Faculty Bibliography

Information transfer analysis [G. A. Miller and P. E. Nicely, J. Acoust. Soc. Am. 27, 338-352 (1955)] is a tool used to measure the extent to which speech features are transmitted to a listener, e.g., duration or formant frequencies for vowels; voicing, place and manner of articulation for consonants. An information transfer of 100% occurs when no confusions arise between phonemes belonging to different feature categories, e.g., between voiced and voiceless consonants. Conversely, an information transfer of 0% occurs when performance is purely random. As asserted by Miller and Nicely, the maximum-likelihood estimate for information transfer is biased to overestimate its true value when the number of stimulus presentations is small. This small-sample bias is examined here for three cases: a model of random performance with pseudorandom data, a data set drawn from Miller and Nicely, and reported data from three studies of speech perception by hearing impaired listeners. The amount of overestimation can be substantial, depending on the number of samples, the size of the confusion matrix analyzed, as well as the manner in which data are partitioned therein

Neuroimaging studies of speech processing increasingly rely on artificial speech-like sounds whose perceptual status as speech or non-speech is assigned by simple subjective judgments; brain activation patterns are interpreted according to these status assignments. The naive perceptual status of one such stimulus, spectrally-rotated speech (not consciously perceived as speech by naive subjects), was evaluated in discrimination and forced identification experiments. Discrimination of variation in spectrally-rotated syllables in one group of naive subjects was strongly related to the pattern of similarities in phonological identification of the same stimuli provided by a second, independent group of naive subjects, suggesting either that (1) naive rotated syllable perception involves phonetic-like processing, or (2) that perception is solely based on physical acoustic similarity, and similar sounds are provided with similar phonetic identities. Analysis of acoustic (Euclidean distances of center frequency values of formants) and phonetic similarities in the perception of the vowel portions of the rotated syllables revealed that discrimination was significantly and independently influenced by both acoustic and phonological information. We conclude that simple subjective assessments of artificial speech-like sounds can be misleading, as perception of such sounds may initially and unconsciously utilize speech-like, phonological processing.

Objective: To examine speech perception outcomes and determine the impact of length of deafness and time between implants on performance in the sequentially bilateral implanted population. STUDY DESIGN: Retrospective review. SETTING: Tertiary academic referral center. PATIENTS: Forty-three children (age, <18 yr) and 22 adults underwent sequential bilateral implantation with at least 6 months between surgeries. The mean age at the time of the second implant in children was 7.83 years, and mean time between implants was 5.16 years. Five children received the first side implant (C1) below 12 months of age; 16, at 12 to 23 months; 9, between the ages of 24 and 35 months; and 11, at 36 to 59 months; 2 were implanted above the age of 5 years. In adults, mean age at second implant was 46.6 years, and mean time between implants was 5.6 years. INTERVENTION: Sequential implantation with 6 months or more between implantations. MAIN OUTCOME MEASURES: Speech perception tests were performed preoperatively before the second implantation and at 3 months postoperatively. RESULTS: Results revealed significant improvement in the second implanted ear and in the bilateral condition, despite time between implantations or length of deafness; however, age of first-side implantation was a contributing factor to second ear outcome in the pediatric population. CONCLUSION: Sequential bilateral implantation leads to significantly better speech understanding. On average, patients improved, despite length of deafness, time between implants, or age at implantation

OBJECTIVE: To assess word recognition and pitch-scaling abilities of cochlear implant users first implanted with a Nucleus 10-mm Hybrid electrode array and then reimplanted with a full length Nucleus Freedom array after loss of residual hearing. BACKGROUND: Although electroacoustic stimulation is a promising treatment for patients with residual low-frequency hearing,a small subset of them lose that residual hearing. It is not clear whether these patients would be better served by leaving in the 10-mm array and providing electric stimulation through it, or by replacing it with a standard full-length array. METHODS: Word recognition and pitch-scaling abilities were measured in 2 users of hybrid cochlear implants who lost their residual hearing in the implanted ear after a few months. Tests were repeated over several months, first with a 10-mm array, and after, these patients were reimplanted with a full array. The word recognition task consisted of 2 50-word consonant nucleus consonant (CNC) lists. In the pitch-scaling task, 6 electrodes were stimulated in pseudorandom order, and patients assigned a pitch value to the sensation elicited by each electrode. RESULTS: Shortly after reimplantation with the full electrode array, speech understanding was much better than with the 10-mm array. Patients improved their ability to perform the pitch-scaling task over time with the full array, although their performance on that task was variable, and the improvements were often small. CONCLUSION: 1) Short electrode arrays may help preserve residual hearing but may also provide less benefit than traditional cochlear implants for some patients. 2) Pitch percepts in response to electric stimulation may be modified by experience

