Biomedical subjects

J I Alcántara

Publications and source records attributed to J I Alcántara.

At least 19 recordsLinked to original sources

PubMed2001

Comparison of the electroacoustic characteristics of five hearing aids.

This paper describes a comparison of the electroacoustic characteristics of five hearing aids: (1) a linear BTE aid of the type dispensed under the UK National Health Service (NHS), the BE19; (2) an analogue programmable BTE aid incorporating two-channel wide dynamic range compression, the ReSound BT2; (3) and (4) two digital BTE aids incorporating multi-channel wide dynamic range compression, the Phonak Claro and the Danavox Danalogic; (5) a disposable ITE hearing aid with single-channel compression, the Songbird. Measurements of frequency response using a 2 cc coupler showed that the NHS aid had a distinct undesired peak around 1 kHz. The response rolled off at low and high frequencies, and no gain was applied above about 4000 Hz. The BT2 and Claro both showed somewhat irregular responses with effective upper frequency limits of 5000-6000 Hz. The Danalogic had a reasonably smooth response and provided gain up to 6000 Hz. The Songbird had a smooth response and provided gain up to about 7000 Hz. All aids showed reasonably low harmonic and intermodulation distortion (probably below audible levels for hearing-impaired listeners), the Phonak Claro being the best in this respect. Measures of the effective input noise were obtained using two new methods. The NHS aid had the highest (worst) effective input noise, whereas the Songbird had the lowest, especially at low frequencies. The BT2 and the two digital aids had similar noise levels on one measure, but the BT2 was superior on the other measure. The compression circuits were characterized by measuring attack and release times and by using a method described by Stone and Moore (1992). The aids varied markedly in the extent to which they compressed amplitude modulation at the rates typically occurring in speech (2-10 Hz), the Claro providing the least compression and the Danalogic and Songbird aids providing the most. Overall, the results indicate that the NHS aid performed more poorly in several respects than the other aids. There were no great differences in electroacoustic characteristics between the remaining analogue aids and the digital aids, although the Songbird had a somewhat wider frequency range and lower effective input noise than the other aids.

Acoustic Stimulation↗

PubMed2001

Comparison of three procedures for initial fitting of compression hearing aids. I. Experienced users, fitted bilaterally.

We compared the effectiveness of three procedures for the initial fitting of hearing aids with multi-band compression: (1) CAMEQ, which aims to amplify speech so as to give equal loudness per critical band over the frequency range important for speech intelligibility, and to give similar overall loudness to 'normal': (2) CAMREST, which aims to amplify speech so as to restore 'normal' specific loudness patterns, over a wide range of speech levels; (3) DSL I/O, which aims to map the dynamic range of normally hearing people into the reduced dynamic range of hearing-impaired people, with 'full' restoration of audibility. Ten experienced hearing aid users with moderate sensorineural loss were fitted bilaterally with Danalogic 163D digital hearing aids, using each procedure in turn; the order was counterbalanced across subjects. The fitting required specification of gains for input levels of 55 and 80 dB SPL at six centre frequencies. Real-ear measurements were made to ensure that target gains were reached (+/-3 dB). Immediately after fitting with a given procedure, and one week after fitting, the gains were adjusted when required by the minimum amount necessary to achieve acceptable fittings. The amount of adjustment required provides one measure of the adequacy of the initial fitting. On average, the adjustments were smallest for the CAMEQ procedure. The gain changes were slightly larger for the CAMREST procedure and were largest of all for DSL I/O. For the latter, the gain changes were mostly negative, especially for high frequencies and the higher input level. This indicates that the DSL I/O procedure prescribes more high-frequency gain than is preferred by adult users. After these gain adjustments, users wore the aids for at least three weeks before filling out the APHAB questionnaire and taking part in laboratory measurements of the speech reception threshold (SRT) for sentences in quiet and in steady and fluctuating background noise at levels of 60 and 75 dB SPL. Following these tests, the hearing aids were re-fitted with the next procedure. The scores on the APHAB test and the SRTs did not differ significantly for the three procedures. We conclude that the CAMEQ and CAMREST procedures provide more appropriate initial fittings than DSL I/O.

