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PubMed2001

Effect of residual hearing prior to cochlear implantation on speech perception in children.

We examined the impact of residual hearing prior to cochlear implantation on pre- and postimplantation speech perception outcomes in children. Stimulation of the auditory system prior to implantation because of the presence of residual hearing is important for development of the central auditory pathways, whereas, in the absence of such stimulation, the pathways show less development. We hypothesized that children who had some degree of residual hearing preimplantation achieve better speech perception skills than their peers with poorer hearing. From the 133 children followed in our program, we identified 37 children who had an audiometric pure-tone average of better than 95 dB HL in the better ear at any time preimplantation. Psychophysical speech perception measures, the Word Identification Picture Inventory and the Phonetically Balanced Kindergarten list, in these children were compared with those of 96 implanted children who had poorer hearing prior to implantation. Children with more residual hearing showed higher speech perception scores both before implantation and over their first year of implant use than children with poorer hearing, suggesting that there is an advantage in having a greater degree of residual hearing preimplantation. We suggest that this advantage is promoted, in part, by the greater potential for auditory stimulation provided by high-gain hearing aids in children with greater degrees of residual hearing. This advantage appears to be maintained at least over 1 year postimplantation, yet the rates of development of postimplantation speech perception are not different between the groups. We suggest that this may be due to the unique aspects of electrical stimulation from a cochlear implant. Our findings suggest that it is important to minimize the delay of speech perception skills in the preimplantation phase, particularly in children with poor residual hearing. This can be accomplished by implanting children with congenital severe to profound hearing loss at young ages and children with acquired hearing loss soon after the onset. Also, auditory stimulation prior to implantation should be maximized through the consistent use of hearing aids and therapy that emphasizes development of auditory skills.

Child↗

PubMed2003

Perceptibility of large and sequential changes in somatosensory information during leaning forward and backward when standing.

11 healthy young men served as subjects in two experiments on perceptibility of (1) large changes in foot pressure and muscle activity induced by body leaning and (2) sequential changes in pressure at the first toe and the head of the first metatarsalis when leaning forward. The effects of reduced sensitivity on that perceptibility were also studied by repeating the experiments while cooling localized plantar areas of the sole (the head of the first metatarsalis, the first toe, and the heel). Under the normal (noncooled) condition, all subjects accurately perceived maximum pressure at the head of the first metatarsalis, but most subjects misperceived the second large increase in pressure at the first toe and in muscle activity as the first large increase. Under the cooling condition, localized cooling did not affect the perceptibility of maximum pressure at the head of the first metatarsalis or the activity in the tibialis anterior, but the perceptibility of pressure at the first toe and activity of the abductor hallucis were reduced. There were individual differences in perceptibility of activity of the rectus femoris when the heel was cooled. Perceptibility of sequential changes in the pressure was affected differently by the localized cooling of each region. Given these findings, we discussed the role and interrelatedness of pressure sensation in perceiving large and sequential changes in somatosensory information while standing and leaning forward and backward.

Adult↗

PubMed2004

Depth perception of elementary school students with qualitatively evidenced locomotor impairments.

The purpose of the study was to examine differences in depth perception of students classified according to their gross locomotor skills. The seven qualitative gross locomotor tasks of Ulrich's Test of Gross and Motor Development were used to classify 162 students as either motor impaired (n1 =27) or nonimpaired (n2= 135). The Howard Dollman Apparatus was used to measure depth perception. Analysis showed that the motor-impaired group scored significantly lower than the nonimpaired group on depth perception. Discriminant function analysis indicated that only the running task separated the students by depth perception scores. Subsequent multiple regression analysis confirmed that the running task, along with sliding and galloping, were significant predictors of the students' perception of the third dimension. Physical educators working with students with gross locomotor impairments or low perception of the third dimension need to adjust their teaching and offer opportunities for successful involvement in physical education classes and sports.

Child↗

PubMed1997

Social anxiety and performance in an interpersonal perception task.

The Interpersonal Perception Task-15 videotape served as a criterion measure to test hypotheses about individual differences in interpersonal perception. 160 undergraduates completed the Personal Report of Communication Apprehension Scale, the Shyness and Sociability Scale, and the Interpersonal Perception Task-15. Scores on the Communication Apprehension Scale were negatively correlated with Interpersonal Perception Task-15 scores, as predicted. Scores on the Shyness scale were negatively correlated with scores on the Interpersonal Perception Task-15, while Sociability scale scores were positively correlated. These results underscore the association between social anxiety and interpersonal perception.

Adolescent↗

PubMed1990

Auditive and cognitive factors in speech perception by elderly listeners.

