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Objective: An experiment was conducted to investigate the possibility that speech perception could be improved for some cochlear implant (CI) users by adjustment of the frequency allocation to the electrodes, following assessment of pitch perception along the electrode array., Study Sample: Thirteen adult CI users with MED-EL devices participated in the study., Design: Pitch perception was assessed for individual CI electrode pairs using the Pitch Contour Test (PCT), giving information on pitch discrimination and pitch ranking for adjacent electrodes. Sentence perception in noise was also assessed with ten different frequency allocations, including the default., Results: Pitch perception was found to be poorer for both discrimination and ranking scores at either end of the electrode array. A significant effect of frequency allocation was found for sentence scores [F(4.24,38.2) = 7.14, p < 0.001] and a significant interaction between sentence score and PCT ranking score for basal electrodes was found [F(4.24,38.2) = 2.95, p = 0.03]. Participants with poorer pitch perception at the basal end had poorer scores for some allocations with greater basal shift., Conclusions: The results suggest that speech perception could be improved for CI users by assessment of pitch perception using the PCT and subsequent adjustment of pitch-related stimulation parameters.

Objectives: To identify factors preimplantation associated with postimplantation speech perception improvement in the adult congenitally deaf population., Design: Forty-four adult cochlear implant (CI) patients who had a severe to profound hearing loss from birth were identified from this centre's database. Eight preimplantation factors, speech intelligibility, preimplantation hearing levels, communication mode, preimplantation speech perception scores, progression of hearing loss, age at implantation, hearing aid use preimplantation, and gender, were recorded during the CI assessment process. These factors were investigated to determine their effect on speech perception improvement postimplantation. The outcome measures were the improvement in scores for the BKB Sentence test and CUNY Sentence test with lipreading after implantation. In the final analysis, 26 patients were included in the CUNY analysis, and 30 patients were included in the BKB analysis., Results: Speech intelligibility rating, preimplantation hearing levels, and communication mode were shown to be significantly associated with improvements in speech perception postimplantation., Conclusion: Three factors were identified that affected speech perception improvement postimplantation: speech intelligibility, preimplantation hearing levels, and communication mode. These factors can be used to counsel CI patients regarding potential speech perception improvements from cochlear implantation, although these are based on average data and may not reflect individual performance.

Objectives: To assess the perceived pitch and naturalness of popular music by cochlear implant (CI) users., Methods: Eleven experienced post-lingually deafened adult CI users rated the pitch, naturalness, and clarity of a popular song with 10 frequency allocation settings, including the default. The alternative settings all had logarithmic frequency spacing and frequency shifts of less than one octave compared with the default map. For maps which were perceived as having incorrect pitch, participants adjusted the pitch of the song in real time using a slider, in order to normalize it, and the amount of adjustment was recorded., Results: The default map was rated as having close to correct pitch. Naturalness rating was negatively correlated with basal shift from a baseline logarithmic map, which was the same as the default map for basal electrodes (R(2) = 0.77). Ratings of the clarity of the lyrics were adversely affected by basal shift. The majority of participants were able to rate and adjust pitch appropriately. The frequency shift in the map was highly correlated with participants' adjustments of the pitch slider (R(2) = 0.94), but the adjustments were less than expected for the majority of participants., Discussion: The pitch ratings for the default allocation suggest that participants have acclimatized to their processors' frequency allocations. Adjustment of the pitch of the song was possible for the majority and suggested that all but one participant was experiencing frequency compression. Expansion of the frequency allocation might help to alleviate this., Conclusion: Adjustment of the pitch of a popular song could be helpful for tuning CIs.

Objectives: Many cochlear implant (CI) users wish to enjoy music but are dissatisfied by its quality as perceived through their implant. Although there is evidence to suggest that training can improve CI users' perception and appraisal of music, availability of interactive music-based aural rehabilitation for adults is limited. In response to this need, an 'Interactive Music Awareness Programme' (IMAP) was developed with and for adult CI users., Methods: An iterative design and evaluation approach was used. The process began with identification of user needs through consultations, followed by use of mock-up applications in workshops. Feedback from these were used to develop the prototype IMAP; a programme of 24 interactive sessions, enabling users to create and manipulate music. The prototype IMAP was subsequently evaluated in a home trial with 16 adult CI users over a period of 12 weeks., Results: Overall ratings for the prototype IMAP were positive and indicated that it met users' needs. Quantitative and qualitative feedback on the sessions and software in the prototype IMAP were used to identify aspects of the programme that worked well and aspects that required improvement. The IMAP was further developed in response to users' feedback and is freely available online., Conclusions: The participatory design approach used in developing the IMAP was fundamental in ensuring its relevance, and regular feedback from end users in each phase of development proved valuable for early identification of issues. Observations and feedback from end users supported a holistic approach to music aural rehabilitation.