Acoustic Stimulation↗

PubMed2001

Effects of slow- and fast-acting compression on the detection of gaps in narrow bands of noise.

The inherent amplitude fluctuations in narrow bands of noise may limit the ability to detect gaps in the noise; 'dips' in the noise may be confused with the gap to be detected. For people with cochlear hearing loss, loudness recruitment may effectively magnify the fluctuations and this could partly account for the reduced ability to detect gaps in noise bands that is usually found for such people. Previously, we tested these ideas by processing the envelopes of noise bands to alter the amount of envelope fluctuation. We showed that instantaneous compression, implemented via processing of the Hilbert envelope, led to smaller (that is, better) gap detection thresholds for subjects with cochlear hearing loss. In the present experiment, we determined whether fast-acting compression of the type sometimes used in hearing aids could also lead to improved gap detection. A behind-the-ear (BTE) digital hearing aid was programmed to implement multi-band compression, either fast-acting or slow-acting (control condition). A reference condition using unaided listening was also used. Stimuli were delivered via an earphone placed over the hearing aid. Overall stimulus levels at the output of the hearing aid were similar across conditions. Thresholds for detecting gaps in noise bands centred at 4 kHz were measured as a function of noise bandwidth (10-500 Hz). To prevent the detection of spectral changes introduced by the gap, stimuli were presented in a broad-band background noise. Three normally hearing subjects and three subjects with bilateral cochlear hearing loss were tested. Gap thresholds varied non-monotonically with noise bandwidth, being maximal around 50 Hz. Gap thresholds were generally higher for the hearing-impaired than for the normally hearing subjects. For the latter, gap thresholds were similar for the three conditions. For the hearing-impaired subjects, gap thresholds were similar for the unaided condition and the condition using slow compression. However, fast compression led to smaller gap thresholds, especially for noise bandwidths up to 50 Hz. The results show that fast compression can improve the ability of hearing-impaired subjects to detect gaps in sounds with slowly fluctuating envelopes.

Adult↗

PubMed2001

The use of psychophysical tuning curves to explore dead regions in the cochlea.

OBJECTIVE: "Dead regions" are regions in the cochlea with no functioning inner hair cells (IHCs) and/or neurons. Amplification (using a hearing aid) over a frequency range corresponding to a dead region may not be beneficial and may even impair speech intelligibility. The objective of this article is to illustrate the use of psychophysical tuning curves (PTCs) as a tool for investigating dead regions and to illustrate the variety of audiogram configurations that can be associated with dead regions. We explore the influence of signal level and signal frequency to test the hypothesis that the frequency at the tip of the tuning curve defines the boundary of the dead region. DESIGN: PTCs were measured for five subjects with sensorineural hearing loss who were suspected of having dead regions. One had a relatively "flat" loss, one had a mild mid-frequency loss and three had high-frequency losses, varying in severity from 70 dB to more than 120 dB. For each PTC, the level and frequency of the sinusoidal signal were fixed, and the level of a narrowband noise masker needed just to mask the signal was determined as a function of the masker frequency. When the signal falls in a frequency region that is not "dead," the signal is detected via IHCs with characteristic frequencies (CFs) at or close to the signal frequency. In such a case, the tip of the PTC (the masker frequency at which the masker level is lowest) lies at or close to the signal frequency. When a dead region is present, the signal is detected via IHCs with CFs different from that of the signal frequency. In such a case, the tip of the PTC is shifted away from the signal frequency. RESULTS: PTCs with frequency-shifted tips (indicative of dead regions) were found for all subjects. The frequencies at the tips sometimes decreased slightly with increasing signal level. For the subject with a relatively flat loss, PTCs with tips close to 3000 Hz were obtained for signal frequencies of 400, 1000 and 1500 Hz. A PTC with a tip at 5000 Hz was found for a signal frequency of 6000 Hz. These results suggest that this subject had an "island" of surviving IHCs and neurons with CFs ranging from 3000 to 5000 Hz, with extensive dead regions on either side. For the subject with a mid-frequency loss, the pattern of results suggested a mid-frequency dead region. For the subjects with high-frequency loss, the results suggested the presence of high-frequency dead regions, in one case starting at a frequency where absolute thresholds were only slightly higher than normal. CONCLUSIONS: PTCs can be used to detect and delimit dead regions. Often, the frequency at the tip of the PTC can be used to define approximately one boundary of the dead region. However, the detection of beats can affect the shape of the PTC around the tip when the signal frequency lies just inside the dead region. The level of the signal can also have some effect on the frequency at the tip of the PTC. Very low signal levels can lead to variable results. Dead regions can start at frequencies where absolute thresholds are near normal.

