantation of appropriate cochlear implant (CI) candidates lead to significant improvements in speech recognition and quality of life (QoL). However, clinical practice is variable, with some providers using outdated criteria and others exceeding current labeled indications. As a results, only a fraction of those persons who could benefit from CI technology receive it.

Clinical perspective on hearing preservation in cochlear implantation, the University of Iowa experience.

Preservation of residual acoustic hearing has emerged as an important concept for those individuals undergoing cochlear implantation with residual low frequency hearing. Acoustic plus electric speech processing improves hearing outcomes in quiet, enables melody recognition, preserves spatial hearing if there is acoustic hearing in both ears and significantly improves hearing in noise. The development of our experience with acoustic plus electric processing is reviewed along with clinical trials and patient outcomes that our team has documented over the past twenty years.

Practices and Attitudes That Enhance Music Engagement of Adult Cochlear Implant Users.

Background: Cochlear implants (CIs) are auditory prostheses designed to support spoken communication in persons with severe to profound hearing loss. Many post-lingually deaf adult CI users achieve good speech recognition in quiet; unfortunately, CI technology conveys a degraded representation of pitch and timbre, essential components of music. Not surprisingly, most CI users achieve significantly poorer perception and enjoyment of music compared with normal hearing listeners.

Adult Cochlear Implant Recipients' Perspectives on Experiences With Music in Everyday Life: A Multifaceted and Dynamic Phenomenon.

Background: Cochlear implants (CIs), which have been designed primarily to support spoken communication of persons with severe to profound hearing loss, are highly effective in supporting speech perception in quiet listening conditions. CI users as a group achieve significantly poorer perception and appraisal of music, and speech perception is compromised when background music is present, though outcomes vary considerably across recipients. A number of factors have been identified that contribute to variable music listening experiences, but many questions remain, particularly regarding experiences in everyday life from the perspective of CI users.

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 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.

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.

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.

The Effects of Training on Recognition of Musical Instruments by Adults with Cochlear Implants.

This study examines the efficiency and effectiveness of three types of training on recognition of musical instruments by adults with cochlear implants (CI). Seventy-one adults with CIs were randomly assigned to one of three training conditions: feedback on response accuracy, feedback-plus (response accuracy plus correct answer), and direct instruction. Each participant completed three training sessions per week over a five-week time period in which they listened to recorded excerpts of eight different musical instruments.

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.

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.

The effects of musical and linguistic components in recognition of real-world musical excerpts by cochlear implant recipients and normal-hearing adults.

Background: Cochlear implants (CI) are effective in transmitting salient features of speech, especially in quiet, but current CI technology is not well suited in transmission of key musical structures (e.g., melody, timbre).

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.

Effects of training on recognition of musical instruments presented through cochlear implant simulations.

Background: The simulation of the CI (cochlear implant) signal presents a degraded representation of each musical instrument, which makes recognition difficult.

Purpose: To examine the efficiency and effectiveness of three types of training on recognition of musical instruments as presented through simulations of the sounds transmitted through a CI.

Research Design: Participants were randomly assigned to one of three training conditions: repeated exposure, feedback, and direct instruction.

Hybrid 10 clinical trial: preliminary results.

Acoustic plus electric (electric-acoustic) speech processing has been successful in highlighting the important role of articulation information in consonant recognition in those adults that have profound high-frequency hearing loss at frequencies greater than 1500 Hz and less than 60% discrimination scores. Eighty-seven subjects were enrolled in an adult Hybrid multicenter Food and Drug Administration clinical trial. Immediate hearing preservation was accomplished in 85/87 subjects.

Accuracy of cochlear implant recipients on pitch perception, melody recognition, and speech reception in noise.

Objective: The purposes of this study were to (a) examine the accuracy of cochlear implant recipients who use different types of devices and signal processing strategies on pitch ranking as a function of size of interval and frequency range and (b) to examine the relations between this pitch perception measure and demographic variables, melody recognition, and speech reception in background noise.

Design: One hundred fourteen cochlear implant users and 21 normal-hearing adults were tested on a pitch discrimination task (pitch ranking) that required them to determine direction of pitch change as a function of base frequency and interval size. Three groups were tested: (a) long electrode cochlear implant users (N = 101); (b) short electrode users that received acoustic plus electrical stimulation (A+E) (N = 13); and (c) a normal-hearing (NH) comparison group (N = 21).

Effects of frequency, instrumental family, and cochlear implant type on timbre recognition and appraisal.

The purpose of this study was to compare postlingually deafened cochlear implant recipients and normal-hearing adults on timbre (tone quality) recognition and appraisal of 8 musical instruments representing 3 frequency ranges and 4 instrumental families. The implant recipients were significantly less accurate than the normal-hearing adults on timbre recognition. The implant recipients gave significantly poorer ratings than did the normal-hearing adults to those instruments played in the higher frequency range and to those from the string family.