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PubMed1989

Social experiences of hearing-impaired high school youth.

The purpose of the present study is to investigate the reasons why hearing-impaired students describe their high school experiences as positive or negative and to identify the specific classroom dynamics that contribute to or detract from social development. Data were collected from 49 hearing-impaired undergraduate students who were asked to describe their high school experiences on an open-ended questionnaire with a follow-up interview. The results indicated that graduates of residential programs described their social experiences significantly more positively than graduates of mainstream programs. Reasons included their teachers' ability to sign, socializing with friends and participation in after-school activities. Positive feelings in mainstream programs were associated with such factors as availability of supportive services, ability to voice and lipread, parent involvement, encouragement of interaction and deaf awareness by the teachers. Mainstream students who had the benefit of supportive services reported different perceptions of supportiveness of the academic environment and of teachers' expectations than did those who had no such services in high schools. Implications are drawn for the improved academic and social development of hearing-impaired high school students.

Adolescent↗
PubMedDate not supplied

[Status of the development of cochlear prostheses relying on electric stimulation].

Inner ear prostheses, or cochlear implants, are neuroprostheses providing profoundly deaf people with sound sensations through electrical stimulation of the auditory nerve. Approximately 2,000 of these devices are currently in use worldwide. Five models are each being used by more than 50 patients. Among other features they differ from one another mainly in the design and placement of electrodes and in the particular speech coding strategy used, periodicity and tonotopy priciple being made use of to a highly varying degree. Nevertheless, 4 of the 5 devices lead to quite comparable degrees of speech understanding without additional lipreading.

Cochlear Implants↗
PubMed1992

Phoneme recognition by deaf individuals using the multichannel nucleus cochlear implant.

Experiments have been carried out to determine which cues are used in phoneme identification by deaf individuals using a cochlear implant. Five deaf individuals with a Nucleus 22-channel cochlear implant were tested with open set speech audiometry in free field without lipreading. Speech material consisted of lists of Dutch words of the Consonant-Vowel-Consonant type (CVC-words). Word scores ranged from 0 to 22%, phoneme scores from 11 to 54%. For each subject the responses to the initial consonant, the vowel and the final consonant were entered into separate confusion matrices. Kruskal analysis, which provided a geometric representation of these confusions, showed that in the recognition of consonants the feature of voicing is all important. Vowels were identified on the basis of the frequencies of the first and second formants. In one subject the electrode array could only partially be inserted into the cochlea, leaving roughly half the second formant area of the electrode array outside the cochlea. For this subject vowel identification was based upon the first formant and vowel duration; there was no contribution of second formant information to vowel identification. Compressing the first and second formant frequency to the limited intracochlear array did not enhance transmission of second formant information and did not improve performance. The basic findings for consonant and vowel recognition could be explained by the speech coding strategy of the Nucleus speech processor in which voicing determines stimulus periodicity and formant frequencies determine channel selection. Kruskal analysis of phoneme confusions may aid in programming and evaluating the performance of the Nucleus cochlear implant.

Adult↗
PubMed1995

Evaluation of a communication course for new hearing aid users.

A communication course for new hearing aid users, covering explanations of hearing loss and hearing aids, hearing tactics, lipreading and relaxation techniques in three 2 h sessions, was developed. The course was tested on groups of adults fitted with NHS post-aural hearing aids at the Audiology Clinic at the Royal South Hants Hospital. The course content, presentation, length and pace were evaluated by means of a questionnaire given at the end of the last session, and the effects on aid usage, satisfaction and benefit ratings were assessed by pre- and post-fitting questionnaires given to those who attended and to a matched group of control subjects. The course was offered to 41 men and 46 women. The acceptance rate was rather higher for women than for men, but attendance rates were similar for both sexes, men attending 33% and women 36% of the sessions offered. No relationship was observed between age or degree of hearing loss and rates of acceptance and attendance. All those who completed the evaluation questionnaire were satisfied with the content, length, pace and presentation of the course, and considered that it had helped them to understand and cope with their hearing loss. Most (28 out of 31) felt that they would use their aids more as a result of the course. However, their aid usage and ratings of benefit derived from the aids did not differ significantly from those of a matched group of controls who were not offered the course.