Adult↗

PubMed2000

The relative role of beats and combination tones in determining the shapes of masking patterns at 2 kHz: I. Normal-hearing listeners.

Masking patterns for a 2-kHz sinusoidal masker at 45, 65 or 85 dB SPL were measured for three normal-hearing subjects, using a 3-AFC method with feedback (condition 1). The patterns showed distinct irregularities, particularly at the highest masker level. In condition 2, a lowpass noise was added to mask combination tones. The noise increased thresholds mainly for the 85 dB masker, for signal frequencies of 2.3-3.0 kHz. In condition 3, a pair of high-frequency tones ('modulation detection interference (MDI) tones') was used to introduce beats at the same rate as produced by the interaction of the masker and signal. Thresholds were higher than for condition 1, particularly for signal frequencies adjacent to the masker frequency. In condition 4, the lowpass noise was presented simultaneously with the MDI tones. Thresholds were well predicted as a combination of the effects of the lowpass noise and the MDI tones. In condition 5, a pair of low-frequency MDI tones was added to the masker. The thresholds had the same overall pattern as in condition 4. We conclude that the shapes of masking patterns measured using a 2-kHz masker are influenced by the detection of beats for masker-signal frequency separations up to at least 300 Hz and by the detection of combination tones for separations between 300 and 1000 Hz.

Acoustic Stimulation↗

PubMed2000

A test for the diagnosis of dead regions in the cochlea.

Hearing impairment may sometimes be associated with complete loss of inner hair cells (IHCs) over a certain region of the basilar membrane. We call this a 'dead region'. Amplification (using a hearing aid) over a frequency range corresponding to a dead region may not be beneficial and may even impair speech intelligibility. However, diagnosis of dead regions is not easily done from the audiogram. This paper reports the design and evaluation of a method for detecting and delimiting dead regions. A noise, called 'threshold equalizing noise' (TEN), was spectrally shaped so that, for normally hearing subjects, it would give equal masked thresholds for pure tone signals at all frequencies within the range 250-10,000 Hz. Its level is specified as the level in a one-ERB (132 Hz) wide band centred at 1000 Hz. Measurements obtained from 22 normal-hearing subjects and TEN levels of 30, 50 and 70 dB/ERB confirmed that the signal level at masked threshold was approximately equal to the noise level/ERB and was almost independent of signal frequency. Masked thresholds were measured for 20 ears of 14 subjects with sensorineural hearing loss, using TEN levels of 30, 50 and 70 dB/ERB. Psychophysical tuning curves (PTCs) were measured for the same subjects. When there are surviving IHCs corresponding to a frequency region with elevated absolute thresholds, a signal in that frequency region is detected via IHCs with characteristic frequencies (CFs) close to that region. In such a case, threshold in the TEN is close to that for normal-hearing listeners, provided that the noise intensity is sufficient to produce significant masking. Also, the tip of the PTC lies close to the signal frequency. When a dead region is present, the signal is detected via IHCs with CFs different from that of the signal frequency. In such a case, threshold in the TEN is markedly higher than normal, and the tip of the PTC is shifted away from the signal frequency. Generally, there was a very good correspondence between the results obtained using the TEN and the PTCs. We conclude that the measurement of masked thresholds in TEN provides a quick and simple method for the diagnosis of dead regions.

