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Luzum NR, Hamel BL, Shafiro V, Harris MS. Identification Accuracy of Safety-Relevant Environmental Sounds in Adult Cochlear Implant Users. Laryngoscope 2023; 133:2388-2393. [PMID: 36317721 PMCID: PMC10149563 DOI: 10.1002/lary.30475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Examine cochlear implant (CI) users' ability to identify safety-relevant environmental sounds, imperative for safety, independence, and personal well-being. METHODS Twenty-one experienced adult CI users completed an Environmental Sound Identification (ESI) test consisting of 42 common environmental sounds, 28 of which were relevant to personal safety, along with 14 control sounds. Prior to sound identification, participants were shown sound names and asked to rate the familiarity and, separately, relevance to safety of each corresponding sound on a 1-5 scale. RESULTS Overall ESI accuracy was 57% correct for the safety-relevant sounds and 55% correct for control sounds. Participants rated safety-relevant sounds as more important to safety and more familiar than the non-safety sounds. ESI accuracy significantly correlated with familiarity ratings. CONCLUSION The present findings suggest mediocre ESI accuracy in postlingual adult CI users for safety-relevant and other environmental sounds. Deficits in the identification of these sounds may put CI listeners at increased risk of accidents or injuries and may require a specific rehabilitation program to improve CI outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2388-2393, 2023.
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Affiliation(s)
| | - Benjamin L. Hamel
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Valeriy Shafiro
- Department of Communication Disorders & Sciences, College of Health Sciences & Graduate College, Rush University, Chicago, IL, USA
| | - Michael S. Harris
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin Milwaukee, WI, USA
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
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Shekar RCMC, Hansen JHL. A convolutional neural network-based framework for analysis and assessment of non-linguistic sound classification and enhancement for normal hearing and cochlear implant listeners. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2720. [PMID: 36456299 PMCID: PMC9637023 DOI: 10.1121/10.0014955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/17/2023]
Abstract
Naturalistic sounds encode salient acoustic content that provides situational context or subject/system properties essential for acoustic awareness, autonomy, safety, and improved quality of life for individuals with sensorineural hearing loss. Cochlear implants (CIs) are an assistive hearing device that restores auditory function in hearing impaired individuals. Most CI research advancements have focused on improving speech recognition in noisy, reverberant, or time-varying diverse environments. Relatively few studies have explored non-linguistic sound (NLS) perception among CIs, and those that have carried out such studies generally reported poor perception, suggesting a clear deficit in current CI sound processing systems. In this study, a convolutional neural network (CNN)-based NLS classification model is used as a framework to compare unprocessed and CI-simulated NLS classification and evaluate NLS perception targeted algorithms among CI listeners. Additionally, a NLS enhancement algorithm that focuses on improving identifiability and perception among CI listeners is proposed. The proposed NLS enhancement algorithm is evaluated based on identifiability performance using the CI-simulated NLS classification model. The proposed NLS classification framework was able to achieve near human-level performance with no significant effect of classification modality (model vs human subject) and achieved mean classification scores of 85.86% for NH (p = 0.3758) and 65.25% for CI (p = 0.1725). Among the four different feature-based methods of the proposed NLS enhancement algorithm, the "harmonicity"-based one achieved highest mean classification accuracy of 63.75%, when compared to baseline, and demonstrated significant improvement in performance (p = 0.0403). The resulting proposed comparative NLS classification framework contributes toward (i) advancement of NLS recognition studies, (ii) mitigation of CI user recruitment constraints and listener evaluation with NH listeners, (iii) development of a community shared testbed for comparative NLS studies, and (iv) advancement of NLS enhancement studies (identifiability and perceptual factors) among CI listeners.
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Affiliation(s)
- Ram C M C Shekar
- Cochlear Implant Processing Laboratory-Center for Robust Speech Systems (CRSS-CILab), University of Texas at Dallas, Richardson, Texas 75080, USA
| | - John H L Hansen
- Cochlear Implant Processing Laboratory-Center for Robust Speech Systems (CRSS-CILab), University of Texas at Dallas, Richardson, Texas 75080, USA
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Shafiro V, Luzum N, Moberly AC, Harris MS. Perception of Environmental Sounds in Cochlear Implant Users: A Systematic Review. Front Neurosci 2022; 15:788899. [PMID: 35082595 PMCID: PMC8785216 DOI: 10.3389/fnins.2021.788899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives: Improved perception of environmental sounds (PES) is one of the primary benefits of cochlear implantation (CI). However, past research contains mixed findings on PES ability in contemporary CI users, which at times contrast with anecdotal clinical reports. The present review examined extant PES research to provide an evidence basis for clinical counseling, identify knowledge gaps, and suggest directions for future work in this area of CI outcome assessment. Methods: Six electronic databases were searched using medical subject headings (MeSH) and keywords broadly identified to reference CI and environmental sounds. Records published between 2000 and 2021 were screened by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to identify studies that met the inclusion criteria. Data were subsequently extracted and evaluated according to synthesis without-meta-analysis (SWiM) guidelines. Results: Nineteen studies met the inclusion criteria. Most examined PES in post-lingually implanted adults, with one study focused on pre/perilingual adults. Environmental sound identification (ESI) in quiet using open- or closed-set response format was most commonly used in PES assessment, included in all selected studies. ESI accuracy in CI children (3 studies) and adults (16 studies), was highly variable but generally mediocre (means range: 31–87%). Only two studies evaluated ESI performance prospectively before and after CI, while most studies were cross-sectional. Overall, CI performance was consistently lower than that of normal-hearing peers. No significant differences in identification accuracy were reported between CI candidates and CI users. Environmental sound identification correlated in CI users with measures of speech perception, music and spectro-temporal processing. Conclusion: The findings of this systematic review indicate considerable limitations in the current knowledge of PES in contemporary CI users, especially in pre/perilingual late-implanted adults and children. Although no overall improvement in PES following implantation was found, large individual variability and existing methodological limitations in PES assessment may potentially obscure potential CI benefits for PES. Further research in this ecologically relevant area of assessment is needed to establish a stronger evidence basis, identify CI users with significant deficits, and improve CI users' safety and satisfaction through targeted PES rehabilitation.
