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Biomedical subjects

R C Dowell

Publications and source records attributed to R C Dowell.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1989

Results for two children using a multiple-electrode intracochlear implant.

Assessments in speech perception, speech production, and language skills were conducted on two children, 5 and 10 years old at the time of surgery, using the Nucleus multiple-electrode cochlear implant. Data were collected pre- and post-operatively to measure changes in performance over time. For closed-set speech perception tests in the audition alone condition, post-operative performance was generally better than pre-operative performance and performance improved post-operatively for both patients. In closed-set vowel and consonant identification and open-set sentence perception for the older patient, post-operative improvements from the vision alone to the auditory-visual condition were recorded and performance improved post-operatively in both conditions. In all measures of speech production for both patients, post-operative scores were higher than pre-operative scores and performance improved post-operatively. In language skills, post-operative scores were higher than pre-operative scores and scores improved post-operatively in all measures for both patients.

Child↗
PubMed1988

Initial experience with children using the Nucleus 22 Channel cochlear implant.

The Nucleus 22 Channel cochlear prosthesis developed by the University of Melbourne and Cochlear Pty Ltd is now being used in over 90 clinics worldwide, in fourteen countries and fifteen languages. A total of thirty adolescents and thirty-nine children have now been implanted in Australia, America and more recently Germany. There have been no significant postoperative complications, and the device has been successfully programmed in children as young as two years nine months. Comprehensive evaluation and training programs are being undertaken with each implanted child to assess long term development of speech perception and communication skills. The average postoperative stimulation time for most of the children implanted is around 3 months, so as yet, little data has been recorded on these patients. However, the two original children implanted in Melbourne have now been using their speech processors in excess of 18 months. The focus of this paper will be on the performance of these two children.

Child↗
PubMed1987

A multiple-electrode intracochlear implant for children.

A multiple-electrode intracochlear implant that provides 21 stimulus channels has been designed for use in young children. It is smaller than the adult version and has magnets to facilitate the attachment of the headset. It has been implanted in two children aged 5 and 10 years. The two children both lost hearing in their third year, when they were still learning language. Following implantation, it was possible to determine threshold and comfortable listening levels for each electrode pair. This was facilitated in the younger child by prior training in scaling visual and electrotactile stimuli. Both children are regular users of the implant, and a training and assessment program has been commenced.

Child↗
PubMed1987

Vowel and consonant recognition of cochlear implant patients using formant-estimating speech processors.

Vowel and consonant confusion matrices were collected in the hearing alone (H), lipreading alone (L), and hearing plus lipreading (HL) conditions for 28 patients participating in the clinical trial of the multiple-channel cochlear implant. All patients were profound-to-totally deaf and "hearing" refers to the presentation of auditory information via the implant. The average scores were 49% for vowels and 37% for consonants in the H condition and the HL scores were significantly higher than the L scores. Information transmission and multidimensional scaling analyses showed that different speech features were conveyed at different levels in the H and L conditions. In the HL condition, the visual and auditory signals provided independent information sources for each feature. For vowels, the auditory signal was the major source of duration information, while the visual signal was the major source of first and second formant frequency information. The implant provided information about the amplitude envelope of the speech and the estimated frequency of the main spectral peak between 800 and 4000 Hz, which was useful for consonant recognition. A speech processor that coded the estimated frequency and amplitude of an additional peak between 300 and 1000 Hz was shown to increase the vowel and consonant recognition in the H condition by improving the transmission of first formant and voicing information.

Cochlear Implants↗
PubMed1987

Acoustic parameters measured by a formant-estimating speech processor for a multiple-channel cochlear implant.

In order to assess the limitations imposed on a cochlear implant system by a wearable speech processor, the parameters extracted from a set of 11 vowels and 24 consonants were examined. An estimate of the fundamental frequency EF 0 was derived from the zero crossings of the low-pass filtered envelope of the waveform. Estimates of the first and second formant frequencies EF 1 and EF 2 were derived from the zero crossings of the waveform, which was filtered in the ranges 300-1000 and 800-4000 Hz. Estimates of the formant amplitudes EA 1 and EA 2 were derived by peak detectors operating on the outputs of the same filters. For vowels, these parameters corresponded well to the first and second formants and gave sufficient information to identify each vowel. For consonants, the relative levels and onset times of EA 1 and EA 2 and the EF 0 values gave cues to voicing. The variation in time of EA 1, EA 2, EF 1, and EF 2 gave cues to the manner of articulation. Cues to the place of articulation were given by EF 1 and EF 2. When pink noise was added, the parameters were gradually degraded as the signal-to-noise ratio decreased. Consonants were affected more than vowels, and EF 2 was affected more than EF 1. Results for three good patients using a speech processor that coded EF 0 as an electric pulse rate, EF 1 and EF 2 as electrode positions, and EA 1 and EA 2 as electric current levels confirmed that the parameters were useful for recognition of vowels and consonants. Average scores were 76% for recognition of 11 vowels and 71% for 12 consonants in the hearing-alone condition. The error rates were 4% for voicing, 12% for manner, and 25% for place.

Cochlear Implants↗
PubMed1987

The University of Melbourne--nucleus multi-electrode cochlear implant.

