Children Using Cochlear Implants Capitalize on Acoustical Hearing for Music Perception

The first specific aim of the present study is to compare the ability of normal-hearing and cochlear implant listeners to use temporal cues in three music perception tasks: tempo discrimination, rhythmic pattern identification, and melody identification. The second aim is to identify the relative contribution of temporal and spectral cues to melody recognition in acoustic and electric hearing. Both normal-hearing and cochlear implant listeners participated in the experiments. Tempo discrimination was measured in a two-interval forced-choice procedure in which subjects were asked to choose the faster tempo at four standard tempo conditions (60, 80, 100, and 120 beats per minute). For rhythmic pattern identification, seven different rhythmic patterns were created and subjects were asked to read and choose the musical notation displayed on the screen that corresponded to the rhythmic pattern presented. Melody identification was evaluated with two sets of 12 familiar melodies. One set contained both rhythm and melody information (rhythm condition), whereas the other set contained only melody information (no-rhythm condition). Melody stimuli were also processed to extract the slowly varying temporal envelope from 1, 2, 4, 8, 16, 32, and 64 frequency bands, to create cochlear implant simulations. Subjects listened to a melody and had to respond by choosing one of the 12 names corresponding to the melodies displayed on a computer screen. In tempo discrimination, the cochlear implant listeners performed similarly to the normal-hearing listeners with rate discrimination difference limens obtained at 4-6 beats per minute. In rhythmic pattern identification, the cochlear implant listeners performed 5-25 percentage points poorer than the normal-hearing listeners. The normal-hearing listeners achieved perfect scores in melody identification with and without the rhythmic cues. However, the cochlear implant listeners performed significantly poorer than the normal-hearing listeners in both rhythm and no-rhythm conditions. The simulation results from normal-hearing listeners showed a relatively high level of performance for all numbers of frequency bands in the rhythm condition but required as many as 32 bands in the no-rhythm condition. Cochlear-implant listeners performed normally in tempo discrimination, but significantly poorer than normal-hearing listeners in rhythmic pattern identification and melody recognition. While both temporal (rhythmic) and spectral (pitch) cues contribute to melody recognition, cochlear-implant listeners mostly relied on the rhythmic cues for melody recognition. Without the rhythmic cues, high spectral resolution with as many as 32 bands was needed for melody recognition for normal-hearing listeners. This result indicates that the present cochlear implants provide sufficient spectral cues to support speech recognition in quiet, but they are not adequate to support music perception. Increasing the number of functional channels and improved encoding of the fine structure information are necessary to improve music perception for cochlear implant listeners.

The acceptance of cochlear implantation as an effective and safe treatment for deafness has increased steadily over the past quarter century. The earliest devices were the first implanted prostheses found to be successful in compensating partially for lost sensory function by direct electrical stimulation of nerves. Initially, the main intention was to provide limited auditory sensations to people with profound or total sensorineural hearing impairment in both ears. Although the first cochlear implants aimed to provide patients with little more than awareness of environmental sounds and some cues to assist visual speech-reading, the technology has advanced rapidly. Currently, most people with modern cochlear implant systems can understand speech using the device alone, at least in favorable listening conditions. In recent years, an increasing research effort has been directed towards implant users' perception of nonspeech sounds, especially music. This paper reviews that research, discusses the published experimental results in terms of both psychophysical observations and device function, and concludes with some practical suggestions about how perception of music might be enhanced for implant recipients in the future. The most significant findings of past research are: (1) On average, implant users perceive rhythm about as well as listeners with normal hearing; (2) Even with technically sophisticated multiple-channel sound processors, recognition of melodies, especially without rhythmic or verbal cues, is poor, with performance at little better than chance levels for many implant users; (3) Perception of timbre, which is usually evaluated by experimental procedures that require subjects to identify musical instrument sounds, is generally unsatisfactory; (4) Implant users tend to rate the quality of musical sounds as less pleasant than listeners with normal hearing; (5) Auditory training programs that have been devised specifically to provide implant users with structured musical listening experience may improve the subjective acceptability of music that is heard through a prosthesis; (6) Pitch perception might be improved by designing innovative sound processors that use both temporal and spatial patterns of electric stimulation more effectively and precisely to overcome the inherent limitations of signal coding in existing implant systems; (7) For the growing population of implant recipients who have usable acoustic hearing, at least for low-frequency sounds, perception of music is likely to be much better with combined acoustic and electric stimulation than is typical for deaf people who rely solely on the hearing provided by their prostheses.

To investigate the music perception skills of adult cochlear implant (CI) users in comparison with hearing aid (HA) users who have similar levels of hearing impairment. It was hypothesized that the HA users would perform better than the CI recipients on tests involving pitch, instrument, and melody perception, but similarly for rhythm perception. Fifteen users of the Nucleus CI system and 15 HA users participated in a series of music perception tests. All subjects were postlingually deafened adults, with the HA subjects being required to meet the current audiological criteria for CI candidacy. A music test battery was designed for the study incorporating four major tasks: (1) discrimination of 38 pairs of rhythms; (2) pitch ranking of one-octave, half-octave, and quarter-octave intervals; (3) instrument recognition incorporating three subtests, each with 12 different instruments or ensembles; and (4) recognition of 10 familiar melodies. Stimuli were presented via direct audio input at comfortable presentation levels. The test battery was administered to each subject on two separate occasions, approximately 4 mo apart. The results from the rhythm test were 93% correct for the CI group and 94% correct for the HA group; these scores were not significantly different. For the pitch test, there was a significant difference between the HA group and the CI group (p < 0.001), with higher mean scores recorded by the HA group for all three interval sizes. The CI subject group was unable to rank pitches a quarter-octave apart, only scoring at chance level for this interval size. In the instrument recognition test, although there was no significant difference between the mean scores of the two groups, both groups obtained significantly higher scores for the subtest incorporating single instrument stimuli than those incorporating multiple instrumentations (p < 0.001). In the melody test, there was a significant difference between the implantees' mean score of 52% correct and the HA group's mean of 91% (p < 0.001). As hypothesized, results from the two groups were almost identical for the rhythm test, with the HA group performing significantly better than the CI group on the pitch and melody tests. However, there was no difference between the groups in their ability to identify musical instruments or ensembles. The results of this study indicate that HA users with similar levels of hearing loss perform at least equal to, if not better than, CI users on these music perception tests. However, despite the differences between scores obtained by the CI and HA subject groups, both these subject groups were largely unable to achieve accurate or effective music perception, regardless of the device they used.