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Affiliation(s)
- Valeriy Shafiro
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, IL, United States
- *Correspondence: Valeriy Shafiro
| | - Nathan Luzum
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Aaron C. Moberly
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Michael S. Harris
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
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Shafiro V, Hebb M, Walker C, Oh J, Hsiao Y, Brown K, Sheft S, Li Y, Vasil K, Moberly AC. Development of the Basic Auditory Skills Evaluation Battery for Online Testing of Cochlear Implant Listeners. Am J Audiol 2020; 29:577-590. [PMID: 32946250 DOI: 10.1044/2020_aja-19-00083] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Cochlear implant (CI) performance varies considerably across individuals and across domains of auditory function, but clinical testing is typically restricted to speech intelligibility. The goals of this study were (a) to develop a basic auditory skills evaluation battery of tests for comprehensive assessment of ecologically relevant aspects of auditory perception and (b) to compare CI listeners' performance on the battery when tested in the laboratory by an audiologist or independently at home. Method The battery included 17 tests to evaluate (a) basic spectrotemporal processing, (b) processing of music and environmental sounds, and (c) speech perception in both quiet and background noise. The battery was administered online to three groups of adult listeners: two groups of postlingual CI listeners and a group of older normal-hearing (ONH) listeners of similar age. The ONH group and one CI group were tested in a laboratory by an audiologist, whereas the other CI group self-tested independently at home following online instructions. Results Results indicated a wide range in the performance of CI but not ONH listeners. Significant differences were not found between the two CI groups on any test, whereas on all but two tests, CI listeners' performance was lower than that of the ONH participants. Principal component analysis revealed that four components accounted for 82% of the variance in measured results, with component loading indicating that the test battery successfully captures differences across dimensions of auditory perception. Conclusions These results provide initial support for the use of the basic auditory skills evaluation battery for comprehensive online assessment of auditory skills in adult CI listeners.
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Affiliation(s)
- Valeriy Shafiro
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Megan Hebb
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Chad Walker
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Jasper Oh
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Ying Hsiao
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Kelly Brown
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Stanley Sheft
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Yan Li
- Department Communication Disorders & Sciences, Rush University Medical Center, Chicago, IL
| | - Kara Vasil
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus
| | - Aaron C. Moberly
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus
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Environmental Sound Awareness in Experienced Cochlear Implant Users and Cochlear Implant Candidates. Otol Neurotol 2019; 39:e964-e971. [PMID: 30252797 DOI: 10.1097/mao.0000000000002006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine if postlingually deaf adult cochlear implant (CI) users have better environmental sound awareness (ESA) compared with adult patients eligible for CIs who have not yet undergone implantation. STUDY DESIGN Cross-sectional cohort study. SETTING Tertiary referral center. PATIENTS A group of 39 postlingually deaf adult patients who are experienced CI users (ECI), and a group of 20 postlingually deaf adult patients who are cochlear implant candidates (CIC) awaiting implantation. INTERVENTION Cochlear implantation. MAIN OUTCOME MEASURE Environmental sound awareness as measured by accuracy (percent correct) using the computerized, Familiar Environmental Sounds Test-Identification (FEST-I). RESULTS There was no significant difference between ESA in our sample of ECI users versus CIC patients. The ECI users scored an average FEST-I accuracy of 59.9% (SD 14.3). In comparison, the CICs had an average FEST-I accuracy of 54.7% (SD 26.4). This difference was not statistically significant. CONCLUSIONS Our findings suggest that, despite the commonly held notion that improved ESA may be a benefit of cochlear implantation, our sample of ECI users did not demonstrate superior performance compared with CICs.