Aged↗

PubMed1999

Comparison of different forms of compression using wearable digital hearing aids.

Four different compression algorithms were implemented in wearable digital hearing aids: (1) The slow-acting dual-front-end automatic gain control (AGC) system [B. C. J. Moore, B. R. Glasberg, and M. A. Stone, Br. J. Audiol. 25, 171-182 (1991)], combined with appropriate frequency response equalization, with a compression threshold of 63 dB sound pressure level (SPL) and with a compression ratio of 30 (DUAL-HI); (2) The dual-front-end AGC system combined with appropriate frequency response equalization, with a compression threshold of 55 dB SPL and with a compression ratio of 3 (DUAL-LO). This was intended to give some impression of the levels of sounds in the environment; (3) Fast-acting full dynamic range compression in four channels (FULL-4). The compression was designed to minimize envelope distortion due to overshoots and undershoots; (4) A combination of (2) and (3) above, where each applied less compression than when used alone (DUAL-4). Initial fitting was partly based on the concept of giving a flat specific-loudness pattern for a 65-dB SPL speech-shaped noise input, and this was followed by fine tuning using an adaptive procedure with speech stimuli. Eight subjects with moderate to severe cochlear hearing loss were tested in a counter-balanced design. Subjects had at least 2 weeks experience with each system in everyday life before evaluation using the Abbreviated Profile of Hearing Aid Benefit (APHAB) test and measures of speech intelligibility in quiet (AB word lists at 50 and 80 dB SPL) and noise (adoptive sentence lists in speech-shaped noise, or that same noise amplitude modulated with the envelope of speech from a single talker). The APHAB scores did not indicate clear differences between the four systems. Scores for the AB words in quiet were high for all four systems at both 50 and 80 dB SPL. The speech-to-noise ratios required for 50% intelligibility were low (indicating good performance) and similar for all the systems, but there was a slight trend for better performance in modulated noise with the DUAL-4 system than with the other systems. A subsequent trial where three subjects directly compared each of the four systems in their everyday lives indicated a slight preference for the DUAL-LO system. Overall, the results suggest that it is not necessary to compress fast modulations of the input signal.

Acoustic Stimulation↗

PubMed1999

Use of a loudness model for hearing aid fitting: II. Hearing aids with multi-channel compression.

A model for predicting loudness for people with cochlear hearing loss was applied to the problem of the initial fitting of a multi-channel compression hearing aid. The fitting was based on two constraints: (1) The specific loudness pattern evoked by speech of a moderate level (65 dB SPL) should be reasonably flat (equal loudness per critical band), and the overall loudness should be similar to that evoked in a normal listener by 65-dB speech (about 23 sones for binaural listening); (2) Speech with an overall level of 45 dB SPL should just be audible in all frequency bands from 500 Hz up to about 4 kHz, provided that this does not require compression ratios exceeding about 3. These two constraints were used to determine initial values for the gain, compression ratio and compression threshold in each channel of a multi-channel compression system. This initial fitting was based entirely on audiometric thresholds; it does not require suprathreshold loudness measures. The fitting method was evaluated using an experimental fast-acting four-channel compression system. The initial fitting was followed by an adaptive procedure to 'fine tune' the fitting, and the aids were then used in everyday life. Performance was evaluated by use of questionnaires and by measures of speech intelligibility. Although the fine tuning resulted in modest changes in the fitting parameters for some subjects, on average the frequency response shapes and compression ratios were similar before and after the fine tuning. The fittings led to satisfactory loudness impressions in everyday life and to high speech intelligibility over a wide range of levels. It was concluded that the initial fitting method gives reasonable starting values for the fine tuning.

