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PubMed1983

Information transmission across the skin: high-resolution tactile sensory aids for the deaf and the blind.

New techniques are described for implementing high-resolution communication interfaces to the skin, by direct electrical stimulation of the sense of touch. The psychophysical properties of these displays are summarized, and a practical application is presented: an electrotactile sensory aid for profoundly deaf children, which displays acoustic information on the skin of the abdomen, via a belt of electrotactile stimulators. The resulting tactile patterns provide cues for recognizing environmental sounds, enhance the accuracy of lipreading, and enable the child to monitor his/her own voice. The tactile patterns corresponding to sounds must be learned, much like acquiring a second language; substantial training and experience is required. Other applications are discussed, both for the rehabilitation of sensory handicaps and for tactile communication in general.

Blindness↗

PubMed1986

The use of a temporary extracochlear electrode in preoperative testing of permanent implant candidates.

This paper describes hearing and speech perception in 9 post-lingually deaf adults fitted with a temporary single electrode, surgically positioned close to the round window niche. After baseline testing, unaided and aided binaurally with the high-power Phonic Ear PE 845, each subject was admitted to hospital for a period of 7 days. During each test session, stimuli were presented directly to the electrode lead by means of an isolation unit. Current thresholds, upper tolerable limits and gap detection were measured for various acoustical waveforms and stimulus frequencies. A laryngograph was used to test the discrimination of prelinguistic and suprasegmental speech features. The results indicated that the prosthesis could provide acoustic sensations of loudness, pitch and duration that changed with stimulus waveform, level of current and frequency, and a gap threshold less than 50 msec. Lipreading appeared to be a necessary adjunct for consonant discrimination.

Adult↗

PubMed1996

Facial expressions and speechreading performance.

In the present study, the role of facial expressions in visual speechreading (lipreading) was examined. Speechreading was assessed by three different tests: sentence-based speechreading, word-decoding, and word discrimination. Twenty-seven individuals participated as subjects in the study. The results revealed that no general improvement as a function of expression was obtained across all tests. Nevertheless, skilled speechreaders could significantly improve their performance as a function of emotional expression in the word-decoding and word-discrimination conditions. Furthermore, a correlational analysis indicated that there was a significant relationship between the subjects' rating of confidence regarding their responses to each test-item and performance on speechreading tests where lexical analysis is a necessary task-demand. The results are discussed with respect to how information from facial expressions is integrated with the information given by the lip movements in visual speechreading, and also with respect to general models of face-processing (i.e., Bruce & Young, 1986; Young & Bruce, 1991).

Adult↗

PubMed1982

Tactile perception by the profoundly deaf. Speech and environmental sounds.

Four subjects fitted with single-channel vibrotactile aids and provided with training in their use took part in a testing programme aimed at assessing their aided and unaided lipreading performance, their ability to detect segmental and suprasegmental features of speech, and the discrimination of common environmental sounds. The results showed that the vibrotactile aid provided very useful information as to speech and non-speech stimuli with the subjects performing best on those tasks where time/intensity cues provided sufficient information to enable identification. The implications of the study are discussed and a comparison made with those results reported for subjects using cochlear implants.

Adult↗

PubMed1984

Comparison of live and video presentation of a speechreading test with children.

This paper compares the speechreading scores given by a group of normally hearing children aged 9 years using live and video presentation of the Manchester Speechreading (Lipreading) Test. Twenty children (10 boys and 10 girls) took part in the investigation. The same speaker was involved in the two modes of presentation which were given at a distance of 6 feet in the same room and against the same background. To simulate normal classroom and clinic situations the live mode was presented by uttering test stimuli without giving acoustic clues. Although there was a preference for the live mode, there was no significant difference between the scores obtained. The scores of the boys and girls are compared and discussed. A test re-rest involving 5 boys and 5 girls from the original sample substantially corroborated the original finding with high correlations for word and sentence tests. Consistency of presentation and reliability of the test were also supported by high correlations. These findings are discussed in the light of possible standardisation of test material.

Child↗

PubMed1989

Background noise and lip-reading ability.

The main aim of this pilot experiment was to determine whether background noise affects the lip-reading ability of normally hearing people. Ten university students took part in a lip-reading test presented both in the quiet and with two types of competing noise. The first type of noise used was speech-shaped, continuous and with a steady intensity level. The second type was again continuous but with frequent and intermittent peaks of energy (classroom noise). It was found that the second type of noise had a significantly adverse effect on lipreading ability. Further experimentation with hearing-impaired subjects was suggested.

Adult↗

PubMed2000

Cross-modal selective attention: on the difficulty of ignoring sounds at the locus of visual attention.

