Sensitivity to isolated and concurrent intensity and fundamental frequency increments by cochlear implant users under natural listening conditions

The effects of estimation accuracy, estimation approach, and number of selected channels using formant-priority channel selection for an "n-of-m" sound processing strategy for cochlear implants

Previously, selection of l channels was prioritized according to formant frequency locations in an l-of-n-of-m-based signal processing strategy to provide important voicing information independent of listening environments for cochlear implant (CI) users. In this study, ideal, or ground truth, formants were incorporated into the selection stage to determine the effect of accuracy on (1) subjective speech intelligibility, (2) objective channel selection patterns, and (3) objective stimulation patterns (current). An average +11% improvement (p < 0.05) was observed across six CI users in quiet, but not for noise or reverberation conditions. Analogous increases in channel selection and current for the upper range of F1 and a decrease across mid-frequencies with higher corresponding current, were both observed at the expense of noise-dominant channels. Objective channel selection patterns were analyzed a second time to determine the effects of estimation approach and number of selected channels (n). A significant effect of estimation approach was only observed in the noise and reverberation condition with minor differences in channel selection and significantly decreased stimulated current. Results suggest that estimation method, accuracy, and number of channels in the proposed strategy using ideal formants may improve intelligibility when corresponding stimulated current of formant channels are not masked by noise-dominant channels.

Identification and Comprehension of Narrow Focus by Arabic-Speaking Adolescents With Moderate-to-Profound Hearing Loss

PURPOSE

Processing narrow focus (NF), the stressed word in the sentence, includes both the perceptual ability to identify the stressed word in the sentence and the pragmatic-semantic ability to comprehend the nonexplicit linguistic message. NF and its underlying meaning can be conveyed only via the auditory modality. Therefore, NF can be considered as a measure for assessing the efficacy of the hearing aid (HA) and cochlear implants (CIs) for acquiring nonexplicit language skills. The purpose of this study was to assess identification and comprehension of NF by HA and CI users who are native speakers of Arabic and to associate NF outcomes with speech perception and cognitive and linguistic abilities.

METHOD

A total of 46 adolescents (age range: 11;2-18;8) participated: 18 with moderate-to-severe hearing loss who used HAs, 10 with severe-to-profound hearing loss who used CIs, and 18 with typical hearing (TH). Test materials included the Arabic Narrow Focus Test (ANFT), which includes three subtests assessing identification (ANFT1), comprehension of NF in simple four-word sentences (ANFT2), and longer sentences with a construction list at the clause or noun phrase level (ANFT3). In addition, speech perception, vocabulary, and working memory were assessed.

RESULTS

All the participants successfully identified the word carrying NF, with no significant difference between the groups. Comprehension of NF in ANFT2 and ANFT3 was reduced for HA and CI users compared with TH peers, and speech perception, hearing status, and memory for digits predicted the variability in the overall results of ANFT1, ANFT2, and ANFT3, respectively.

CONCLUSIONS

Arabic speakers who used HAs or CIs were able to identify NF successfully, suggesting that the acoustic cues were perceptually available to them. However, HA and CI users had considerable difficulty in understanding NF. Different factors may contribute to this difficulty, including the memory load during the task as well as pragmatic-linguistic knowledge on the possible meanings of NF.

Standardization of the Prosody in Use Battery (PUB): a speech prosody perception test in Danish