Acoustic Stimulation↗

PubMed1998

Masking patterns for sinusoidal and narrow-band noise maskers.

The masking patterns produced by narrow-band maskers can show distinct irregularities. These experiments attempted to clarify the relative importance of factors contributing to these irregularities. A three-alternative adaptive forced-choice method with feedback was used, to promote use of the optimal detection cues. The masker and signal were either a sinusoid or a band of noise that was 80 Hz wide, giving four possible combinations of masker and signal type. In experiment 1, masking patterns were measured for maskers centered at 1 kHz, for all combinations of masker and signal type (tone or noise). The masking patterns showed irregularities (dips or "shoulders") above the masker frequency, and the irregularities were larger for the sinusoidal than for the noise masker. Experiment 2 was similar to experiment 1, except that low-pass noise was added to mask combination products. For the noise masker, the low-pass noise slightly increased thresholds, and largely eliminated the irregularities in the patterns, but for the tone masker, the irregularities persisted. Experiment 3 used a noise signal with tone and noise maskers centered at 250, 1000, and 4000 Hz. The tone masker produced less masking than the noise masker for masker-signal frequency separations of 150-250 Hz, regardless of masker frequency. Experiment 4 used an additional masker tone to introduce beats similar to those produced by the interaction of the signal and (main) masker, and to mask combination products. This largely eliminated the dips in the masking patterns for both the noise and tone maskers. Experiment 5 used an additional pair of high-frequency tones to introduce beats, with similar results. We conclude that temporal fluctuations (beats) have a strong influence on the masking patterns for sinusoidal maskers, for masker-signal frequency separations up to a few hundred Hz. Beats may also have some influence on the masking patterns for noise maskers. The detection of combination products also plays a role.

Auditory Perception↗

PubMed1998

Development and evaluation of a procedure for fitting multi-channel compression hearing aids.

Hearing aids with multi-channel compression are often fitted on the basis of loudness scaling data obtained using narrow bands of noise or tones. Here, we report the development and evaluation of an alternative fitting procedure based on the use of speech signals. The parameters of the hearing aid (the gains in each channel for high and low input levels) are adjusted adaptively under computer control on the basis of the listener's responses. The goal is that speech at 85 dB SPL should be judged as 'loud', speech at 60 dB SPL should be judged as 'quiet', and speech at both levels should be judged as 'neither tinny nor boomy'. The procedure was evaluated using a two-channel compression hearing aid, the remote control of which allowed two programs to be stored. One program was based on our fitting procedure. The other was either based on the manufacturer's recommended full fitting procedure (which included loudness scaling with bands of noise), or was based on the audiogram alone, using the manufacturer's algorithm. After an acclimatization period of at least two weeks, subjects were then asked to fill in a questionnaire about their experiences with the two programs in different listening situations. The results generally indicated a preference for the program based on our adaptive fitting procedure. We also conducted laboratory measurements of speech intelligibility, in quiet and in a background of a single competing talker. These showed no clear difference between programs, although scores overall were very high. We conclude that our adaptive procedure gives very satisfactory results in everyday life. Parameter values giving good comfort also give good intelligibility. The procedure typically takes between five and 10 minutes per ear, which is quicker than most loudness scaling procedures.

Hearing Aids↗

PubMed1996

Vowel identification based on amplitude modulation.

