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Biomedical subjects

P W Dawson

Publications and source records attributed to P W Dawson.

13 recordsLinked to original sources
PubMed2004

Optimizing dynamic range in children using the nucleus cochlear implant.

OBJECTIVE: The aim of this study was to investigate the benefits of the preprocessing scheme "Adaptive Dynamic Range Optimization" (ADRO) in children using Nucleus cochlear implants. Previous research with adults indicates improved speech perception in quiet and improved sound quality in everyday listening environments with the ADRO scheme. DESIGN: Children were given 4 wk of take-home experience with ADRO, with a minimum of 2 wk in which ADRO was "locked-in." After 1 wk of ADRO use and again after 4 wk of ADRO use, Bench-Kowal-Bamford (BKB) sentence perception in quiet at a low input level of 50 dB SPL (unweighted root mean square) and sentence perception in noise were compared with the child's everyday (Standard) program and the ADRO program. Children also rated the loudness of a variety of environmental sounds and indicated which program provided the best hearing in a variety of everyday listening situations. RESULTS: On average, BKB sentence perception in quiet at 50 dB SPL was significantly better with the ADRO program compared with the Standard program. The group mean improvement was 8.60%. Similarly, group mean scores for BKB sentences presented at 65 dB SPL in multitalker babble were significantly higher with the ADRO program (an improvement of 6.87%). The ADRO program was the preferred program in 46% of the listening situations, whereas the Standard program was preferred in 26% of situations. Everyday sounds were not unacceptably loud with ADRO. CONCLUSIONS: There was an ADRO benefit for this group of children in quiet and in noise. These findings suggest that young children would benefit from the ADRO programming option being locked in along with other processor settings in the SPrint processor once their MAP levels have stabilized. Some older children and teenagers may choose to use ADRO selectively for specific listening situations.

Acoustic Stimulation↗
PubMed2002

Short-term auditory memory in children using cochlear implants and its relevance to receptive language.

The aim of this study was to assess auditory sequential, short-term-memory (SSTM) performance in young children using cochlear implants (CI group) and to examine the relationship of this performance to receptive language performance. Twenty-four children, 5 to 11 years old, using the Nucleus 22-electrode cochlear implant, were tested on a number of auditory and visual tasks of SSTM. The auditory memory tasks were designed to minimize the effect of auditory discrimination ability. Stimuli were chosen that children with cochlear implants could accurately identify with a reaction time similar to that of a control group of children with normal hearing (NH group). All children were also assessed on a receptive language test and on a nonverbal intelligence scale. As expected, children using cochlear implants demonstrated poorer auditory and visual SSTM skills than their hearing peers when the stimuli were verbal or were pictures that could be readily labeled. They did not differ from their peers with normal hearing on tasks where the stimuli were less likely to be verbally encoded. An important finding was that the CI group did not appear to have a sequential memory deficit specific to the auditory modality. The difference scores (auditory minus visual memory performance) for the CI group were not significantly different from those for the NH group. SSTM performance accounted for significant variance in the receptive language performance of the CI group. However, a forward stepwise regression analysis revealed that visual spatial memory (one of the subtests of the nonverbal IQ test) was the main predictor of variance in the language scores of the children using cochlear implants.

Acoustic Stimulation↗
PubMed2000

Electrode discrimination and speech perception in young children using cochlear implants.

OBJECTIVE: The aim was to determine the efficacy of a child-appropriate procedure to assess electrode discrimination ability in young children using cochlear implants and to investigate the relationship of electrode discrimination ability and speech perception performance in children implanted at a young age. DESIGN: An adaptation of the play audiometry procedure was used to assess electrode discrimination in seventeen 4- to 10-yr-old children. The children were required to respond with a game-like motor response when a repeating stimulation on a reference electrode "changed" to a different electrode. They were also assessed on a speech feature discrimination test, a closed-set word recognition test and a nonverbal intelligence task. RESULTS: Sixty-five percent of subjects demonstrated ability to discriminate adjacent electrodes in mid and apical regions of the cochlea, whilst the remaining subjects needed electrode separations of between two and nine electrodes for successful discrimination. In a forward stepwise regression analysis electrode discrimination ability was found to be the strongest factor in accounting for variance in the speech perception scores. Subject variables such as duration of deafness, nonverbal intelligence and implant experience did not significantly account for further variance in the speech perception scores for this group of children. CONCLUSIONS: Electrode discrimination ability was the strongest factor in predicting performance on speech perception measures in a group of children using cochlear implants.