Assessment of prosody perception may be useful in a number of clinical scenarios, including the rehabilitation of cochlear implant recipients. It is with this group in mind that we have derived and standardized a battery of tests that assess speech prosody perception in the Danish language. The prosodic contrasts included in the battery are vowel length, compounds and phrases, emotions, questions and statements, prominence and pronoun reference, all of which are commonly encountered in everyday communication. Lists of candidate stimuli were compiled and recorded by a representative speaker of Danish. All candidate stimuli were presented to normal hearing subjects (n = 12) in both unprocessed and 8-channel noise vocoded conditions. Subjects performed closed-set identification and the results were used to derive the final stimulus set. We report the results of the six subtests, in which we observed a bias to compounds in the compound/phrase subtest, and to statements in question/statement subtest. The pronoun reference subtest assessed the ability of a listener to infer a referent from the stress status of a pronoun, and we found high accuracy rates on this task indicating that it is suitable for inclusion in the battery. We discuss the possible uses of the Prosody in Use Battery in cochlear implant mapping and device verification. We also consider the role of the results from the test battery in guiding clinicians to material suitable for aural rehabilitation.

Voice Discrimination by Adults with Cochlear Implants: the Benefits of Early Implantation for Vocal-Tract Length Perception

Cochlear implant (CI) users find it extremely difficult to discriminate between talkers, which may partially explain why they struggle to understand speech in a multi-talker environment. Recent studies, based on findings with postlingually deafened CI users, suggest that these difficulties may stem from their limited use of vocal-tract length (VTL) cues due to the degraded spectral resolution transmitted by the CI device. The aim of the present study was to assess the ability of adult CI users who had no prior acoustic experience, i.e., prelingually deafened adults, to discriminate between resynthesized "talkers" based on either fundamental frequency (F0) cues, VTL cues, or both. Performance was compared to individuals with normal hearing (NH), listening either to degraded stimuli, using a noise-excited channel vocoder, or non-degraded stimuli. Results show that (a) age of implantation was associated with VTL but not F0 cues in discriminating between talkers, with improved discrimination for those subjects who were implanted at earlier age; (b) there was a positive relationship for the CI users between VTL discrimination and speech recognition score in quiet and in noise, but not with frequency discrimination or cognitive abilities; (c) early-implanted CI users showed similar voice discrimination ability as the NH adults who listened to vocoded stimuli. These data support the notion that voice discrimination is limited by the speech processing of the CI device. However, they also suggest that early implantation may facilitate sensory-driven tonotopicity and/or improve higher-order auditory functions, enabling better perception of VTL spectral cues for voice discrimination.

Recognition and Comprehension of "Narrow Focus" by Young Adults With Prelingual Hearing Loss Using Hearing Aids or Cochlear Implants

PURPOSE

The stressed word in a sentence (narrow focus [NF]) conveys information about the intent of the speaker and is therefore important for processing spoken language and in social interactions. The ability of participants with severe-to-profound prelingual hearing loss to comprehend NF has rarely been investigated. The purpose of this study was to assess the recognition and comprehension of NF by young adults with prelingual hearing loss compared with those of participants with normal hearing (NH).

METHOD

The participants included young adults with hearing aids (HA; n = 10), cochlear implants (CI; n = 12), and NH (n = 18). The test material included the Hebrew Narrow Focus Test (Segal, Kaplan, Patael, & Kishon-Rabin, in press), with 3 subtests, which was used to assess the recognition and comprehension of NF in different contexts.

RESULTS

The following results were obtained: (a) CI and HA users successfully recognized the stressed word, with the worst performance for CI; (b) HA and CI comprehended NF less well than NH; and (c) the comprehension of NF was associated with verbal working memory and expressive vocabulary in CI users.

CONCLUSIONS

Most CI and HA users were able to recognize the stressed word in a sentence but had considerable difficulty understanding it. Different factors may contribute to this difficulty, including the memory load during the task itself and linguistic and pragmatic abilities.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.5572792.