In three experiments, we investigated whether the ease with which distracting sounds can be ignored depends on their distance from fixation and from attended visual events. In the first experiment, participants shadowed an auditory stream of words presented behind their heads, while simultaneously fixating visual lip-read information consistent with the relevant auditory stream, or meaningless "chewing" lip movements. An irrelevant auditory stream of words, which participants had to ignore, was presented either from the same side as the fixated visual stream or from the opposite side. Selective shadowing was less accurate in the former condition, implying that distracting sounds are harder to ignore when fixated. Furthermore, the impairment when fixating toward distractor sounds was greater when speaking lips were fixated than when chewing lips were fixated, suggesting that people find it particularly difficult to ignore sounds at locations that are actively attended for visual lipreading rather than merely passively fixated. Experiments 2 and 3 tested whether these results are specific to cross-modal links in speech perception by replacing the visual lip movements with a rapidly changing stream of meaningless visual shapes. The auditory task was again shadowing, but the active visual task was now monitoring for a specific visual shape at one location. A decrement in shadowing was again observed when participants passively fixated toward the irrelevant auditory stream. This decrement was larger when participants performed a difficult active visual task there versus fixating, but not for a less demanding visual task versus fixation. The implications for cross-modal links in spatial attention are discussed.

Adolescent↗

PubMed1965

DEAFNESS.

Dr T E T Weston describes his research into the effect of noise on hearing acuity and of deafness in the aged. He found that presbyacusis is associated with a multiplicity of factors, e.g. smoking, circulatory disturbance, urban domicile, heredity and occupational acoustic trauma.Miss W Galbraith describes the social implications of various degrees of deafness and the ways in which they can be overcome by such measures as lipreading, hearing aids and rehabilitation.Sir Terence Cawthorne discusses otosclerosis, nearly 1% of the population being affected by this type of deafness. He describes the modern operation of insertion of an artificial piston through the stapes and states that 90% of cases submitted to this operation will show immediate improvement, whilst 85% should still have retained this improvement at the end of two years.

Audiometry↗

PubMed1992

Preparing for communication interactions: the value of anticipatory strategies for adults with hearing impairment.

Some people with hearing impairment may use anticipatory strategies to prepare for an upcoming communication interaction, such as a doctor's appointment. They may consider vocabulary and statements that might occur, and they may practice speechreading a partner saying the items. Experiment 1 evaluated the effectiveness of two types of anticipatory strategies: workbook activities and situation-specific lipreading practice. Two groups of normal-hearing subjects were asked to prepare for a communication interaction in a bank setting where they would be required to recognize speech using only the visual signal. Each group was assigned to one type of anticipatory strategy. A third group served as a control group. Experiment 2 evaluated whether multifaceted anticipatory practice improved cochlear implant users' ability to recognize statements and words audiovisually that might occur in a doctor's office, bank, movie theater, and gas station. One group of implanted subjects received 4 days of training, 1 day for each setting, and a second group served as a control group. In both experiments, subjects who used anticipatory strategies did not improve their performance on situation-specific sentence tests more than the control subjects.

Cochlear Implants↗

PubMed1989

Speech perception using combinations of auditory, visual, and tactile information.

Four normally-hearing subjects were trained and tested with all combinations of a highly-degraded auditory input, a visual input via lipreading, and a tactile input using a multichannel electrotactile speech processor. The speech perception of the subjects was assessed with closed sets of vowels, consonants, and multisyllabic words; with open sets of words and sentences, and with speech tracking. When the visual input was added to any combination of other inputs, a significant improvement occurred for every test. Similarly, the auditory input produced a significant improvement for all tests except closed-set vowel recognition. The tactile input produced scores that were significantly greater than chance in isolation, but combined less effectively with the other modalities. The addition of the tactile input did produce significant improvements for vowel recognition in the auditory-tactile condition, for consonant recognition in the auditory-tactile and visual-tactile conditions, and in open-set word recognition in the visual-tactile condition. Information transmission analysis of the features of vowels and consonants indicated that the information from auditory and visual inputs were integrated much more effectively than information from the tactile input. The less effective combination might be due to lack of training with the tactile input, or to more fundamental limitations in the processing of multimodal stimuli.

Adult↗

PubMed1989

Cochlear implant hearing performance at the University of Minnesota.

The hearing performance of six post-lingually deaf adults implanted with the Nucleus 22-channel device are presented. All patients achieved measurable open set speech recognition with implant alone. The best hearing performance was achieved with a combination of lipreading and cochlear implant. For this condition our group achieved an average open set speech discrimination score of 85% (CID sentences) and an average speech tracking rate of 70 words per minute. We attribute the success of our group to careful pre-operative selection, including attention to candidate motivation toward hearing rehabilitation.

Adult↗

PubMed1988

[Rehabilitation of cochlear implant patients].