Child↗
PubMed1998

A modification of play audiometry to assess speech discrimination ability in severe-profoundly deaf 2- to 4-year-old children.

OBJECTIVE: The aim was to develop an assessment procedure that was independent of language and speech production ability, to test speech feature discrimination in severe-profoundly deaf children 2 to 4 yr of age. DESIGN: The procedure being trialed was adapted from existing procedures. The child was required to respond with a game-like motor response to a "change" in a speech stimulus that was being presented repeatedly through a speaker. The change occurred at randomly determined times, and false alarm responses were measured during the waiting periods (while the child waited for the change). Two- to four-yr-old normally hearing children and hearing-impaired children using hearing aids and a group of 4-yr-old hearing-impaired children using cochlear implants were assessed on the task. RESULTS: More than 82% of the 3- and 4-yr-old normally hearing and hearing-impaired children were able to complete the testing for the eight speech sound contrasts within three 20 minute sessions. Fifty percent of the 2-yr-old normally hearing and hearing-impaired children were able to condition and complete the task. All of the normally hearing children who completed the task successfully discriminated all speech sound contrasts. The performance of the hearing-impaired children using hearing aids was influenced by the degree of hearing loss and the type of speech contrast being tested. Similarly, the average performance of the children using cochlear implants was better for easier contrasts such as /ba/bi/ with contrasting vowel formant cues. CONCLUSIONS: This procedure has potential for use as a reliable clinical and research tool for assessing the development of auditory discrimination ability in 2- to 4-yr-old severe-profoundly deaf children.

Audiometry, Speech↗
PubMed1997

The effect of loudness imbalance between electrodes in cochlear implant users.

OBJECTIVE: The aim was to determine the effect of loudness imbalance between electrodes in patients using the 22-electrode cochlear implant (Cochlear Pty Ltd). It was hypothesized that speech perception scores would be greater when the loudness of electrodes was balanced at the comfort (C) levels than when the C levels were unbalanced. DESIGN: Ten adult patients received a monosyllabic word test (CNC) words) in quiet and a sentence test (CUNY sentences) in noise under two conditions: with C levels balanced for equal loudness and with unbalanced C levels. RESULTS: When the C levels across electrodes were pseudo-randomly unbalanced by 0 to +/- 20% of the electrodes' dynamic ranges (20% unbalancing), 6 of the 10 subjects showed a significant drop in sentence perception scores. Of these patients, none had a significant decrease in perception when the degree of unbalancing was halved. Of the four patients who showed no change with 20% unbalancing, three revealed a significant decline in sentence perception when the degree of unbalancing was doubled. There also were significant group effects for phonemes on the word test as well as for sentences in noise for the 20% unbalancing. CONCLUSIONS: The implications for clinical practice are that it is important to balance the C levels and that clinicians should be encouraged to refine methods for setting C levels in very young children, who may be using unbalanced MAPs. Nevertheless, although most patients revealed a statistically significant drop in sentence perception with 20% imbalance of the C levels, the changes in percentage scores often were only small.

Adolescent↗
PubMed1997

Changes in synthetic and natural vowel perception after specific training for congenitally deafened patients using a multichannel cochlear implant.

