This document summarizes research on cochlear implants conducted in New Zealand. It discusses improvements in speech perception over time for implant users, changes in the auditory brain measured by evoked potentials, benefits of auditory training and noise reduction, and the relationship between cognition and speech perception. Recent studies showed noise reduction improved speech scores and dual task performance depended on working memory ability. The research aims to better understand variable outcomes and rehabilitation factors for adult cochlear implant users.
The risk of cognitive impairment assosiated with congenital deafness in child...MaritLobben
Overall poor performance of cognitive and behavioral skills are predictors of poor language skills and vice versa: we need to realise that language, perception, thought, and problem-solving constitute a continuum of interdependent functions.
Some refer to this as polymodal development of the sensory apparatus, as the developing trend in typically developing individuals (Bailey, 2002).
Sensory input participates not only in a simple additive way but also has a reciprocal influence in that it modulates synergistically the unyielding of neural networks.
This is probably why children with deafness exhibit subtle differences from hearing subjects also in functions that seem far removed from the auditory function, such as visuomotor integration or abstract thinking.
From a neuroscientific perspective, this is an interesting demonstration in relation to the extent of the role of hearing in the building of neural networks that result from sensorimotor exposure and practice.
The risk of cognitive impairment assosiated with congenital deafness in child...MaritLobben
Overall poor performance of cognitive and behavioral skills are predictors of poor language skills and vice versa: we need to realise that language, perception, thought, and problem-solving constitute a continuum of interdependent functions.
Some refer to this as polymodal development of the sensory apparatus, as the developing trend in typically developing individuals (Bailey, 2002).
Sensory input participates not only in a simple additive way but also has a reciprocal influence in that it modulates synergistically the unyielding of neural networks.
This is probably why children with deafness exhibit subtle differences from hearing subjects also in functions that seem far removed from the auditory function, such as visuomotor integration or abstract thinking.
From a neuroscientific perspective, this is an interesting demonstration in relation to the extent of the role of hearing in the building of neural networks that result from sensorimotor exposure and practice.
Efficacy of auditory training in adults with hearing loss and auditory proces...HEARnet _
The biggest challenge for people with hearing loss is to communicate in noise. Even some normal Even some normal hearing older adults have issues understanding speech in noise.
The current study was conducted for children with CP who are Hindi speakers, to analyze voice onset time (VOT) patterns associated with stop consonants. The purpose was to gain more detailed insights into how the coordination and timing needed for these articulations may be affected by the neurodevelopmental disorder ultimately opening up avenues for improved treatment solutions. Total 20 children in the age group of 6 - 8 years were taken for the study which was divided into two groups: 10 children diagnosed with spastic CP and 10 typical children speaking Hindi. Measuring VOT through voice analysis helped us gauge the interval lapsing between releasing a stop closure and voicing onset. The outcomes exhibited considerable variation in VOT values when comparing groups of children with cerebral palsy (CP) against typical children speaking Hindi. Specifically, CP children showed longer VOT durations indicating delayed voicing onset compared to controls. These findings point out that children who have cerebral palsy exhibit different timing and coordination patterns upon pronouncing stop consonants. It is essential to grasp the VOT traits in children with cerebral palsy. This will aid in creating suitable intervention techniques that enhance their speech comprehensibility and communication skills.
Autism challenges the individual, their family, the community and the practitioner. The complexity and variety of symptoms that define Autism Spectrum Disorders (ASD) require service providers to constantly update their knowledge and skills to best serve these individuals. Sensorimotor synchronization training with Interactive Metronome (IM), as part of a comprehensive treatment plan, has the potential to directly and positively influence the person’s ability to learn and engage with the world around him. This course will introduce practitioners to new advances in our understanding of ASD, including the pivotal role of timing & rhythm for speech, language, pragmatic, cognitive, motor and sensory processing skills. Participants will learn strategies to evaluate the unique strengths and needs of each individual with ASD as well as how to develop and implement effective IM training with consideration for communication, sensory, motor & behavioral challenges. The expert presenter will incorporate several videos and real examples to illustrate techniques. Take the course at https://secure.interactivemetronome.com/NetSite/IM/CEU/SimpleRegistration.aspx?course_id=2778
Deaf Speech Assessment Using Digital Processing Techniquessipij
This paper mainly deals with analysis on acoustical characteristics of speeches of deaf people for the purpose of increasing the speech recognition rate. Since speech to text or sound system for a normal
speaker is available, by designing a speech to text or sound system for deaf, they can make use of all computer aided devices and normal speakers can also communicate with them freely. Fundamental frequency or the pitch frequency of the vocal fold and resonant frequency of the vocal tract or formants are considered for analysis which are the foremost characteristics of speech. Compared to normal speech, there is a high variability in deaf speech and by hearing once we couldn’t understand it. Deaf speech is taken from children in the age group of 5-10 years from Maharishi vidya mandir centre for hearing impaired. Another set of speech were taken from normal speakers for comparison. Initially the input is sampled, filtered, windowed and Pitch frequency is determined for each frame. Similarly first six formants are determined for each frame. The fundamental frequency contour of deaf children exhibit unusual characteristics, and the formants are also very closed. This shows that, pitch and formants cannot be used as features for deaf speech recognition. At the same time, variation in the pitch and formants for deaf is larger than normal speakers it can be used for speaker classification purpose.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Efficacy of auditory training in adults with hearing loss and auditory proces...HEARnet _
The biggest challenge for people with hearing loss is to communicate in noise. Even some normal Even some normal hearing older adults have issues understanding speech in noise.