This study investigated the extent to which flat-spectrum harmonic complexes could be identified as one of six vowels when three pairs of successive harmonics, located at the first, second, and third formant frequency values, were amplitude modulated. In experiment 1, the amplitude modulation (AM) rate was at or close to 10 Hz. In condition 1, all components were added in cosine phase, and the 10-Hz AM was in phase for all "formants." Performance improved monotonically with increasing modulation index, m. In condition 2, m was fixed at 0.5 and the level of each background harmonic was varied randomly (roved) from stimulus to stimulus. Even a rove range of only +/- 2 dB reduced scores considerably. Condition 3 was like condition 1, but with components added in random phase. Performance was very poor for all modulation indices. This suggests that subjects were unable to use momentary differences in level between formant and background harmonics, and supports the idea that, for cosine-phase stimuli, they were using information from the low-amplitude portions ("valleys") of the cochlea-filtered waveforms. In further conditions, the components were added in cosine phase and the AM had a different phase and/or different rate (10, 16, and 24 Hz) on the different formants. Scores were very similar to those obtained when the AM was identical for all formants. In experiment 2, the AM rate was at or close to 2 Hz. When all formants were modulated in phase at 2 Hz, very good performance was found for components added in cosine phase, and performance was essentially unaffected by making the AM different in rate and/or phase across formants. When the components were added in random phase, performance was well above chance when the formants were modulated in-phase at 2-Hz, but worsened markedly when the modulation differed in rate and/or phase across formants. Randomizing the level of each background harmonic caused performance to deteriorate and to become similar for cosine-phase and random-phase stimuli. Performance deteriorated further when the AM differed in phase across formants. The results suggest that, for a 2-Hz modulation rate, and when information from the valleys is not available, performance depends on momentary increases in level of the formant harmonics relative to the background.

Humans↗

PubMed1996

Effects of phase and level on vowel identification: data and predictions based on a nonlinear basilar-membrane model.

This paper examines the role of component phase and level on vowel identification and interprets the results in terms of the shapes of the waveforms occurring at the outputs of the filters in a nonlinear basilar-membrane model. Four normally hearing subjects were asked to identify which of six possible vowel-like harmonic complexes was presented on each trial. The stimuli were complex tones containing the first 35 harmonics of a 100-Hz fundamental. All of the harmonics below 3000 Hz were equal in amplitude except for three pairs of successive harmonics, at frequencies corresponding to the first three formants of six vowels, which were incremented in level relative to the background harmonics by 1, 2, 4, 8, and 16 dB. The components in the harmonic complexes were added in four different starting phase relationships; cosine, random, Schroeder positive, and Schroeder negative. The stimuli were presented at three overall levels; 85, 65, and 45 dB SPL. Performance was similar for the random and Schroeder-negative phases and did not vary as a function of level. Performance for the cosine- and Schroeder-positive-phase conditions was better than for the other two phase conditions, but decreased as the level was reduced. Performance for all four phase conditions was equivalent for the lowest level. The variation in performance as a function of level and component phase is explained in terms of the shapes of the temporal waveforms that would occur at the output of nonlinear "basilar-membrane filters" [H. W. Strube, J. Acoust. Soc. Am. 79, 1511-1518 (1986)], with asymmetric phase responses about the center frequency.

Adolescent↗

PubMed1995

The identification of vowel-like harmonic complexes: effects of component phase, level, and fundamental frequency.

These experiments investigate how the identification of vowel-like harmonic complexes, similar to those used by Leek et al. [J. Acoust. Soc. Am. 81, 148-154 (1987)], is affected by spectral contrast, overall level, component phase, and fundamental frequency (F0). Four normally hearing subjects were required to identify which of six vowel-like harmonic complexes was presented on each trial. The test stimuli were complex tones containing the first 35 harmonics of a 100-Hz fundamental or the first 70 harmonics of a 50-Hz fundamental. All of the harmonics with frequencies below 3000 Hz were equal in amplitude except for three pairs of successive harmonics which were located at the first, second, and third formant frequency values, and incremented in level by 1, 2, 4, 8, and 16 dB relative to the other components. Three overall levels were used, 85, 65, and 45 dB SPL, and harmonics were added in either cosine or random phase. The results indicated that identification was better for cosine phase than for random phase, except for the 100-Hz fundamental at 45 dB SPL. The difference between the two phase conditions increased with increasing presentation level and with decreasing fundamental frequency. The results are explained in terms of the waveforms that would occur at the outputs of different auditory filters. It does not appear necessary to invoke nonlinear enhancement mechanisms to explain the results, although an influence of such mechanisms cannot be ruled out.