Acoustic Context Alters Vowel Categorization in Perception of Noise-Vocoded Speech

Normal-hearing listeners' speech perception is widely influenced by spectral contrast effects (SCEs), where perception of a given sound is biased away from stable spectral properties of preceding sounds. Despite this influence, it is not clear how these contrast effects affect speech perception for cochlear implant (CI) users whose spectral resolution is notoriously poor. This knowledge is important for understanding how CIs might better encode key spectral properties of the listening environment. Here, SCEs were measured in normal-hearing listeners using noise-vocoded speech to simulate poor spectral resolution. Listeners heard a noise-vocoded sentence where low-F1 (100-400 Hz) or high-F1 (550-850 Hz) frequency regions were amplified to encourage "eh" (/ɛ/) or "ih" (/ɪ/) responses to the following target vowel, respectively. This was done by filtering with +20 dB (experiment 1a) or +5 dB gain (experiment 1b) or filtering using 100 % of the difference between spectral envelopes of /ɛ/ and /ɪ/ endpoint vowels (experiment 2a) or only 25 % of this difference (experiment 2b). SCEs influenced identification of noise-vocoded vowels in each experiment at every level of spectral resolution. In every case but one, SCE magnitudes exceeded those reported for full-spectrum speech, particularly when spectral peaks in the preceding sentence were large (+20 dB gain, 100 % of the spectral envelope difference). Even when spectral resolution was insufficient for accurate vowel recognition, SCEs were still evident. Results are suggestive of SCEs influencing CI users' speech perception as well, encouraging further investigation of CI users' sensitivity to acoustic context.

Low-frequency fine-structure cues allow for the online use of lexical stress during spoken-word recognition in spectrally degraded speech

English listeners use suprasegmental cues to lexical stress during spoken-word recognition. Prosodic cues are, however, less salient in spectrally degraded speech, as provided by cochlear implants. The present study examined how spectral degradation with and without low-frequency fine-structure information affects normal-hearing listeners' ability to benefit from suprasegmental cues to lexical stress in online spoken-word recognition. To simulate electric hearing, an eight-channel vocoder spectrally degraded the stimuli while preserving temporal envelope information. Additional lowpass-filtered speech was presented to the opposite ear to simulate bimodal hearing. Using a visual world paradigm, listeners' eye fixations to four printed words (target, competitor, two distractors) were tracked, while hearing a word. The target and competitor overlapped segmentally in their first two syllables but mismatched suprasegmentally in their first syllables, as the initial syllable received primary stress in one word and secondary stress in the other (e.g., "'admiral," "'admi'ration"). In the vocoder-only condition, listeners were unable to use lexical stress to recognize targets before segmental information disambiguated them from competitors. With additional lowpass-filtered speech, however, listeners efficiently processed prosodic information to speed up online word recognition. Low-frequency fine-structure cues in simulated bimodal hearing allowed listeners to benefit from suprasegmental cues to lexical stress during word recognition.

Auditory Discrimination of Lexical Stress Patterns in Hearing-Impaired Infants with Cochlear Implants Compared with Normal Hearing: Influence of Acoustic Cues and Listening Experience to the Ambient Language

OBJECTIVES

To assess discrimination of lexical stress pattern in infants with cochlear implant (CI) compared with infants with normal hearing (NH). While criteria for cochlear implantation have expanded to infants as young as 6 months, little is known regarding infants' processing of suprasegmental-prosodic cues which are known to be important for the first stages of language acquisition. Lexical stress is an example of such a cue, which, in hearing infants, has been shown to assist in segmenting words from fluent speech and in distinguishing between words that differ only the stress pattern. To date, however, there are no data on the ability of infants with CIs to perceive lexical stress. Such information will provide insight to the speech characteristics that are available to these infants in their first steps of language acquisition. This is of particular interest given the known limitations that the CI device has in transmitting speech information that is mediated by changes in fundamental frequency.

DESIGN

Two groups of infants participated in this study. The first group included 20 profoundly hearing-impaired infants with CI, 12 to 33 months old, implanted under the age of 2.5 years (median age of implantation = 14.5 months), with 1 to 6 months of CI use (mean = 2.7 months) and no known additional problems. The second group of infants included 48 NH infants, 11 to 14 months old with normal development and no known risk factors for developmental delays. Infants were tested on their ability to discriminate between nonsense words that differed on their stress pattern only (/dóti/ versus /dotí/ and /dotí/ versus /dóti/) using the visual habituation procedure. The measure for discrimination was the change in looking time between the last habituation trial (e.g., /dóti/) and the novel trial (e.g., /dotí/).