Pre- and post-surgical treatment of cochlear implant patients is discussed. Before surgery training of lipreading ability, auditory training with conventional hearing aids and counselling should be offered. After surgery the main focus lies on auditory training with the cochlear implant; communication training in a group and counselling should be offered too.

Cochlear Implants↗

PubMed1987

Pre-implant evaluation of speech and hearing.

This paper describes an approach taken to predict, in advance of invasive surgery, whether a permanent cochlear prosthesis will serve as an aid to hearing in postlingually deaf adults. Nine subjects were implanted transtympanically with a temporary single-channel round window electrode. Over the course of one week a number of tests were conducted, including (1) the measurement of current thresholds over a range of frequencies for sine, square and biphasic pulse waveforms and minimum detectable gap between a pair of short bursts; (2) the discrimination of elementary speech features of live voice such as interruption, intonation, and stress placement; (3) the recognition of consonants, and (4) speech tracking. Eight subjects were able to appreciate changes in loudness, pitch, duration and temporal gap for frequencies below 1 kHz. All showed significant improvements over listening with high-power hearing aids in discriminating a variety of changes in elementary speech features. It was found that the recognition of consonants and speech tracking was heavily dependent on lipreading.

Adult↗

PubMed1987

The Nucleus Children's Program.

Two programs have been developed for the selection and rehabilitation of children to receive the Nucleus 22-channel cochlear implant system. One program focuses on postlingually deafened children from the ages of 10 to 17, while the other is designed for deafened children from 2 to 9 years. Each has been approved under separate IDEs by the Food and Drug Administration. The selection criteria for these two programs are described. Preliminary results for two adolescents implanted with the Nucleus multichannel device are also presented. Complete pre- and postevaluation results are shown for one adolescent who has completed a ten-week rehabilitation program. Initial findings suggest that hearing-only skills can be developed in this population and that children with short-term deafness may be able to develop some degree of open-set speech recognition without lipreading.

Adolescent↗

PubMedDate not supplied

Subject acceptance of implanted auditory prosthesis.

Each of the 13 subjects was interviewed, in a structured context, to determine their estimate of the value of the prosthesis to their daily life. The subjects who used their prostheses eight or more hours a day reported it to be more valuable in their daily living than did those who used it less than eight hours a day. The fulltime users reported that the prosthesis is most helpful to them as an adjunct to lipreading. All of them thought the prosthesis valuable in terms of "hearing" environmental sounds. While all of them reported noisy environments to be bothersome, the fulltime users did not turn off their stimulators in noise. Only two subjects, both infrequent users of their prostheses, reported that they would not undergo implant surgery again.

Cochlea↗

PubMed1979

[Hearing rehabilitation, possibilities and limitations].

The increase of hearing loss in the aged looks like a natural process. The handicap problems caused by this process have not to be accepted as such. A hard of hearing aged may be helped by a hearing aid if he is willing to learn again how to communicate. Just in the learning period professional support has to be given, in the field of handling the hearing aid, training lipreading and learning a number of hearing tactics.

Aged↗

PubMed1984

Clinical results using a multiple-channel cochlear prosthesis.

A total of eight profoundly deaf patients have been implanted with the Nucleus Limited multiple-channel cochlear prosthesis at the University of Melbourne since it became available in late 1982. All patients are everyday users of the device. Speech testing using the device alone has shown consistently high scores for a variety of closed set tests and significant levels of open set speech understanding in most of the patients. Lipreading assessment with phoneme, word, sentence and speech tracking material shows significant improvement when using the prosthesis for all patients tested. Other benefits reported are recognition of environmental sounds, decrease in tinnitus, increased confidence in social and vocational situations and improved voice control. One patient is able to cope with interactive conversations over the telephone and three others are able to use the telephone in a limited way without special codes.

Adult↗

PubMed1983

Encephalitis herpes simplex: aural rehabilitation following bilateral deafness.

Aural rehabilitation is a critical and often neglected aspect of a hearing-impaired patient's total rehabilitation. This case description illustrates the need for implementation of aural rehabilitation services. A 59-year-old woman exhibited bilateral profound sensorineural hearing loss following the onset of encephalitis herpes simplex. Auditory amplification attempts were unsuccessful. Aural rehabilitation was initiated immediately, and she was seen for lipreading and vibrotactile stimulation training. Goals progressed from identification of single words within a category to phonemic recognition. Vibrotactile stimulation was used to facilitate environmental awareness. Therapy goals reflected the patient's increased motivation to communicate within her environment. This patient's communicative status is viewed on a continuum: from success in individual treatment goals, extending to successful communication within the structure of the entire rehabilitation setting, and finally to functional communication within her home environment.

Deafness↗