Adult↗

PubMed1993

Tactile-auditory speech perception by unimodally and bimodally trained normal-hearing subjects.

The following study compared the effectiveness of unimodal and bimodal training strategies at improving the perception of speech information under a variety of conditions. Normal-hearing subjects were trained in the perception of vowel and consonant stimuli. Speech information was provided either via a multiple channel electrotactile speech processing aid (the Tickle Talker), and/or by a 200-Hz low-pass filtered auditory signal. Two subjects were trained only in the combined tactile-plus-auditory (TA) condition; the remaining two were trained in both the tactile-alone (T) and auditory-alone (A) conditions; however, only one condition was used at any single time. All subjects were evaluated in the TA, T, and A conditions, both at the beginning of the study, prior to training, and at the completion of training, on closed-set vowel and consonant confusion tests, and on an open-set word test. Results indicated that whilst statistically significant improvements occurred from one evaluation period to the next, in both groups of subjects, the improvements per condition were not dependent on the type of training received. The results provide a preliminary indication that the provision of unimodal training does not impair the perception of speech information under bimodal perception conditions.

Acoustic Stimulation↗

PubMed1992

Safety studies with the University of Melbourne multichannel electrotactile speech processor.

Results of safety investigations conducted as an integral part of the development of a multichannel electrotactile speech processor (Tickle Talker) are reported. Electrical parameters of the stimulus waveform, design of the electrode handset and cabling, and the electrical circuitry of the speech processor/stimulator and programming interface have been analyzed for potential risks. Constant current biphasic square pulses delivered to electrodes positioned on the skin surface over the digital nerve bundles were chosen to optimize the safety, comfort, and function of the electrotactile stimulus. The device was battery-powered, and the user circuit was isolated from earth-referenced sources. Each electrode was isolated by capacitive coupling, preventing DC leakage of current to the user circuit. Studies of finger temperature showed slight cooling of the skin on the fingers of both stimulated and unstimulated hands for individual subjects following electrotactile stimulation through the Tickle Talker. Subsequent analysis of finger and hand vascular circulation in five subjects showed slight reductions in hand blood flow in some individuals. The results did not demonstrate a significant mean decrease in hand or finger blood flow following electrotactile stimulation. No evidence of sympathetic involvement was found, nor were any changes in vascular structure of the hand such as those associated with Raynaud's disease found. Evidence suggests that the decrease in temperature found in the initial study may be due to a change in the ratio of blood flow between arteriovenous anastomoses and nutritive capillary beds. Studies of: 1) changes in mean threshold and comfortable pulse widths over time; and, 2) changes in tactual sensitivity as measured by hot/cold, sharp/dull, and two-point difference limen discrimination, did not detect any systematic change in peripheral nervous system function following electrotactile stimulation. Analysis of electroencephalogram (EEG) recordings taken during electrotactile stimulation, and after relatively long periods of experience with the device did not show any pathological changes which might be associated with epileptic foci. In summary, no contraindications to long-term use of the Tickle Talker were detected in the studies performed.

Adult↗

PubMed1991

Use of a multichannel electrotactile speech processor by profoundly hearing-impaired children in a total communication environment.