RESULTS

(1) Infants with CI showed discrimination between lexical stress pattern with only limited auditory experience with their implant device, (2) discrimination of stress patterns in infants with CI was reduced compared with that of infants with NH, (3) both groups showed directional asymmetry in discrimination, that is, increased discrimination from the uncommon to the common stress pattern in Hebrew (/dóti/ versus /dotí/) compared with the reversed condition.

CONCLUSIONS

The CI device transmitted sufficient acoustic information (amplitude, duration, and fundamental frequency) to allow discrimination between stress patterns in young hearing-impaired infants with CI. The present pattern of results is in support of a discrimination model in which both auditory capabilities and "top-down" interactions are involved. That is, the CI infants detected changes between stressed and unstressed syllables after which they developed a bias for the more common weak-strong stress pattern in Hebrew. The latter suggests that infants with CI were able to extract the statistical distribution of stress patterns by listening to the ambient language even after limited auditory experience with the CI device. To conclude, in relation to processing of lexical stress patterns, infants with CI followed similar developmental milestones as hearing infants thus establishing important prerequisites for early language acquisition.

Gender categorization is abnormal in cochlear implant users

In normal hearing (NH), the perception of the gender of a speaker is strongly affected by two anatomically related vocal characteristics: the fundamental frequency (F0), related to vocal pitch, and the vocal tract length (VTL), related to the height of the speaker. Previous studies on gender categorization in cochlear implant (CI) users found that performance was variable, with few CI users performing at the level of NH listeners. Data collected with recorded speech produced by multiple talkers suggests that CI users might rely more on F0 and less on VTL than NH listeners. However, because VTL cannot be accurately estimated from recordings, it is difficult to know how VTL contributes to gender categorization. In the present study, speech was synthesized to systematically vary F0, VTL, or both. Gender categorization was measured in CI users, as well as in NH participants listening to unprocessed (only synthesized) and vocoded (and synthesized) speech. Perceptual weights for F0 and VTL were derived from the performance data. With unprocessed speech, NH listeners used both cues (normalized perceptual weight: F0 = 3.76, VTL = 5.56). With vocoded speech, NH listeners still made use of both cues but less efficiently (normalized perceptual weight: F0 = 1.68, VTL = 0.63). CI users relied almost exclusively on F0 while VTL perception was profoundly impaired (normalized perceptual weight: F0 = 6.88, VTL = 0.59). As a result, CI users' gender categorization was abnormal compared to NH listeners. Future CI signal processing should aim to improve the transmission of both F0 cues and VTL cues, as a normal gender categorization may benefit speech understanding in competing talker situations.

The effect of emphasis and position on word identification by adult cochlear implant listeners

This study examined the effect of emphasis and word position on word identification by postlingually deafened adult cochlear implant (CI) listeners (n = 20). These participants performed an identification task where Swedish (quasi-) minimal pairs were drawn from sentences and presented in a carrier sentence framework. It was found that emphasised stimuli were not identified more accurately than unemphasised stimuli. A regression analysis revealed a significant main effect for words drawn from the initial position in a sentence, however there was no interaction between original word position and emphasis. Post hoc analysis of the stimuli revealed that variations in the mean intensity of items arising from their original position in the sentence or emphasis status were unlikely to account for these results. These findings have implications for those who communicate regularly with CI listeners.

Gender categorization in cochlear implant users

PURPOSE

In this study, the authors examined the ability of subjects with cochlear implants (CIs) to discriminate voice gender and how this ability evolved as a function of CI experience.