A key issue in research on speech perception in the elderly is whether the difficulties in understanding speech are caused by auditive and/or cognitive factors. Resolving this issue is not only scientific interest but has many practical, i.e. diagnostic and rehabilitative, implications as well. We developed a test battery comprising auditive (sensitivity, frequency selectivity and temporal resolution), cognitive (memory performance, processing speed and intellectual abilities), and speech perception tests (at the phoneme, spondee and sentence level). This test battery was administered to 72 elderly subjects (aged 60 to 93 years). The results show that the deterioration of speech perception in the elderly consists of two statistically independent components (a) a large component mainly representing the progressive high-frequency hearing loss with age which accounts for approximately two-thirds of the systematic variance of the tests of speech perception, and (b) a smaller component (accounting for one-third of the systematic variance of the speech perception tests) mainly representing a general performance decrement due to reduced mental efficiency, which is indicated by a general slowing of performance and a reduced memory capacity. Although both components are correlated with age, it was found that the balance between auditive and cognitive contributions to speech perception performance did not change with age.

Aged↗

PubMed1997

Improved word perception in tinnitus patients following electrical stimulation of the ear: a preliminary report.

The present study showed that there were close relationships between tinnitus relief and improved word perception by means of a grammatically correct but non-sense Japanese word perception test. Fourteen out of 20 patients reported tinnitus relief and improvement in hearing. Nine out of the 14 patients were thought to be significantly improved in word perception. Improved word perception was observed in 7 out of 10 patients whose ears tested were opposite to ears treated while in 2 out of 10 patients whose ears tested were the same as ears treated. Improved word perception was observed in 5 patients at one segment, 2 patients at two segments and 2 patients at three segments. Improved word perception was observed in one patient at the first segment, 5 patients at the second segment, 5 patients at the third segment and 5 patients at the fourth segment. There were no significant differences in hearing level nor age in patients with and without relief of tinnitus.

Electric Stimulation↗

PubMed1997

Improved word perception following electrical stimulation of the ear in hearing-impaired patients without tinnitus.

Improved word perception in hearing-impaired patients following electrical stimulation of ears was shown by means of a grammatically correct but non-sense Japanese 4-segment sentence perception test. Improved word perception was reported in 15 out of 20 patients without tinnitus following electrical stimulation of ears. In 11 out of 15 patients, the number of incorrect words significantly decreased, showing that electrical stimulation of ears improved word perception. Improved word perception was observed in 5 out of 8 patients whose tested ears were contralateral to treated ears while in 8 out of 12 patients whose tested ears were the same as treated ears. The present study suggests that electrical stimulation of ears improves word perception in hearing-impaired patients without tinnitus.

Aged↗

PubMed2004

Unconscious perception: a model-based approach to method and evidence.

Unconscious perceptual effects remain controversial because it is hard to rule out alternative conscious perception explanations for them. We present a novel methodological framework, stressing the centrality of specifying the single-process conscious perception model (i.e., the null hypothesis). Various considerations, including those of SDT (Macmillan & Creelman, 1991), suggest that conscious perception functions hierarchically, in such a way that higher level effects (e.g., semantic priming) should not be possible without lower level discrimination (i.e., detection and identification). Relatedly, alternative conscious perception accounts (as well as the exhaustiveness, null sensitivity, and exclusiveness problems-Reingold & Merikle, 1988, 1990) predict positive relationships between direct and indirect measures. Contrariwise, our review suggests that negative and/or nonmonotonic relationships are found, providing strong evidence for unconscious perception and further suggesting that conscious and unconscious perceptual influences are functionally exclusive (cf. Jones, 1987), in such a way that the former typically override the latter when both are present. Consequently, unconscious perceptual effects manifest reliably only when conscious perception is completely absent, which occurs at the objective detection (but not identification) threshold.

Humans↗

PubMed1990

On the perception of speech from time-varying acoustic information: contributions of amplitude variation.

The cyclic variation in the energy envelope of the speech signal results from the production of speech in syllables. This acoustic property is often identified as a source of information in the perception of syllable attributes, though spectral variation can also provide this information reliably. In the present study of the relative contributions of the energy and spectral envelopes in speech perception, we employed sinusoidal replicas of utterances, which permitted us to examine the roles of these acoustic properties in establishing or maintaining time-varying perceptual coherence. Three experiments were carried out to assess the independent perceptual effects of variation in sinusoidal amplitude and frequency, using sentence-length signals. In Experiment 1, we found that the fine grain of amplitude variation was not necessary for the perception of segmental and suprasegmental linguistic attributes; in Experiment 2, we found that amplitude was nonetheless effective in influencing syllable perception, and that in some circumstances it was crucial to segmental perception; in Experiment 3, we observed that coarse-grain amplitude variation, above all, proved to be extremely important in phonetic perception. We conclude that in perceiving sinusoidal replicas, the perceiver derives much from following the coherent pattern of frequency variation and gross signal energy, but probably derives rather little from tracking the precise details of the energy envelope. These findings encourage the view that the perceiver uses time-varying acoustic properties selectively in understanding speech.