As part of a larger subject group, four profoundly hearing-impaired children enrolled in a total communication educational program were fitted with the University of Melbourne's multichannel electrotactile speech processor (Tickle Talker). Sound detection thresholds for pure tones were at lower levels with the tactile device than with hearing aids, especially for high frequency sounds above 2 kHz. Two of the children also detected all speech sounds of the Ling five-sound test at normal conversational levels using only the Tickle Talker. The children were able to use tactile input to achieve higher scores on three speech feature subtests of the PLOTT test when using the Tickle Talker plus hearing aids as compared to hearing aids alone. Mean improvements were 22.4 percent on vowel length, 28 percent on vowel identification, and 35 percent on consonant manner. Improvements were also shown by individual children on the closed-set WIPI and open-set PBK word tests, and on the open-set BKB sentence test, when the Tickle Talker was combined with hearing aids, and with hearing aids and lipreading. Comparisons of these results with those of children using the Tickle Talker in other educational settings show that children in a total communication environment can potentially benefit to a similar degree from use of tactual input. Anecdotal reports from the children and school staff members indicated that daily use of the Tickle Talker did not interfere with the signing aspects of total communication.

Adolescent↗

PubMed1990

Speech feature recognition by profoundly hearing impaired children using a multiple-channel electrotactile speech processor and aided residual hearing.

A group of prelinguistically hearing impaired children, between 7 and 11 years of age, were trained in the perception of vowel duration and place, the fricative /s/, and manner of articulation (/m/ vs /b/ and /s/ vs /t/) distinctions, using information provided by a multiple-channel electrotactile aid (Tickle Talker), and through aided hearing. Training was provided in the tactile-plus-aided hearing (TA) and tactile (T) conditions. Speech feature recognition tests were conducted in the TA, T, and aided hearing (A) conditions, during pretraining, training, and post-training phases. Test scores in the TA and T conditions were significantly greater than scores in the A condition for all tests, suggesting that perception of these features was improved when the tactile aid was worn. Test scores in the training and post-training phases were significantly greater than in the pretraining phase, suggesting that the training provided was responsible for the improvement in feature perception. Statistical analyses demonstrated a significant interaction between the main effects of condition and phase, suggesting that training improved perception in the TA and T conditions, but not in the A condition. Post-training and training test scores were similar suggesting that the perceptual skills acquired during training were retained after the removal of training. Recognition of trained features improved for trained, as well as for untrained words.

Child↗

PubMed1990

Perception of sentences, words, and speech features by profoundly hearing-impaired children using a multichannel electrotactile speech processor.

Fourteen prelinguistically profoundly hearing-impaired children were fitted with the multichannel electrotactile speech processor (Tickle Talker) developed by Cochlear Pty. Ltd. and the University of Melbourne. Each child participated in an ongoing training and evaluation program, which included measures of speech perception and production. Results of speech perception testing demonstrate clear benefits for children fitted with the device. Thresholds for detection of pure tones were lower for the Tickle Talker than for hearing aids across the frequency range 250-4000 Hz, with the greatest tactual advantage in the high-frequency consonant range (above 2000 Hz). Individual and mean speech detection thresholds for the Ling 5-sound test confirmed that speech sounds were detected by the electrotactile device at levels consistent with normal conversational speech. Results for three speech feature tests showed significant improvement when the Tickle Talker was used in combination with hearing aids (TA) as compared with hearing aids along (A). Mean scores in the TA condition increased by 11% for vowel duration, 20% for vowel formant, and 25% for consonant manner as compared with hearing aids alone. Mean TA score on a closed-set word test (WIPI) was 48%, as compared with 32% for hearing aids alone. Similarly, mean WIPI score for the combination of Tickle Talker, lipreading, and hearing aids (TLA) increased by 6% as compared with combined lipreading and hearing aid (LA) scores. Mean scores on open-set sentences (BKB) showed a significant increase of 21% for the tactually aided condition (TLA) as compared with unaided (LA). These results indicate that, given sufficient training, children can utilize speech feature information provided through the Tickle Talker to improve discrimination of words and sentences. These results indicate that, given sufficient training, children can utilize speech feature information provided through the Tickle Talker to improve discrimination of words and sentences. These results are consistent with improvement in speech discrimination previously reported for normally hearing and hearing-impaired adults using the device. Anecdotal evidence also indicates some improvements in speech production for children fitted with the Tickle Talker.

Adolescent↗