To summarize, our preliminary results indicate that some prelingually deaf patients may get worthwhile help from a multiple-electrode cochlear implant which extracts formants. They can understand words and running speech better when using the cochlear implant with lip-reading compared to lip-reading alone. It has been encouraging that these improvements can occur in young adults and teenagers. It has also been encouraging that some can recognize place pitch as well as rate pitch. There are, however, considerable variations in performance and this may be due to the following factors: whether they have had some hearing after birth, the method of education used, the motivation of the patient and age at implantation. In conclusion it is important to emphasize that deaf children are severely disadvantaged however good their teacher of the deaf. Research on cochlear implants offers hope for profoundly-totally deaf children. These developments will not replace the caring, competent educators but complement their skills. There is also a greater need than ever for an interdisciplinary approach to these children.

Animals↗
PubMed1987

Recent developments with the nucleus 22-electrode cochlear implant: a new two formant speech coding strategy and its performance in background noise.

A clinical evaluation of speech processing strategies for the Nucleus 22-electrode cochlear implant showed improvements in understanding speech using the new FOF1F2 speech coding strategy instead of the F0F2 strategy. Significant improvement in closed-set speech recognition in the presence of background noise was an additional advantage of the new speech processing strategy.

Cochlear Implants↗
PubMed1987

Preliminary results for the cochlear corporation multielectrode intracochlear implant in six prelingually deaf patients.

The preliminary results from this study indicate that some prelingually deaf patients may get worthwhile help from a multiple-electrode cochlear implant that uses a formant-based speech processing strategy. It is encouraging that these improvements can occur in young adults and teenagers. The results for two children are also encouraging. A 10-year-old child obtained significant improvement on some speech perception tests. It was easy to set thresholds and comfortable listening levels on a 5-year-old child, and he is now a regular user of the device. There are, however, considerable variations in performance among the prelingual patients, which may be related to the following factors: whether they have had some hearing after birth, the method of education used, the motivation of the patient, and age at implantation.

Adolescent↗
PubMed1986

Speech recognition for 40 patients receiving multichannel cochlear implants.

We collected data on 40 patients who received the Nucleus multichannel cochlear implant. Results were reviewed to determine if the coding strategy is effective in transmitting the intended speech features and to assess patient benefit in terms of communication skills. All patients demonstrated significant improvement over preoperative results with a hearing aid for both lipreading enhancement and speech recognition without lipreading. Of the patients, 50% demonstrated ability to understand connected discourse with auditory input only. For the 23 patients who were tested 12 months postoperatively, there was substantial improvement in open-set speech recognition.

Adult↗
PubMed1985

Telephone use by a multi-channel cochlear implant patient. An evaluation using open-set CID sentences.

A totally deaf person with a multiple-channel cochlear prosthesis obtained open-set speech discrimination using the telephone. CID Everyday Sentences were presented by telephone to the patient, who repeated an average of 21 per cent of key words correctly on the first presentation, and 47 per cent when a repeat of the sentences was permitted. This result is consistent with the patient's reports of telephone usage.

Adult↗
PubMed1985

Clinical results with a hearing aid and a single-channel vibrotactile device for profoundly deaf adults.

The speech perception of a group of 19 adults with post-lingual profound to total hearing loss was tested with nine closed-set speech tests without lipreading, two open-set tests without lipreading and two open-set speech tests with lipreading. The subjects were all prospective cochlear implant patients participating in a clinical trial of the implant and the results reported here were obtained as part of the pre-operative assessment. They were divided into groups on the basis of their prior experience with the aid(s), their speech detection thresholds with the two aids and their personal preferences. Seven of the subjects used a hand-held single-channel vibrotactile device and the other 12 used a powerful conventional hearing aid. Subjects from each group scored significantly better than chance on the closed set tests without lipreading. Training or regular hearing aid use was correlated with good performance on the closed-set tests. No subject showed a significant improvement of the lipreading score when the aid was used as a supplement. The use of sophisticated wearable tactile devices and extensive training may allow a better result, but in this clinical program, neither a hearing aid nor a single-channel vibrotactile device greatly benefited the postlingually profoundly deaf adults.

Adult↗
PubMed1984

Clinical trial of a multi-channel cochlear prosthesis: results on 10 postlingually deaf patients.

The clinical trial of a multi-channel cochlear prosthesis has been carried out on 10 profoundly-totally deaf adult patients. Speech perception tests have shown that all the patients received significant benefit from the device. They obtained improvements in understanding running speech from 47% to 550% when using the device in conjunction with lipreading compared to lipreading alone. With an open-set CID sentence test, three patients obtained scores showing an ability to understand speech without the need to lipread, and a further three patients had scores indicating they could also receive useful information without lipreading. In two patients, very limited open-set scores for electrical stimulation alone were obtained. This was most probably due to the fact that only a few channels of stimulation were possible due to cochlear disease, and they were therefore receiving information more like a single-channel device. The prosthesis has also been found to provide considerable help in hearing and recognizing everyday sounds.

Adult↗
PubMed1984

An acoustic model of a multiple-channel cochlear implant.

A set of bandpass filtered, pulsed noise stimuli presented to three normally hearing subjects was found to have psychophysical properties similar to those of a set of pulsed electrical stimuli presented to two cochlear implant patients. Identical procedures were used to compare the performances of the two groups of subjects in the following tasks: (a) pulse rate difference limen measurements, (b) pitch scaling for stimuli differing in pulse rate, (c) pitch scaling and categorization of stimuli differing in filter frequency or electrode position, and (d) similarity judgments of stimuli differing in pulse rate and filter frequency or electrode position. By choosing the parameters of the acoustic stimuli appropriately, a high level of agreement between the two sets of results was achieved. Electrical stimuli on electrodes at different sites in the cochlea were matched with pulsed noise passed through bandpass filters with different center frequencies. Matching was achieved for equal electrical and acoustic pulse rates.

Adult↗