The current study was conducted for children with CP who are Hindi speakers, to analyze voice onset time (VOT) patterns associated with stop consonants. The purpose was to gain more detailed insights into how the coordination and timing needed for these articulations may be affected by the neurodevelopmental disorder ultimately opening up avenues for improved treatment solutions. Total 20 children in the age group of 6 - 8 years were taken for the study which was divided into two groups: 10 children diagnosed with spastic CP and 10 typical children speaking Hindi. Measuring VOT through voice analysis helped us gauge the interval lapsing between releasing a stop closure and voicing onset. The outcomes exhibited considerable variation in VOT values when comparing groups of children with cerebral palsy (CP) against typical children speaking Hindi. Specifically, CP children showed longer VOT durations indicating delayed voicing onset compared to controls. These findings point out that children who have cerebral palsy exhibit different timing and coordination patterns upon pronouncing stop consonants. It is essential to grasp the VOT traits in children with cerebral palsy. This will aid in creating suitable intervention techniques that enhance their speech comprehensibility and communication skills.
Autism challenges the individual, their family, the community and the practitioner. The complexity and variety of symptoms that define Autism Spectrum Disorders (ASD) require service providers to constantly update their knowledge and skills to best serve these individuals. Sensorimotor synchronization training with Interactive Metronome (IM), as part of a comprehensive treatment plan, has the potential to directly and positively influence the person’s ability to learn and engage with the world around him. This course will introduce practitioners to new advances in our understanding of ASD, including the pivotal role of timing & rhythm for speech, language, pragmatic, cognitive, motor and sensory processing skills. Participants will learn strategies to evaluate the unique strengths and needs of each individual with ASD as well as how to develop and implement effective IM training with consideration for communication, sensory, motor & behavioral challenges. The expert presenter will incorporate several videos and real examples to illustrate techniques. Take the course at https://secure.interactivemetronome.com/NetSite/IM/CEU/SimpleRegistration.aspx?course_id=2778
Deaf Speech Assessment Using Digital Processing Techniquessipij
This paper mainly deals with analysis on acoustical characteristics of speeches of deaf people for the purpose of increasing the speech recognition rate. Since speech to text or sound system for a normal
speaker is available, by designing a speech to text or sound system for deaf, they can make use of all computer aided devices and normal speakers can also communicate with them freely. Fundamental frequency or the pitch frequency of the vocal fold and resonant frequency of the vocal tract or formants are considered for analysis which are the foremost characteristics of speech. Compared to normal speech, there is a high variability in deaf speech and by hearing once we couldn’t understand it. Deaf speech is taken from children in the age group of 5-10 years from Maharishi vidya mandir centre for hearing impaired. Another set of speech were taken from normal speakers for comparison. Initially the input is sampled, filtered, windowed and Pitch frequency is determined for each frame. Similarly first six formants are determined for each frame. The fundamental frequency contour of deaf children exhibit unusual characteristics, and the formants are also very closed. This shows that, pitch and formants cannot be used as features for deaf speech recognition. At the same time, variation in the pitch and formants for deaf is larger than normal speakers it can be used for speaker classification purpose.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Top 10 Best Ayurvedic Kidney Stone Syrups in India
CI Forum Purdy et al CI research.pptx
1. Breaking the Sounds of Silence
Adult Cochlear Implant Forum
11 March 2017
Cochlear Implant Research in New Zealand
(45 minutes): 1.45-2.30 pm, 2.45-3.30 pm, 3.45-4.30 pm
Suzanne C Purdy
Speech Science
School of Psychology
2. Captioning
Workshop: NZ Research (SP) Suzanne Purdy
Room 731.203 (LC)
http://captioningstudio.com/live/?bookingref=GXMG5DZP482
03&fs=40
bookingref=GXMG5DZP48203
Live stream: https://auckland.zoom.us/j/828466835
3. • Improvements in speech perception over time are well
documented for cochlear implant users
• Most improvement occurs within a short time after cochlear
implantation in adults
• Some studies show a plateau in performance after several
years
• Auditory evoked potentials (brain responses to sound) are of
interest as they provide an objective measure of auditory
brain change
• Some evoked potential measures, especially cortical evoked
potentials, correlate with performance
Background
3
4. Topics
1. Auditory evoked potentials
2. Auditory plasticity and training
3. Cognition and speech in noise in people with cochlear implants
4. Processing of speech emotion (‘prosody’)
(5 published New Zealand studies)
7. 1. Electrophysiological and
speech perception measures of
auditory processing in
experienced adult cochlear
implant users
AS Kelly, SC Purdy, PR Thorne (2005).