METHOD

The authors presented a continuum of voice samples created by voice morphing, with 9 intermediate acoustic parameter steps between a typical male and a typical female. This method allowed for the evaluation of gender categorization not only when acoustical features were specific to gender but also for more ambiguous cases, when fundamental frequency or formant distribution were located between typical values.

RESULTS

Results showed a global, though variable, deficit for voice gender categorization in CI recipients compared with subjects with normal hearing. This deficit was stronger for ambiguous stimuli in the voice continuum: Average performance scores for CI users were 58% lower than average scores for subjects with normal hearing in cases of ambiguous stimuli and 19% lower for typical male and female voices. The authors found no significant improvement in voice gender categorization with CI experience.

CONCLUSIONS

These results emphasize the dissociation between recovery of speech recognition and voice feature perception after cochlear implantation. This large and durable deficit may be related to spectral and temporal degradation induced by CI sound coding, or it may be related to central voice processing deficits.

Perception of vowels and prosody by cochlear implant recipients in noise

The aim of the present study was to compare the ability of cochlear implant (CI) recipients to recognise speech prosody in the presence of speech-weighted noise to their ability to recognise vowels in the same test paradigm and listening condition. All test materials were recorded from four different speakers (two male, two female). Two prosody recognition tasks were developed, both using single words as stimuli. The first task involved a question/statement distinction, while the second task required listeners to make a judgement about the speaker's attitude. Vowel recognition tests were conducted using vowel pairs selected on the basis of specific acoustic cues (frequencies of the first two formants and duration). Ten CI users and ten normal-hearing controls were tested in both quiet and an adaptive noise condition, using a two-alternative forced-choice test paradigm for all the tests. Results indicated that vowel recognition was significantly better than prosody recognition in both listener groups in both quiet and noise, and that question/statement discrimination was the most difficult task for CI listeners in noise. Data from acoustic analyses were used to interpret differences in performance on different tasks and with different speakers.

LEARNING OUTCOMES

As a result of this activity, readers will be able to (1) describe suitable methods for comparing vowel and prosody perception in noise, (2) compare performance on vowel and prosody perception tasks in quiet in normal-hearing listeners and cochlear implant recipients, (3) compare performance on vowel and prosody perception tasks in noise in normal-hearing listeners and cochlear implant recipients and (4) relate performance on prosody tasks in quiet to performance on these tasks in noise.

Evidence of across-channel processing for spectral-ripple discrimination in cochlear implant listeners

Spectral-ripple discrimination has been used widely for psychoacoustical studies in normal-hearing, hearing-impaired, and cochlear implant listeners. The present study investigated the perceptual mechanism for spectral-ripple discrimination in cochlear implant listeners. The main goal of this study was to determine whether cochlear implant listeners use a local intensity cue or global spectral shape for spectral-ripple discrimination. The effect of electrode separation on spectral-ripple discrimination was also evaluated. Results showed that it is highly unlikely that cochlear implant listeners depend on a local intensity cue for spectral-ripple discrimination. A phenomenological model of spectral-ripple discrimination, as an "ideal observer," showed that a perceptual mechanism based on discrimination of a single intensity difference cannot account for performance of cochlear implant listeners. Spectral modulation depth and electrode separation were found to significantly affect spectral-ripple discrimination. The evidence supports the hypothesis that spectral-ripple discrimination involves integrating information from multiple channels.

Effects of consonant-vowel intensity ratio on loudness of monosyllabic words

Previous research has suggested that speech loudness is determined primarily by the vowel in consonant-vowel-consonant (CVC) monosyllabic words, and that consonant intensity has a negligible effect. The current study further examines the unique aspects of speech loudness by manipulating consonant-vowel intensity ratios (CVRs), while holding the vowel constant at a comfortable listening level (70 dB), to determine the extent to which vowels and consonants contribute differentially to the loudness of monosyllabic words with voiced and voiceless consonants. The loudness of words edited to have CVRs ranging from -6 to +6 dB was compared to that of standard words with unaltered CVR by 10 normal-hearing listeners in an adaptive procedure. Loudness and overall level as a function of CVR were compared for four CVC word types: both voiceless consonants modified; only initial voiceless consonants modified; both voiced consonants modified; and only initial voiced consonants modified. Results indicate that the loudness of CVC monosyllabic words is not based strictly on the level of the vowel; rather, the overall level of the word and the level of the vowel contribute approximately equally. In addition to furthering the basic understanding of speech perception, the current results may be of value for the coding of loudness by hearing aids and cochlear implants.