Adult↗

PubMedDate not supplied

Parental perception and factors associated with glycemic control in pediatric patients with type 1 diabetes.

OBJECTIVE: To compare subjective parental perceptions of short-term diabetes control with objective glycated hemoglobin (HbA1c) measurements in a pediatric population. METHODS: Parents of 159 children and adolescents with type 1 diabetes anonymously completed a questionnaire concerning demographics, parental perception of the child's recent glycemic control, concern about nocturnal blood glucose levels, and factors related to severity of the child's diabetes. Nonparametric correlations were performed among all variables and the child's current HbA1c measurement. Good short-term glycemic control was defined as an HbA1c value of < or = 8.5%. RESULTS: Five factors were found to correlate significantly with good glycemic control, and these variables were subjected to a logistic regression analysis. With use of a cutoff value of 0.58, results explained 26% of the variance and had an overall 71% correct classification rate. Children with good glycemic control were younger, had a shorter duration of diabetes, lived in families with higher socioeconomic status, were less likely to experience hospitalizations due to their diabetes, and had parents who "always worried" about nocturnal blood glucose variations. Parental perception and HbA1c values were not significantly related (P>0.19); 60% of the parents correctly perceived the status of diabetes in their children, and 40% misperceived the level of glycemic control. Further analysis suggested that accuracy of parental perception was highly dependent on the child's level of glycemic control. Parents whose children had lower HbA1c values (< or = 7.5%) correctly perceived the status of blood glucose control in their children, whereas parents whose children had poorer glycemic control (HbA1c > or = 9.5%) had inaccurate perceptions. CONCLUSION: Subjective parental perceptions of diabetes control in their children may not correspond to objective assessments. Our findings suggest a need for more educational feedback concerning HbA1c levels and recommended goals for glycemic control.

Adolescent↗

PubMed2005

[Perceptions of classroom goal structures, personal achievement goal orientations, and learning strategies].

We examined the relations among students' perceptions of classroom goal structures (mastery and performance goal structures), students' achievement goal orientations (mastery, performance, and work-avoidance goals), and learning strategies (deep processing, surface processing and self-handicapping strategies). Participants were 323 5th and 6th grade students in elementary schools. The results from structural equation modeling indicated that perceptions of classroom mastery goal structures were associated with students' mastery goal orientations, which were in turn related positively to the deep processing strategies and academic achievement. Perceptions of classroom performance goal stractures proved associated with work avoidance-goal orientations, which were positively related to the surface processing and self-handicapping strategies. Two types of goal structures had a positive relation with students' performance goal orientations, which had significant positive effects on academic achievement. The results of this study suggest that elementary school students' perceptions of mastery goal structures are related to adaptive patterns of learning more than perceptions of performance goal structures are. The role of perceptions of classroom goal structure in promoting students' goal orientations and learning strategies is discussed.

Child↗

PubMed1995

Visual perception and praxis in adults after stroke.

OBJECTIVES: The purpose of this study was to examine the performance of persons with right cerebrovascular accident (RCVA) and persons with left cerebrovascular accident (LCVA) on a variety of measures of praxis and visual perception in order to examine the relative contributions of the left and right cerebral hemispheres to praxis and perception. METHODS: Forty-five subjects, 15 with RCVA, 15 with LCVA, and 15 without CVA (control subjects), were tested on three tests of praxis-praxic production, gesture comprehension, and gesture discrimination-and selected tests of visual perception, including the Judgement of Line Orientation Test, the Motor Free Visual Perception Test, the Hooper Visual Organization Test, and the Line Bisection Test. RESULTS: Subjects in both groups with CVA performed more poorly on all of the tests than did control subjects. The group with LCVA performed most poorly on tests of gesture comprehension and praxis production, whereas the group with RCVA performed most poorly on tests of gesture discrimination and visual perception. CONCLUSION: These findings suggest that both the right and left cerebral hemispheres contribute to different aspects of praxis. Elements of visual perception may be related to gesture comprehension, gesture discrimination, and praxis production in adults who have had stroke. These findings have clinical implications regarding instructional style and perceptual and praxic training.

Aged↗

PubMedDate not supplied

Interns are from Venus, consultants are from Mars: differential perception among clinicians.