Clin Neurophys 116:1235-46.
250 Hz
4 kHz
Black = control group
Red = ‘better’ CI: sentence scores >85%
Blue = ‘poorer’ CI: sentence scores <40%
• Age range 27–74 years
• CI use 1.3-5.2 years
• Nucleus CI–22M
• Evoked potentials recorded to
tones delivered via
loudspeaker
P1
N1
P2
P1
N1
P2
8. 2. Speech scores improve over time
0
20
40
60
80
100
Visit (months)
Speech
score
(%)
sentences
phonemes
words
0 1 3 6 9
Seminars in Hearing Volume 37 (1) · February 2016
CI24 implant users
9. Evoked potentials improve over time, but with
differing time course: 57 year old with congenital
hearing loss, profoundly deaf for 10 years. P1 changed
very little, N1 reached stable amplitudes at 1 month,
P2 increased in amplitude over the 9 months.
Switch on
1 month
3 months
6 months
9 months
P1
N1
P2
10. Improvements in P2 area over the five visits
• no change for most electrode locations over first 6 months
• 8 of the 10 people had right ear implants
• steady P2 increase over time for C4 (right hemisphere recording)
https://www.sunshinecoastdaily.co
m.au/news/dad-gets-cochlear-
implant-tattoos-support-his-
kids/2991160/
12. Auditory training is a way to
reduce variability in CI outcomes
– Sound and Beyond (Cochlear)
– Hearing for Life (Advanced Bionics)
– only a few independent studies have trialed these programs
independently from the developers (Fu et al., 2007 & Stacey
et al., 2010)
13. Speech in noise scores [and spectral (pitch) discrimination] improved after training
13
0
10
20
30
40
50
60
70
80
v1 v2 v3 v4
Easy Noise Hard Noise
*
15. 4. Impact of cognition and noise reduction on speech
perception in adults with unilateral cochlear implants
Investigators: Suzanne Purdy¹, David Welch2, Ellen
Giles², Catherine Morgan3, Renique Tenhagen¹, Abin
Kuruvilla-Mathew¹
¹Speech Science, Faculty of Science, University of Auckland
²Audiology, Faculty of Medical & Health Sciences, University of Auckland
3Cochlear Ltd, Sydney, Australia
in press, Cochlear Implants International
16. What is cognition?
cog·ni·tion
/kägˈniSHən/
Noun
1.The mental action or process of acquiring knowledge and
understanding through thought, experience, and the
senses.
2. A result of this; a perception, sensation, or intuition.
Synonyms
knowledge – cognizance – acquaintance
http://www.mcgill.ca/cogsci/
17. Cognitive processes
• Executive function (“involved in complex cognitions, such as
solving novel problems, modifying behaviour in the light of
new information, generating strategies or sequencing
complex actions” Elliot 2003 p.50)
• Memory
• Attention
Reference: R. Elliot. Executive functions & their disorders.
British Medical Bulletin 2003;65:49–59)
18. Listening to speech in noise [effortful
listening] depends on hearing and cognition
http://www.brainvolts.northwestern.edu/projects/speech/speechinnoise/index.php
20. Links between cognition and speech
perception with hearing aids
• Thomas Lunner (2003) Cognitive function in relation to hearing aid
use. International Journal of Audiology, 42:sup1, 49-58.
• Thomas Lunner, Mary Rudner, Jerker Rönnberg (2009). Cognition
and hearing aids. Scandinavian Journal of Psychology, 50, 395–403
• Reading span task – process & retain information
simultaneously
• Working memory capacity measured by the reading
span test influenced speech recognition thresholds
in 72 new hearing aid users (40% of variance)
21. Reading span correlated with speech
perception in noise in new hearing aid users
Participants listen to sequences of letters that need to be
recalled at the end
Each letter in the sequence is preceded by an auditory semantic
categorization test – sentence makes sense? yes or no?
Letter recall is tested by asking participants to select letters
they have already seen from a provided letter matrix
http://www.millisecond.com/download/library/v5/L
isteningSpan/AutomatedLSPAN.manual
22. Processing sentences
• The host greeted all the guests and asked them to sit at the
{table | sky}.