Aged↗
PubMedDate not supplied

Proposed use of a digital signal processor in an experimental tactile hearing aid for the profoundly deaf: preliminary communication.

An experimental system for a tactile hearing aid using a digital signal processor (DSP) is being developed. This system can be used to test and evaluate not only the familiar techniques for a tactile hearing aid, such as energy level display, filterbank analysis, etc., but also novel techniques. The system is being developed especially to try out new recognition strategies, because the currently available strategies are not satisfactory. A portable tactile hearing aid that can recognize certain environmental sounds (alarm sounds) and certain features from the speech signal (such as pitch, voiced/voiceless, or even complete phonemes), being a good support for lipreading, should be the final result of the experiments.

Deafness↗
PubMedDate not supplied

Elderly deaf patients' health care experiences.

BACKGROUND: Approximately 10% of the US population has some degree of hearing loss, and 2 million Americans are deaf. Most medical school curricula and major textbooks characterize deafness as pathologic condition only, which is at odds with the movement to understand the Deaf population as a minority group with a unique language and cultural tradition. Physicians might therefore be unprepared to meet the needs of deaf patients effectively and sensitively. This study seeks to understand the health care experiences of elderly Deaf adults in Richmond, Va. METHODS: The authors conducted focus groups of elderly Deaf persons. Real-time voice-interpretation of the sign language communication allowed for tape recording and full transcription. The authors independently analyzed the transcripts using an editing style, and incorporated feedback on their interpretation from participants. RESULTS: Participants experienced many practical barriers to effective health care, including problems with scheduling appointments and communicating with providers. They believed that providers are ill-prepared to care for them and worried that prejudice might be a more subtle obstacle. Participants seemed resigned to these circumstances. CONCLUSIONS: The authors suggest a possible explanation for this perspective, and make specific recommendations for three levels of competency in caring for deaf patients. When the provider and the office staff provide methods to communicate with deaf patients using telephone-assisted communication, qualified interpreters, and some basic knowledge of lipreading or sign language, the care of deaf patients is greatly enhanced and the physician-patient relationship improved.

Age Factors↗
PubMedDate not supplied

Nucleus 21-channel auditory brainstem implant in patients with previous tumour removal.

Three patients with neurofibromatosis type 2 who had undergone previous cochlear nerve tumour removal were implanted with the Nucleus 21-channel auditory brainstem implant (ABI). The time intervals between tumour removal and implantation were 4, 5, and 7 years, respectively. Total bilateral deafness was confirmed before implantation. One patient was also blind after acute intracranial hypertension. The translabyrinthine approach was used in all cases. The choice of side for implantation depended on pre-operative magnetic resonance imaging study, the facial nerve function, the presence of recurrent and/or other lesions, and the patient's preference. Although the scarring of prior surgical procedure largely changed the anatomical structures in the cerebello-pontine angle, various landmarks could be found to locate the foramen of Luschka, where the ABI electrode was inserted into the lateral recess of the fourth ventricle. During surgery, the electrically evoked auditory brainstem responses were recorded to confirm that the ABI stimulation activated the auditory system; the electromyogram of the 7th and 9th nerves was helpful in finding the landmarks and minimising the triggering of the cranial nerves with ABI stimulation. The number of active electrodes was 21, 7, and 4 in the three patients. All obtained meaningful pitch scaling and useful auditory sensations. One patient, with 21 activated electrodes, has achieved functional open-set speech understanding. The second patient, with 7 activated electrodes, has benefited from environmental sound awareness and improved lipreading. The last, blind, patient, with 4 electrodes activated, achieved only perception of environmental sounds.

Adult↗
PubMed1992

[Results of cochlear implants in totally deaf subjects].