OBJECTIVE: To test for the presence of sex-based differences in perception (the notion that men and women "think" differently, and that differences in perception are biologically based) among healthcare professionals. DESIGN: Prospective survey. SETTING AND PARTICIPANTS: 90 medical personnel at a tertiary care hospital in Newcastle, NSW. INTERVENTION: Healthcare professionals were shown two pictures that could be interpreted as depicting either a young or an old person, and a word that could be seen as geometric shapes. MAIN OUTCOME MEASURES: The effects of sex, age, seniority, and specialisation in relation to the first impression of the image, the ability to change one's perception, and the speed of perception. RESULTS: Contrary to popular opinion, male physicians were more likely to perceive the older figures, and just as likely as women to be able to change their perception. Surgeons and junior staff were more likely to see, as well as being faster to form, an impression requiring abstract thought, and were more able to change their perceptions. CONCLUSIONS: Traditional sex stereotypes do not apply to medical personnel, but other age-based stereotypes, and professional rivalries (medical versus surgical) may have some empiric basis.

Adult↗

PubMed2000

Changes in educational placement and speech perception ability after cochlear implantation in children.

OBJECTIVE: The purpose of this study was to evaluate the effect and relationship of paediatric cochlear implantation on educational placement and speech perception ability and to determine the effect of a multilingual background on educational placement and speech perception ability after cochlear implantation. DESIGN: This study consisted of a retrospective chart review of 83 implanted patients and a questionnaire sent to parents of 80 implanted children. SETTING: This study was conducted in a cochlear implant program at a tertiary care centre. METHODS AND OUTCOME MEASURES: From the chart review, the educational placements and speech perception scores of implanted children were determined before and after implantation. In the questionnaire, parents were asked about their preferred educational placement for their child, the language spoken at home, and their impressions of the chosen school program for their child. RESULTS: Of the children who were in nonmainstream school programs at implantation (n = 30), 50% moved toward mainstream with 9 (30%) reaching mainstream placement. Of the children who were preschool at implantation (n = 34), 24 (70%) were placed or planned to be placed in mainstream after implantation. The rate of improvement in speech perception ability was significantly higher in those children who moved toward or remained in mainstream than those who stayed at the same nonmainstream educational placement or moved away from mainstream. Children from a multilingual background were able to achieve similar educational placements and similar rates of progress of speech perception outcome as the only English-speaking children. CONCLUSIONS: Children with cochlear implants have increased educational opportunities, with those children in mainstream and those who have moved toward mainstream demonstrating improved progress in speech perception ability.

Child↗

PubMed2001

Medical care perceptions in elderly patients with musculoskeletal complaints.

BACKGROUND: Musculoskeletal complaints represent the second most common reason for visits to a physician, second only to the common cold. The limited capability of medical treatment for musculoskeletal disease requires modification of communication with patients by attending to their perception of the disease. OBJECTIVES: To assess patients' satisfaction with care provided by their primary physicians, and the relationship of patients' satisfaction to their expectations of that care, perceptions of physician performance, and perceived severity of musculoskeletal disease. METHODS: Questionnaires were administered to 90 community-dwelling elderly patients (mean age 76 +/- 8 years) presenting for follow-up appointments with their primary care physicians. Patients were asked to report on their satisfaction with the medical care provided by the primary physicians for musculoskeletal symptoms, their expectations of that care, their perceptions of their primary physicians' interaction (regarding competence, performance, and communication), and their perceptions of disease severity (based on the number of areas involved, pain frequency and intensity, and impact on daily activity). The effects on the degree of satisfaction were assessed with regard to demographic variables, co-morbidity, site involved, and response to recommended treatment. RESULTS: Most patients (> 85%) expressed overall satisfaction with their doctor's interpersonal skills. Fewer (76.9%) were satisfied with the amount of effort their doctors spend evaluating their musculoskeletal symptoms, the information received regarding their musculoskeletal symptoms (75%), the degree of pain relief (75%), and the degree of functional improvement (61.8%). Level of education and response to recommended treatment for musculoskeletal disease were the only parameters associated with degree of satisfaction (higher education P = 0.005, lower education P = 0.059, medication P = 0.008, rehabilitation P = 0.076). A high level of expectations (regarding physician's care and musculoskeletal disease treatment) was noted. CONCLUSIONS: The high level of patient satisfaction with their primary physicians' care for musculoskeletal symptoms may reflect the overall tendency of the elderly population to be satisfied with its primary care physicians. However, their high level of expectations (related to perceived efficacy of medical treatment) and their unrealistic perceptions of disease may lead to disappointment and non-compliance with their doctor's recommendations. Management of musculoskeletal disease in the elderly should address the patients' disease perceptions, as well as their therapeutic and functional needs.