Advantage of bimodal fitting in prosody perception for children using a cochlear implant and a hearing aid

Cochlear implants are largely unable to encode voice pitch information, which hampers the perception of some prosodic cues, such as intonation. This study investigated whether children with a cochlear implant in one ear were better able to detect differences in intonation when a hearing aid was added in the other ear ("bimodal fitting"). Fourteen children with normal hearing and 19 children with bimodal fitting participated in two experiments. The first experiment assessed the just noticeable difference in F0, by presenting listeners with a naturally produced bisyllabic utterance with an artificially manipulated pitch accent. The second experiment assessed the ability to distinguish between questions and affirmations in Dutch words, again by using artificial manipulation of F0. For the implanted group, performance significantly improved in each experiment when the hearing aid was added. However, even with a hearing aid, the implanted group required exaggerated F0 excursions to perceive a pitch accent and to identify a question. These exaggerated excursions are close to the maximum excursions typically used by Dutch speakers. Nevertheless, the results of this study showed that compared to the implant only condition, bimodal fitting improved the perception of intonation.

Streaming of vowel sequences based on fundamental frequency in a cochlear-implant simulation

Cochlear-implant (CI) users often have difficulties perceiving speech in noisy environments. Although this problem likely involves auditory scene analysis, few studies have examined sequential segregation in CI listening situations. The present study aims to assess the possible role of fundamental frequency (F(0)) cues for the segregation of vowel sequences, using a noise-excited envelope vocoder that simulates certain aspects of CI stimulation. Obligatory streaming was evaluated using an order-naming task in two experiments involving normal-hearing subjects. In the first experiment, it was found that streaming did not occur based on F(0) cues when natural-duration vowels were processed to reduce spectral cues using the vocoder. In the second experiment, shorter duration vowels were used to enhance streaming. Under these conditions, F(0)-related streaming appeared even when vowels were processed to reduce spectral cues. However, the observed segregation could not be convincingly attributed to temporal periodicity cues. A subsequent analysis of the stimuli revealed that an F(0)-related spectral cue could have elicited the observed segregation. Thus, streaming under conditions of severely reduced spectral cues, such as those associated with CIs, may potentially occur as a result of this particular cue.

Effect of spectral smearing on the perceptual segregation of vowel sequences

Although segregation of both simultaneous and sequential speech items may be involved in the reception of speech in noisy environments, research on the latter is relatively sparse. Further, previous studies examining the ability of hearing-impaired listeners to form distinct auditory streams have produced mixed results. Finally, there is little work investigating streaming in cochlear implant recipients, who also have poor frequency resolution. The present study focused on the mechanisms involved in the segregation of vowel sequences and potential limitations to segregation associated with poor frequency resolution. An objective temporal-order paradigm was employed in which listeners reported the order of constituent vowels within a sequence. In Experiment 1, it was found that fundamental frequency based mechanisms contribute to segregation. In Experiment 2, reduced frequency tuning often associated with hearing impairment was simulated in normal-hearing listeners. In that experiment, it was found that spectral smearing of the vowels increased accurate identification of their order, presumably by reducing the tendency to form separate auditory streams. These experiments suggest that a reduction in spectral resolution may result in a reduced ability to form separate auditory streams, which may contribute to the difficulties of hearing-impaired listeners, and probably cochlear implant recipients as well, in multi-talker cocktail-party situations.