Cochlear implants have been applied on a limited scale in the Netherlands since 1985. In a government sponsored health service trial the method was further explored from 1988 to 1991. During this period 20 persons were implanted, ten with a Vienna extracochlear system and ten with a 22-electrode Nucleus intracochlear system. The ages varied from 5 to 62, the duration of deafness from 2 to 47 years. Some patients were congenitally deaf. The major cause of deafness was meningitis. The effect of the implantation was tested with the 'minimal auditory capability' test battery adapted for the Dutch language. 18 persons were wearing their system for more than 8 h a day; one person, a prelingually deaf did no longer use his implant while another one only used it occasionally. Except for two persons, all scored above chance level on several tests. The postlingually deaf persons with the Nucleus system all achieved a certain degree of open set speech understanding without lipreading. With the aim of achieving better selection criteria a new trial has started with the same financial sources in cooperation with the Utrecht University Hospital.

Adolescent↗
PubMed1991

Use of a multichannel electrotactile speech processor by profoundly hearing-impaired children in a total communication environment.

As part of a larger subject group, four profoundly hearing-impaired children enrolled in a total communication educational program were fitted with the University of Melbourne's multichannel electrotactile speech processor (Tickle Talker). Sound detection thresholds for pure tones were at lower levels with the tactile device than with hearing aids, especially for high frequency sounds above 2 kHz. Two of the children also detected all speech sounds of the Ling five-sound test at normal conversational levels using only the Tickle Talker. The children were able to use tactile input to achieve higher scores on three speech feature subtests of the PLOTT test when using the Tickle Talker plus hearing aids as compared to hearing aids alone. Mean improvements were 22.4 percent on vowel length, 28 percent on vowel identification, and 35 percent on consonant manner. Improvements were also shown by individual children on the closed-set WIPI and open-set PBK word tests, and on the open-set BKB sentence test, when the Tickle Talker was combined with hearing aids, and with hearing aids and lipreading. Comparisons of these results with those of children using the Tickle Talker in other educational settings show that children in a total communication environment can potentially benefit to a similar degree from use of tactual input. Anecdotal reports from the children and school staff members indicated that daily use of the Tickle Talker did not interfere with the signing aspects of total communication.

Adolescent↗
PubMed1991

Initial findings with a wearable multichannel vibrotactile aid.

Data are presented on the speech perception performance of two profoundly hearing-impaired subjects while using a two-channel vibrotactile aid (Tactaid II) or a new, seven-channel instrument. Both subjects, one a profoundly hearing-impaired teenager and one a postlingually deaf adult, are experienced users of tactile aids. The data suggest better recognition of speech features, words, environmental sounds, and enhancement of lipreading skills with the new multichannel instrument than with the two-channel device.

Adolescent↗
PubMed1990

Conditions and possibilities for the detection of speech-signal elements by means of vibrotaction.

Investigations have been carried out in order to determine (1) the sensitivity of the two types of skin for sinusoidal mechanical vibrations under different stimulation conditions, and (2) the sensitivity of the skin for amplitude modulations. Maximum sensitivity was found around 200 Hz, with a threshold of 0.03 microns RMS for the glabrous skin of the inner side of the hand under a static force of at least 0.5 N. The sensitivity of the hairy skin of the arm was 12 dB less (static force at least 3 N). The sensitivity increased with increasing contractor area. Maximum modulation sensitivity was found for sinusoidal carriers between 200 and 400 Hz and extended from modulation frequencies of 1 Hz up to 200 Hz (depending on carrier frequency) at a frequency-independent modulation depth of about 0.1. It was concluded that it is certainly possible for the skin to detect the slow amplitude fluctuations of speech signals as a support for lipreading. Attention was paid to the best way of extracting the envelopes from the speech signal and their presentation, as an amplitude modulation, to the skin.

Communication Devices for People with Disabilities↗
PubMed1990

[Analysis of word perception in deaf children. A longitudinal study].

The assessment of speech perception and speech reading has been studied with the phonetic test of J.C. Lafon (lists of 17 french words with 3 phonemes each). 168 children from 7 to 17 have been collected. Deafness was moderate, severe or profound. It was always congenitaly sensoneural hearing loss. In order to precise data, results are giving regard to educational program: mainstream or special classes. Comparative data for each degree of deafness are given for speech perception, lipreading and both auditory and visual sensorial ways.