OBJECTIVE: The aim was to determine whether the ability to use place-coded vowel formant information could be improved after training in a group of congenitally deafened patients, who showed limited speech perception ability after cochlear implant use ranging from 1 yr 8 mo to 6 yr 11 mo. A further aim was to investigate the relationship between electrode position difference limens and vowel recognition. DESIGN: Three children, one adolescent, and one young adult were assessed with synthesized versions of the words/hid, head, had, hud, hod, hood/containing three formants and with a natural version of these words as well as with a 12-alternative, closed-set task containing monosyllabic words. The change in performance during a nontraining period was compared to the change in performance after 10 training sessions. RESULTS: After training, two children showed significant gains on a number of tests and improvements were consistent with their electrode discrimination ability. Difference limens ranged from one to three electrodes for these patients as well as for two other patients who showed minimal to no improvements. The minimal gains shown by the final patient could be partly explained by poorer apical electrode position difference limen. CONCLUSIONS: Significant gains in vowel perception occurred post-training on several assessments for two of the children. This suggests the need for children to continue to have aural rehabilitation for a substantial period after implantation. Minimal improvements, however, occurred for the remaining patients. With the exception of one patient, their poorer performance was not associated with poorer electrode discrimination.

Adolescent↗
PubMed1995

A clinical report on receptive vocabulary skills in cochlear implant users.

OBJECTIVES: The aim was to measure the rate of vocabulary acquisition for cochlear implant users and compare the pre- and postoperative rates with published data for other groups with normal or impaired hearing. The hypothesis was that the postoperative rate would be greater than the preoperative rate. DESIGN: The Peabody Picture Vocabulary Test (PPVT) was administered to 32 children, adolescents, and prelinguistically deafened adults implanted with the 22-electrode cochlear implant. Age at implantation ranged from 2 yr 6 mo to 20 yr and implant use ranged from 6 mo to 7 yr 8 mo. RESULTS: The group mean postoperative performance at various postoperative intervals was significantly higher than mean preoperative performance. Single-subject data indicated statistically significant gains over time on this test for 13 of the subjects. The mean postoperative rate of vocabulary acquisition of 1.06 times the rate for normally hearing children was significantly greater than the mean preoperative rate of 0.43. CONCLUSION: These rates of improvement were in accord with previous reports on smaller numbers of implant users, but could not be attributed unambiguously to use of the implant because no control group was used for this clinical work. Variables such as age at implantation, duration of profound deafness, communication mode, and speech perception skill failed to significantly predict rate of improvement of the PPVT.

Adolescent↗
PubMed1995

A clinical report on speech production of cochlear implant users.

OBJECTIVE: The aim was to assess articulation and speech intelligibility over time in a group of cochlear implant users implanted at 8 yr or over. The hypothesis was that the postoperative speech production performance would be greater than the preoperative performance. DESIGN: A test of intelligibility using sentences and an articulation test measuring non-imitative elicited speech were administered to 11 and 10 subjects, respectively, who were implanted with the 22-electrode cochlear implant. Nine subjects received both tests. Age at implantation ranged from 8 yr to 20 yr and implant use ranged from 1 yr to 4 yr 5 mo. RESULTS: For both the intelligibility and articulation tests roughly half of the subjects showed significant improvements over time and group mean postoperative performance significantly exceeded preoperative performance. Improvements occurred for front, middle, and back consonants; for stops, fricatives, and glides and for voiceless and voiced consonants. CONCLUSIONS: Despite being deprived of acoustic speech information for many childhood years, roughly half of the patients assessed showed significant gains in speech intelligibility and articulation postimplantation. The lack of a control group of non-implanted patients means that we cannot separate out the influence of the implant on speech production from other influences such as training and tactile-kinaesthetic feedback.

Adolescent↗
PubMed1992

Cochlear implants in children, adolescents, and prelinguistically deafened adults: speech perception.

A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Pty Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11 to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.

Adolescent↗
PubMed1991

Multichannel cochlear implantation in children: a summary of current work at the University of Melbourne.

This paper summarizes research work relating to multichannel cochlear implantation in children at the University of Melbourne. Ongoing safety studies relating to the implantation of young children are discussed. Results of these studies suggest that special design considerations are necessary for a prosthesis to be implanted in children under the age of 2 years. Results of clinical assessment of implanted children and adolescents are also discussed in terms of speech perception, speech production, and language development, and some possible predictive factors are suggested. Preliminary data suggests that a high proportion of young children can achieve open-set speech perception with the cochlear implant given appropriate training and support. Initial results with adults using new speech processing hardware and a new coding scheme are also presented. These suggest that improved speech perception in quiet and competing noise is possible with the new system.

Adolescent↗