Individual adjustment of frequency-to-electrode assignment in cochlear implants (CIs) may potentially improve speech perception outcomes. Twelve adult CI users were recruited for an experiment, in which frequency maps were adjusted using insertion angles estimated from post-operative x rays; results were analyzed for ten participants with good quality x rays. The allocations were a mapping to the Greenwood function, a compressed map limited to the area containing spiral ganglion (SG) cells, a reduced frequency range map (RFR), and participants' clinical maps. A trial period of at least six weeks was given for the clinical, Greenwood, and SG maps although participants could return to their clinical map if they wished. Performance with the Greenwood map was poor for both sentence and vowel perception and correlated with insertion angle; performance with the SG map was poorer than for the clinical map. The RFR map was significantly better than the clinical map for three participants, for sentence perception, but worse for three others. Those with improved performance had relatively deep insertions and poor electrode discrimination ability for apical electrodes. The results suggest that CI performance could be improved by adjustment of the frequency allocation, based on a measure of insertion angle and/or electrode discrimination ability.

Background: It has been reported that after speech perception, music appreciation is the second most commonly expressed requirement among cochlear implant (CI) recipients. Certain features of music are known to be more readily accessible; however, provision of music rehabilitation for adult CI users is limited., Purpose: A series of music workshops were organized to (1) enable attendees to explore which aspects of music they are able to perceive and appreciate; (2) raise awareness of listening strategies, technology, and rehabilitation resources for music; and (3) develop ideas, and prototype software, for inclusion in a music rehabilitation program. The therapeutic value of music workshops was concurrently investigated., Research Design: A qualitative, longitudinal study was used. Two consultation meetings were held before a series of nine music workshops that occurred over a period of 5 mo., Study Sample: Five adult CI users participated in consultations before the workshops. Twenty-eight adult CI users from the South of England Cochlear Implant Centre attended at least one of the workshops., Intervention: Participants could attend as many workshops as they wished. Each workshop lasted between 2 to 2.5 hr and included individual computer-based and group activities., Data Collection and Analysis: Responses to open-ended questions were transcribed in the consultation meetings and used to develop workshop activities. A preworkshop survey was used to determine attendees' aspirations and expectations. Postworkshop surveys were used to qualitatively and quantitatively evaluate attendees' immediate reactions to the workshop content, software, and perceived benefits. A 2-month, postworkshop survey evaluated the longer-term impact of the workshops., Results: Overall reaction to the workshops and prototype software was positive. All attendees indicated that they anticipated changing how they engaged with music as a result of the workshops, and data from the preworkshop and postworkshop surveys suggest a positive change in listening habits., Conclusions: The workshops proved to be an effective means of simultaneously encouraging music exploration in a social and safe environment and obtaining feedback on prototype rehabilitation materials. Survey data suggested that through group listening and practical activities, certain aspects of music can be accessible and rewarding through a CI, leading to positive changes in attitude and behavior toward music., (American Academy of Audiology.)

Tests for quantifying the music perception abilities of cochlear implant users are currently being developed and trialled at the South of England Cochlear Implant Centre. In addition to measures of speech perception, tests of rhythm, and pitch have been administered to MED-EL C40+ implant users before and after upgrading from the TEMPO+ processor with continuous interleaved sampling strategy to the OPUS 2 processor with fine structure processing strategy, with the aims of comparing device performance and evaluating the potential of music perception tests for informing processor upgrades and tuning. Eight experienced adult C40+ implant recipients performed tests of rhythm and pitch discrimination using the TEMPO+ processor and, after a minimum of 6 weeks acclimatization, using the OPUS 2 processor. Stimuli included piano and sine tones in two note ranges for the pitch tasks, and drum beats for the rhythm task. Rhythm, pitch, and speech perception scores were comparable for both processors. An effect of note range was observed (z = -2.52, p = 0.008 (two-tailed), r = -0.63), which indicated that the higher range of notes used for the pitch tasks was easier for participants than the lower range. Measures of pitch discrimination in different frequency ranges further informed changes made to one participant's map, resulting in improved pitch discrimination and speech perception scores. The outcomes of this study demonstrate that music perception tests can provide important additional measures for tuning cochlear implant parameters and assessing the impact of changes to device type and processing strategy.

Objective: The development of auditory receptive skills and spoken language is often delayed in children who use cochlear implants, which may affect their appreciation of and responses to music. This in turn may be interpreted as disinterest in music. A questionnaire was developed to determine whether differences in exposure and responses to music exist between young cochlear implant recipients and their normally hearing peers., Design: The questionnaire was developed by a multidisciplinary team and distributed to parents of preschool children with normal hearing and to parents of preschool children who had been implanted at least one year prior., Study Sample: The cochlear implant group comprised 23 children and was gender and age matched (within ±2 months) to a group of children with normal hearing., Results & Conclusions: Young cochlear implant recipients receive similar exposure to audiovisual music media, parental singing and musical instruments at home. However, the data suggest that they receive less exposure to children's music presented without visual stimuli. Parents also reported less sophisticated responses to music for this group. The findings of this study have important implications concerning the provision of age-appropriate music habilitation materials and activities for young cochlear implant recipients.