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Categorization of everyday sounds by cochlear implanted children. Sci Rep 2019; 9:3532. [PMID: 30837546 PMCID: PMC6401047 DOI: 10.1038/s41598-019-39991-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/21/2019] [Indexed: 11/09/2022] Open
Abstract
Auditory categorization is an important process in the perception and understanding of everyday sounds. The use of cochlear implants (CIs) may affect auditory categorization and result in poor abilities. The current study was designed to compare how children with normal hearing (NH) and children with CIs categorize a set of everyday sounds. We tested 24 NH children and 24 children with CI on a free-sorting task of 18 everyday sounds corresponding to four a priori categories: nonlinguistic human vocalizations, environmental sounds, musical sounds, and animal vocalizations. Multiple correspondence analysis revealed considerable variation within both groups of child listeners, although the human vocalizations and musical sounds were similarly categorized. In contrast to NH children, children with CIs categorized some sounds according to their acoustic content rather than their associated semantic information. These results show that despite identification deficits, children with CIs are able to categorize environmental and vocal sounds in a similar way to NH children, and are able to use categorization as an adaptive process when dealing with everyday sounds.
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The Relationship Between Environmental Sound Awareness and Speech Recognition Skills in Experienced Cochlear Implant Users. Otol Neurotol 2018; 38:e308-e314. [PMID: 28731964 DOI: 10.1097/mao.0000000000001514] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS 1) Environmental sound awareness (ESA) and speech recognition skills in experienced, adult cochlear implant (CI) users will be highly correlated, and, 2) ESA skills of CI users will be significantly lower than those of age-matched adults with normal hearing. BACKGROUND Enhancement of ESA is often discussed with patients with sensorineural hearing loss as a potential benefit of implantation and, in some cases, ESA may be a major motivating factor. Despite its ecological validity and patients' expectations, ESA remains largely a presumed skill. The relationship between ESA and speech recognition is not well-understood. METHODS ESA was assessed in 35 postlingually deaf, experienced CI users and a control group of 41 age-matched, normal hearing listeners using the validated, computerized familiar environmental sounds test-identification (FEST-I) and a diverse speech recognition battery. Demographic and audiological factors as well as nonverbal intelligence quotient (IQ)/nonverbal reasoning and spectral resolution were assessed. RESULTS Six of the 35 experienced CI users (17%) demonstrated FEST-I accuracy within the range of the NH controls. Among CI users all correlations between FEST-I accuracy and speech recognition scores were strong. Chronological age at the time of testing, duration of deafness, spectral resolution, and nonverbal IQ/nonverbal reasoning were strongly correlated with FEST-I accuracy. Partial correlation analysis showed that correlations between FEST-I and speech recognition measures remained significant when controlling for the demographic and audiological factors. CONCLUSION Our findings reinforce the hypothesis that ESA and speech perception share common underlying processes rather than reflecting truly separate auditory domains.
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Altieri N. Commentary: Environmental Sound Training in Cochlear Implant Users. Front Neurosci 2017; 11:36. [PMID: 28203144 PMCID: PMC5285350 DOI: 10.3389/fnins.2017.00036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/18/2017] [Indexed: 12/03/2022] Open
Affiliation(s)
- Nicholas Altieri
- Communication Sciences and Disorders, ISU Multimodal Language Processing Lab, Idaho State University Pocatello, ID, USA
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Shafiro V, Sheft S, Norris M, Spanos G, Radasevich K, Formsma P, Gygi B. Toward a Nonspeech Test of Auditory Cognition: Semantic Context Effects in Environmental Sound Identification in Adults of Varying Age and Hearing Abilities. PLoS One 2016; 11:e0167030. [PMID: 27893791 PMCID: PMC5125666 DOI: 10.1371/journal.pone.0167030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 11/08/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Sounds in everyday environments tend to follow one another as events unfold over time. The tacit knowledge of contextual relationships among environmental sounds can influence their perception. We examined the effect of semantic context on the identification of sequences of environmental sounds by adults of varying age and hearing abilities, with an aim to develop a nonspeech test of auditory cognition. METHOD The familiar environmental sound test (FEST) consisted of 25 individual sounds arranged into ten five-sound sequences: five contextually coherent and five incoherent. After hearing each sequence, listeners identified each sound and arranged them in the presentation order. FEST was administered to young normal-hearing, middle-to-older normal-hearing, and middle-to-older hearing-impaired adults (Experiment 1), and to postlingual cochlear-implant users and young normal-hearing adults tested through vocoder-simulated implants (Experiment 2). RESULTS FEST scores revealed a strong positive effect of semantic context in all listener groups, with young normal-hearing listeners outperforming other groups. FEST scores also correlated with other measures of cognitive ability, and for CI users, with the intelligibility of speech-in-noise. CONCLUSIONS Being sensitive to semantic context effects, FEST can serve as a nonspeech test of auditory cognition for diverse listener populations to assess and potentially improve everyday listening skills.
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Affiliation(s)
- Valeriy Shafiro
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois
- * E-mail:
| | - Stanley Sheft
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois
| | - Molly Norris
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois
| | - George Spanos
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois
| | - Katherine Radasevich
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois
| | - Paige Formsma
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois
| | - Brian Gygi
- Veterans Affairs Northern California Health Care System, Martinez, California
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