OBJECTIVES: To examine the conclusions and possible misinterpretations that may or may not be drawn from the 'outcome-matching method,' a study design recently used in the cochlear implant literature. In this method, subject groups are matched not only on potentially confounding variables but also on an outcome measure that is closely related to the outcome measure under analysis. For example, subjects may be matched according to their speech perception scores in quiet, and their speech perception in noise is compared. DESIGN: The present study includes two components, a simulation study and a questionnaire. In the simulation study, the outcome-matching method was applied to pseudo-randomly generated data. Simulated speech perception scores in quiet and in noise were generated for two comparison groups, in two imaginary worlds. In both worlds, comparison group A performed only slightly worse in noise than in quiet, whereas comparison group B performed significantly worse in noise than in quiet. In Imaginary World 1, comparison group A had better speech perception scores than comparison group B. In Imaginary World 2, comparison group B had better speech perception scores than comparison group A. The outcome-matching method was applied to these data twice in each imaginary world: 1) matching scores in quiet and comparing in noise, and 2) matching scores in noise and comparing in quiet. This procedure was repeated 10,000 times. The second part of the study was conducted to address the level of misinterpretation that could arise from the outcome-matching method. A questionnaire was administered to 54 students in a senior level course on speech and hearing to assess their opinions about speech perception with two different models of cochlear implant devices. The students were instructed to fill out the questionnaire before and after reading a paper that used the outcome-matching method to examine speech perception in noise and in quiet with those two cochlear implant devices. RESULTS: When pseudorandom scores were matched in quiet, comparison group A's scores in noise were significantly better than comparison group B's scores. Results were different when scores were matched in noise: in this case, comparison group B's scores in quiet were significantly better than comparison group A's scores. Thus, the choice of outcome measure used for matching determined the result of the comparison. Additionally, results of the comparisons were identical regardless of whether they were conducted using data from Imaginary World 1 (where comparison group A is better) or from Imaginary World 2 (where comparison group B is better). After reading the paper that used the outcome-matching method, students' opinions about the two cochlear implants underwent a significant change even though, according to the simulation study, this opinion change was not warranted by the data. CONCLUSIONS: The outcome-matching method can provide important information about differences within a comparison group, but it cannot be used to determine whether a given device or clinical intervention is better than another one. Care must be used when interpreting the results of a study using the outcome-matching method

This study assessed the effects of age at implantation on the speech intelligibility of congenitally, profoundly deaf pediatric cochlear implant users. The children received implants during the first eight years of life and were divided into subgroups based on their age at implantation. The children's tape recordings of standard sentences were digitized and played back to normal-hearing listeners who were unfamiliar with deaf speech. Intelligibility was measured as the number of words correctly identified averaged across all listeners. The data showed that earlier implantation had a positive and significant effect on the speech intelligibility of cochlear implant users. The results also suggested that a gradual decline in the ability to acquire spoken language skills may occur over time and, furthermore, cochlear implantation before the age of two years may yield significantly better speech intelligibility outcomes than later implantation. (journal abstract)

CONCLUSION: Neither speech understanding nor frequency discrimination ability was better in Nucleus Contour users than in Nucleus 24 straight electrode users. Furthermore, perimodiolar electrode placement does not result in better frequency discrimination. OBJECTIVES: We addressed three questions related to perimodiolar electrode placement. First, do patients implanted with the Contour electrode understand speech better than with an otherwise identical device that has a straight electrode? Second, do these groups have different frequency discrimination abilities? Third, is the distance of the electrode from the modiolus related to frequency discrimination ability? SUBJECTS AND METHODS: Contour and straight electrode users were matched on four important variables. We then tested these listeners on CNC word and HINT sentence identification tasks, and on a formant frequency discrimination task. We also examined X-rays and measured the distance of the electrodes from the modiolus to determine whether there is a relationship between this factor and frequency discrimination ability. RESULTS: Both speech understanding and frequency discrimination abilities were similar for listeners implanted with the Contour vs a straight electrode. Furthermore, there was no linear relationship between electrode-modiolus distance and frequency discrimination ability. However, we did note a second-order relationship between these variables, suggesting that frequency discrimination is worse when the electrodes are either too close or too far away from the modiolus

It is well known that discrimination response variability increases with stimulus intensity, closely related to Weber's Law. It is also an axiom that sensation magnitude increases with stimulus intensity. Following earlier researchers such as Thurstone, Garner, and Durlach and Braida, we explored a new method of exploiting these relationships to estimate the power function exponent relating sound pressure level to loudness, using the accuracy with which listeners could identify the intensity of pure tones. The log standard deviation of the normally distributed identification errors increases linearly with stimulus range in decibels, and the slope, a, of the regression is proportional to the loudness exponent, n. Interestingly, in a demonstration experiment, the loudness exponent estimated in this way is greater for females than for males

Cochlear implants can restore hearing to deaf individuals by electrically stimulating the auditory nerve. They do so by assigning different frequencies to different stimulating electrodes via a frequency map. We have developed a device that enables us to change the frequency map in real time. Here, in normal-hearing adults listening to an acoustic simulation of a cochlear implant, we investigate what frequency maps are initially preferred, and how the ability to understand speech with that preferred map compares with two other maps. We show that naive listeners prefer a map that balances the need for low-frequency information with the desire for a naturally-sounding stimulus, and that initial performance with this listener-selected map is better than that with a map that distorts the signal to provide low-frequency information