Adolescent↗
PubMed1990

Speech perception with the nucleus cochlear implant in children trained with the auditory/verbal approach.

Five children between the ages of 6 to 10 years using the Nucleus 22-electrode cochlear implant were tested on a battery of speech-perception tests. None of the five children used any sign language before implantation, and all received extensive training in auditory/verbal rehabilitation postimplantation. Performance ranged from 81 to 97 percent correct on the Matrix Test, from 24 to 80 percent correct on the WIPI test, from 33 to 73 percent correct on a 10-choice vowel recognition test, from 19 to 50 percent correct on a 13-choice consonant recognition test, from 2 to 46 percent words correct on a PB-K word list, from 4 to 71 percent words correct on a recorded BKB sentence test, and from 8 to 71 percent words correct on a live-voice BKB sentence test. In four of the five children, significant lipreading enhancement was observed on consonant recognition and two prelinguistically deafened children demonstrated some open-set word recognition.

Child↗
PubMed1989

Cochlear implantation in Quebec city: auditory performance in a recently trained patient.

The Quebec Cochlear Implant Research Program has implanted nine patients since 1984. At the same time, we have been developing some original rehabilitative material for these French speaking patients. This paper reports the results obtained with our last adult patient. With his implant, J-P.F. has clearly improved his auditory response to sounds. After the training period, he demonstrated good abilities in detection, discrimination, identification and comprehension of sounds, phonemes, words and sentences. His lipreading has improved. The performance observed with this patient is comparable with the data reported in other studies using the same implant device.

Adult↗
PubMed1989

Issues of candidate selection for a cochlear implant.

The cochlear implant has been successful in providing sound to deaf patients. A wide spectrum of results, from sound awareness to word understanding without lipreading, has been achieved. However, because of the unpredictable nature of the results, appropriate candidate selection is imperative. Medical and surgical criteria for treatment of adults and children are presented.

Age Factors↗
PubMed1989

[Initial experience with rehabilitation of patients after cochlear implants].

The authors describe the first results with rehabilitation of patients with czechoslovak single - channel cochlear implant. The implantation was performed in three postlingually deaf adults. The deafness lasted from 8-28 years. The information about the presence of a sound is considered as the contribution of the cochlear implant. The patients were able to differentiate ten common sounds after the rehabilitation, their ability of understanding speech sounds was better with lipreading and cochlear implant than before implantation.

Adult↗
PubMed1986

Vibrotactile stimulation: case study with a profoundly deaf child.

This case study reports results obtained from a young, profoundly deaf child, M, who was fitted with a single-channel vibrotactile device, the Tactaid I, at 29 months of age. Her progress in speech and language development was evaluated over a 14-month period. During this period, M learned to understand 101 words through lipreading and the Tactaid I, and to produce consistent approximations of 90 words. Her scores on language tests with hearing-impaired norms progressed from below average to above average for her age. M's scores on language tests with hearing norms also reflected significant progress, although she did not achieve normal language development. These results indicate that a single-channel vibrotactile aid may facilitate the acquisition of spoken language in a profoundly deaf child who is unable to benefit from a conventional hearing aid.

Child, Preschool↗
PubMed1984

Description of the French 12 channel cochlear implant.

The sound information is sequentially transmitted to 12 electrodes implanted in the cochlea. An electrode bearer introduced through the round window is now commonly used. Frequencies between 100-4 000 Hz and intensities between 40-100 db are only transmitted in a 3 msec time sampling. The output signal is a positive square wave followed by an equal negative wave. Its voltage varies from 2.5 to 6.5 volts. Its duration varies from 0 to 200 microsec. Its frequency is equal or inferior to 300 Hz. The outside emitter weighs 600 g. This system has been implanted in 58 patients and allows partial speech discrimination without lipreading for more than 6 years.

Action Potentials↗