Biomedical subjects

Mary Joe Osberger

Publications and source records attributed to Mary Joe Osberger.

4 recordsLinked to original sources

PubMed2005

Comparison of continuous interleaved sampling and simultaneous analog stimulation speech processing strategies in newly implanted adults with a Clarion 1.2 cochlear implant.

OBJECTIVE: This study consisted of a within-subjects comparison of speech recognition and patient preference when subjects used two different cochlear implant speech processing strategies with a Clarion 1.2 (enhanced bipolar) device: Simultaneous Analog Stimulation (SAS), and Continuous Interleaved Sampling (CIS). These two strategies used two different electrode configurations: the SAS strategy used bipolar stimulation, whereas the CIS strategy used monopolar stimulation. STUDY DESIGN: This was a multicenter study that used a within-subjects balanced crossover design. Experience with the two strategies was replicated in each subject using an ABAB design. Order of strategy use was balanced across all subjects. SETTING: The study was carried out at several cochlear implant centers affiliated with tertiary medical centers. PATIENTS: Subjects consisted of 25 postlingually deafened adults who received a Clarion cochlear implant. INTERVENTIONS: Total involvement by each subject was 14 weeks. Speech perception testing and sound quality assessments were performed after use with each strategy. MAIN OUTCOME MEASURES: Primary outcome measures include speech perception data and patient responses to questionnaires regarding speech and sound quality. RESULTS: Analyses revealed that performance did not differ significantly by the strategy encountered first as relative to the strategy encountered second and that the order in which a strategy was used did not appear to affect subjects' eventual preference for a particular strategy. Although speech recognition scores tended to be higher for CIS for most of the test measures at most of the test intervals, the analysis of variance to evaluate differences in strategy did not reveal a significant effect of strategy. Further analysis of scores obtained at the replication interval, however, revealed that scores obtained with CIS were significantly higher than scores obtained with SAS on the Hearing in Noise Test sentences in quiet and noise. In addition, significantly more patients indicated a final preference for the CIS strategy than for the SAS strategy. Importantly, both the analysis evaluating order and the analysis evaluating strategy revealed significant effects of evaluation period, indicating that time/experience with the implant had a significant effect on scores for each strategy, regardless of the order in which it was used (first or second). CONCLUSIONS: This study demonstrates that important learning occurs during the first several weeks of cochlear implant use, making it difficult to adequately compare performance with different speech processing strategies. However, the finding that patients often prefer the strategy they understand speech the best with supports the clinical practice of letting adult patients select their preferred strategy without formally evaluating speech perception with each available strategy.

Aged↗

PubMed2004

Effect of age at cochlear implantation on auditory skill development in infants and toddlers.

OBJECTIVES: To investigate the effect of age at cochlear implantation on the auditory development of children younger than 3 years and to compare these children's auditory development with that of peers with normal hearing. DESIGN: Using a repeated-measures paradigm, auditory skill development was evaluated before and 3, 6, and 12 months after implantation. Data were compared with previously published data from cohorts with normal hearing. PARTICIPANTS: One hundred seven hearing-impaired children (age range, 12-36 months) who received a cochlear implant during clinical trials in North America. MAIN OUTCOME MEASURE: Auditory skill development was assessed using the Infant-Toddler Meaningful Auditory Integration Scale, a tool that provides a quantitative measure in children as young as newborns. RESULTS: Infants and toddlers who receive implants show rapid improvement in auditory skills during the first year of device use regardless of age at implantation, although younger children achieve higher scores. Children who undergo implantation at a younger age acquire auditory skills nearer to those of their peers with normal hearing at a younger age. The mean rate of acquisition of auditory skills is similar to that of infants and toddlers with normal hearing regardless of age at implantation. CONCLUSION: Performing implantation in children with profound hearing loss at the youngest age possible allows the best opportunity for them to acquire communication skills that approximate those of their peers with normal hearing.

Age Factors↗

PubMed2002

Cochlear implant candidacy and performance trends in children.

Data from Clarion cochlear implant pediatric clinical trials were examined retrospectively to uncover trends in candidacy and postimplant benefit over time. In particular, age at implantation, educational setting, and communication mode were examined with respect to speech perception performance after implantation. The results showed that 1) age at implantation is decreasing, 2) children in oral education programs obtain more benefit from a cochlear implant than children in total communication programs, 3) children who undergo implantation before 2 years of age show greater benefit than children who undergo implantation between 2 and 3 years of age, 4) more younger children are using oral communication than older children, and 5) more children with good auditory skills before implantation and more residual hearing are undergoing implantation. In sum, in the 11 years since implants have been available to children in the United States, candidacy criteria have evolved and benefit has increased as cochlear implant technology has advanced.

Age Factors↗

PubMedDate not supplied

HiResolution and conventional sound processing in the HiResolution bionic ear: using appropriate outcome measures to assess speech recognition ability.

OBJECTIVE: This study compared speech perception benefits in adults implanted with the HiResolution (HiRes) Bionic Ear who used both conventional and HiRes sound processing. A battery of speech tests was used to determine which formats were most appropriate for documenting the wide range of benefit experienced by cochlear-implant users. STUDY DESIGN: A repeated-measures design was used to assess postimplantation speech perception in adults who received the HiResolution Bionic Ear in a recent clinical trial. Patients were fit first with conventional strategies and assessed after 3 months of use. Patients were then switched to HiRes sound processing and assessed again after 3 months of use. To assess the immediate effect of HiRes sound processing on speech perception performance, consonant recognition testing was performed in a subset of patients after 3 days of HiRes use and compared with their 3-month performance with conventional processing. SETTING: Subjects were implanted and evaluated at 19 cochlear implant programs in the USA and Canada affiliated primarily with tertiary medical centers. PATIENTS: Patients were 51 postlinguistically deafened adults. MAIN OUTCOME MEASURES: Speech perception was assessed using CNC monosyllabic words, CID sentences and HINT sentences in quiet and noise. Consonant recognition testing was also administered to a subset of patients (n = 30) using the Iowa Consonant Test presented in quiet and noise. All patients completed a strategy preference questionnaire after 6 months of device use. RESULTS: Consonant identification in quiet and noise improved significantly after only 3 days of HiRes use. The mean improvement from conventional to HiRes processing was significant on all speech perception tests. The largest differences occurred for the HINT sentences in noise. Ninety-six percent of the patients preferred HiRes to conventional sound processing. Ceiling effects occurred for both sentence tests in quiet. CONCLUSIONS: Although most patients improved after switching to HiRes sound processing, the greatest differences were seen in the 'poor' performers because 'good' performers often reached ceiling performance, especially on tests in quiet. Future evaluations of cochlear-implant benefit should make use of more difficult measures, especially for 'good' users. Nonetheless, a range of difficulty must remain in test materials to document benefit in the entire population of implant recipients.

Adult↗