• John never liked {crowds | chocolate} and that is why he now
lives in the country.
http://www.pitt.edu/~tol7/res/research/psych-tests/rspan/
23. Questions
1. Does SmartSound iQ (SNR-NR) noise reduction algorithm
improve speech perception and decrease listening effort for
CI recipients listening to speech in noise?
2. What is the ability of people with poorer or better
cognitive ability to benefit from the noise reduction?
25. Dual task
• Primary listening task
(repeat sentences in noise)
• Secondary visual task
– correct identification of a
number in a visual stream of
numbers
– speed & accuracy measured
Signal+Noise
27. Good vs. poor working memory
• Trend for scores to be better
with noise reduction ON for
those with better with working
memory during dual task
• No difference in speech scores
with noise reduction ON vs.
OFF for those with poorer
working memory
29. Key points
• Speech perception with a CI varies but improves with
experience and with training
• Brain responses to sound reflect auditory deprivation and can
change over time with a CI (brain ‘plasticity’)
• Some brain responses correlate with performance but this
differs across studies
• Improved auditory attention and/or pitch perception could
mediate improved P2 evoked responses
• Working memory may influence speech perception scores and
interact with CI processing (further research underway)
• Perception of emotion in speech may be challenging – this
could add to listening effort
31. Acknowledgements
• CI participants
• Deafness Research Foundation
• Cochlear Ltd
• Pindrop Foundation
Questions? Email me at sc.purdy@auckland.ac.nz
32. Abstract
New Zealand hearing researchers have been investigating outcomes and
rehabilitation for adults using cochlear implants since the 1990s. This presentation
will talk about findings of some of this research, including variable speech
perception outcomes for adults and factors contributing to this. Changes in the
auditory brain have been shown using auditory evoked potentials (electrical activity
from the brain in response to sound that can be measured with sensors on the
scalp). Brain changes occur within a short time after an adult receives a cochlear
implant and continue over an extended period. Recent research has shown that
adults who have used their implants for a long time can still benefit from auditory
training and noise reduction in the cochlear implant improves speech outcomes but
this may depend on cognitive factors such as memory.
Editor's Notes
Fu’s program is CAST - Computer-Assisted Speech Training (CAST) program and CAST is a research tool developed at the House Ear Institute for the purpose of speech perception testing and training. Three commercially available products have been developed for cochlear implant recipients based on the CAST technology: Sound and Beyond (distributed by Cochlear Americas), Hearing Your Life (distributed by Advanced Bionics Corp, a division of Boston Scientific), and Melody Speech T
raining Software (distributed by Melody Medical Instruments Corp).
The review paper by Fanshawe et al is not restricted to CIs, nevertheless, it is a good review of 13 papers that have evaluated CBAT
1. Listening in noise is often perceived to be effortful. This is partly because cognitive resources are engaged in separating the target signal from background noise, leaving fewer resources for storage and processing of the content of the message in working memory.
2. Will the SNR NR noise reduction algorithm provide a release of cognitive ability -
Explain TEST SPEECH FROM FRONT NOISE FROM FRONT condition
Main effect: when HINT sentences were presented at a fixed SNR, the percentage of words correctly identified was recorded.
There was an improvement on word score when noise reduction was on for all the CI recipients.
Analysis =repeated measures ANOVA to test whether people improved in hearing ability with the NR feature switched on (mean =52% vs 45%). There was no interaction with digit span or coding . The word score improved independently of cognitive ability. Improvement was statistically significant (p=0.038)
There was no interaction with digit span or coding. Meaning The word score improved independently of cognitive ability.
This is similar to other studies
Listening task (HINT sentences presented in noise at SRT of 71%)
71% SRT was identified prior to dual task using adaptive 2 down 1 up procedure.
Speech and noise both coming from same speaker directly in front of listener
Visual task (correct identification of target number in a previous sequence- speed & accuracy)
Participant responds Y or N on computer keyboard ( as quickly as possible) to presence of a number in a visual stream of numbers e.g. 3,8,2,9,4 … 8,
Measures of different cognitive abilities so 2 measures treated separately in analysis digit span (WM)& coding tasks (executive function)did not correlate well (r=0.475, p=0.101)
Adults were identified in the analysis as those w good WK and poor WK based on their (raw scores on digit span tasks (= cumulative score across DS forward, backward & sequencing) Good
The digit span test is primarily a measure of the intactness of your auditory sensory memory. It measures the number of individual sounds you can hold in mind at one time. The examiner reads a string of digits and the patient is required to repeat them back in the same order. We start with short strings of two or three digits, and we increase the length of the string until the patient can no longer repeat them back accurately.