Aged↗

PubMed2002

Activity in the fusiform gyrus predicts conscious perception of Rubin's vase-face illusion.

We localized regions in the fusiform gyrus and superior temporal sulcus that were more active when subjects viewed photographs of real faces than when they viewed complex inanimate objects and other areas in the parahippocampal gyrus and the lateral occipital lobe that showed more activity during the presentation of nonface objects. Event-related functional magnetic resonance imaging was then used to monitor activity in these extrastriate visual areas while subjects viewed Rubin's vase-face stimulus and indicated switches in perception. Since the spontaneous shifts in interpretation were too rapid for direct correlation with hemodynamic responses, each reported percept (faces or vase) was prolonged by suddenly adding subtle local contrast gradients (embossing) to one side or the other of the figure-ground boundary, stabilizing the percept. Under these conditions, only face-selective areas in the fusiform gyrus responded more strongly during the perception of faces. To control for effects of the physical change to Rubin's stimulus (i.e., addition of embossing), we compared activity when the face contours were embossed after the subject had just reported the onset of perception of either faces or vase. Activity in the fusiform face area responded more strongly under the first condition, despite the fact that the physical stimulus sequences were identical. Moreover, on a trial-to-trial basis, the activity was statistically predictive of the subjects' responses, suggesting that the conscious perception of faces could be made explicit in this extrastriate visual area.

Adult↗

PubMed2004

[How can we assess the perception of induced dyspnea in chronic obstructive pulmonary disease?].

OBJECTIVE: To evaluate various methods for studying the perception of dyspnea in chronic obstructive pulmonary disease (COPD) using a new parameter, the change in Borg scale rating, and others already in use: the linear regression slope and the application of Stevens' law to the response perception curve--ie change in forced expiratory volume in 1 second (delta FEV1)--change in dyspnea (delta dyspnea). PATIENTS AND METHODS: A bronchial challenge test was performed on 70 patients with stable COPD and no contraindications for performing the test (European Respiratory Society criteria), during which dyspnea was measured (Borg scale) after each nebulization. Perception was analyzed using: a) the linear regression slope of delta FEV1 plotted against (delta dyspnea); b) the exponent n of Stevens' law (psi=k phi n, in which psi is delta dyspnea and phi is delta FEV1, with perception being poor when n<1 and good when n>1), and c) change in Borg: difference between dyspnea when FEV1 has fallen 20% and dyspnea after saline inhalation. Subjects were classified according to the slope and change in Borg as hypoperceivers, normal perceivers, or hyperperceivers. These 2 methods of classification were compared using the kappa statistic. RESULTS: According to the exponent n, all patients were hypoperceivers (n<1). According to the slope, there were 33 hypoperceivers, 28 normal perceivers, and 9 hyperperceivers. The change in Borg classified 37 subjects as hypoperceivers, 23 as normal perceivers, and 10 as hyperperceivers. All except 5 subjects were classified in the same way by the slope and the change in Borg (kappa=0.88). In most of the 5 cases of discrepancy, the slope classified subjects as better perceivers. CONCLUSIONS: The n exponent is not valid for evaluating the perception of dyspnea induced by a bronchial challenge test in COPD. Change in Borg is at least as useful as the slope for evaluating perception of dyspnea. The percentage of patients with this disease who are hyperperceivers is high.

Adult↗

PubMed2004

Intraoperative perception and sensation in laser in situ keratomileusis (LASIK).

PURPOSE: To investigate intraoperative perception and sensation during Laser in situ Keratomileusis (LASIK). PATIENTS AND METHOD: Sixty patients with uneventful LASIK were included. All procedures were performed by one surgeon with one technique. Any patient with intra-operative complications was excluded. The patients were asked to fill in the subjective evaluation form regarding their perception and sensation during the operation. RESULTS: Twenty-nine patients (48%) reported no pain and twenty-six patients (43%) reported no burning sensation during the surgery. Nineteen patients (32%) reported no light perception during the suction period of microkeratome. There was no correlation between duration of the suction and no light perception (R2 0.01). Thirty-four patients (56%) reported no trouble in maintaining visual fixation at the red light during the laser treatment. Ten patients (16%) reported they could clearly see the movement during the surgery and 5 out of 10 patients (50% of 16%) reported visual frightening. Fifty cases (84%) reported no visual frightening during the surgery after reassurance of the visual experience by the surgeon before the surgery. CONCLUSIONS: Patients undergoing LASIK may experience different visual perceptions. Reassurance of the intraoperative perception and sensation before the surgery can reduce the visual frightening.

Adult↗