Age-Related Changes in Voice Emotion Recognition by Postlingually Deafened Listeners With Cochlear Implants.

OBJECTIVES: Identification of emotional prosody in speech declines with age in normally hearing (NH) adults. Cochlear implant (CI) users have deficits in the perception of prosody, but the effects of age on vocal emotion recognition by adult postlingually deaf CI users are not known. The objective of the present study was to examine age-related changes in CI users' and NH listeners' emotion recognition. DESIGN: Participants included 18 CI users (29.6 to 74.5 years) and 43 NH adults (25.8 to 74.8 years). Participants listened to emotion-neutral sentences spoken by a male and female talker in five emotions (happy, sad, scared, angry, neutral). NH adults heard them in four conditions: unprocessed (full spectrum) speech, 16-channel, 8-channel, and 4-channel noise-band vocoded speech. The adult CI users only listened to unprocessed (full spectrum) speech. Sensitivity (d') to emotions and Reaction Times were obtained using a single-interval, five-alternative, forced-choice paradigm. RESULTS: For NH participants, results indicated age-related declines in Accuracy and d', and age-related increases in Reaction Time in all conditions. Results indicated an overall deficit, as well as age-related declines in overall d' for CI users, but Reaction Times were elevated compared with NH listeners and did not show age-related changes. Analysis of Accuracy scores (hit rates) were generally consistent with d' data. CONCLUSIONS: Both CI users and NH listeners showed age-related deficits in emotion identification. The CI users' overall deficit in emotion perception, and their slower response times, suggest impaired social communication which may in turn impact overall well-being, particularly so for older CI users, as lower vocal emotion recognition scores have been associated with poorer subjective quality of life in CI patients.

Voice Emotion Recognition by Children With Mild-to-Moderate Hearing Loss.

OBJECTIVES: Emotional communication is important in children's social development. Previous studies have shown deficits in voice emotion recognition by children with moderate-to-severe hearing loss or with cochlear implants. Little, however, is known about emotion recognition in children with mild-to-moderate hearing loss. The objective of this study was to compare voice emotion recognition by children with mild-to-moderate hearing loss relative to their peers with normal hearing, under conditions in which the emotional prosody was either more or less exaggerated (child-directed or adult-directed speech, respectively). We hypothesized that the performance of children with mild-to-moderate hearing loss would be comparable to their normally hearing peers when tested with child-directed materials but would show significant deficits in emotion recognition when tested with adult-directed materials, which have reduced prosodic cues. DESIGN: Nineteen school-aged children (8 to 14 years of age) with mild-to-moderate hearing loss and 20 children with normal hearing aged 6 to 17 years participated in the study. A group of 11 young, normally hearing adults was also tested. Stimuli comprised sentences spoken in one of five emotions (angry, happy, sad, neutral, and scared), either in a child-directed or in an adult-directed manner. The task was a single-interval, five-alternative forced-choice paradigm, in which the participants heard each sentence in turn and indicated which of the five emotions was associated with that sentence. Reaction time was also recorded as a measure of cognitive load. RESULTS: Acoustic analyses confirmed the exaggerated prosodic cues in the child-directed materials relative to the adult-directed materials. Results showed significant effects of age, specific emotion (happy, sad, etc.), and test materials (better performance with child-directed materials) in both groups of children, as well as susceptibility to talker variability. Contrary to our hypothesis, no significant differences were observed between the 2 groups of children in either emotion recognition (percent correct or d' values) or in reaction time, with either child- or adult-directed materials. Among children with hearing loss, degree of hearing loss (mild or moderate) did not predict performance. In children with hearing loss, interactions between vocabulary, materials, and age were observed, such that older children with stronger vocabulary showed better performance with child-directed speech. Such interactions were not observed in children with normal hearing. The pattern of results was broadly consistent across the different measures of accuracy, d', and reaction time. CONCLUSIONS: Children with mild-to-moderate hearing loss do not have significant deficits in overall voice emotion recognition compared with their normally hearing peers, but mechanisms involved may be different between the 2 groups. The results suggest a stronger role for linguistic ability in emotion recognition by children with normal hearing than by children with hearing loss.

Forward Digit Span and Word Familiarity Do Not Correlate With Differences in Speech Recognition in Individuals With Cochlear Implants After Accounting for Auditory Resolution.

Purpose In individuals with cochlear implants, speech recognition is not associated with tests of working memory that primarily reflect storage, such as forward digit span. In contrast, our previous work found that vocoded speech recognition in individuals with normal hearing was correlated with performance on a forward digit span task. A possible explanation for this difference across groups is that variability in auditory resolution across individuals with cochlear implants could conceal the true relationship between speech and memory tasks. Here, our goal was to determine if performance on forward digit span and speech recognition tasks are correlated in individuals with cochlear implants after controlling for individual differences in auditory resolution. Method We measured sentence recognition ability in 20 individuals with cochlear implants with Perceptually Robust English Sentence Test Open-set sentences. Spectral and temporal modulation detection tasks were used to assess individual differences in auditory resolution, auditory forward digit span was used to assess working memory storage, and self-reported word familiarity was used to assess vocabulary. Results Individual differences in speech recognition were predicted by spectral and temporal resolution. A correlation was found between forward digit span and speech recognition, but this correlation was not significant after controlling for spectral and temporal resolution. No relationship was found between word familiarity and speech recognition. Forward digit span performance was not associated with individual differences in auditory resolution. Conclusions Our findings support the idea that sentence recognition in individuals with cochlear implants is primarily limited by individual differences in working memory processing, not storage. Studies examining the relationship between speech and memory should control for individual differences in auditory resolution.

Optimization of Cervical and Ocular Vestibular Evoked Myogenic Potential Testing Using an Impulse Hammer in Adults, Adolescents, and Children.

OBJECTIVE: To characterize cervical and ocular vestibular evoked myogenic potential (c- and oVEMP) responses using an impulse hammer (IH) in adults and pediatrics at standardized force levels and evaluate: the relationship of force level on VEMP amplitude, sternocleidomastoid (SCM) contraction on cVEMP amplitude, required number of tap stimuli, and subject comfort. Using these data, optimal testing parameters were selected. STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: Seventy-eight healthy adults, adolescents, and children with no hearing or vestibular deficits. INTERVENTIONS: All subjects received c- and oVEMP testing using IH and 500 Hz tone burst air conduction stimuli. Adults received hard, medium, and soft force levels. Adolescents and children received medium and soft force levels. A comfort questionnaire was administered pre- and post-testing. MAIN OUTCOME MEASURES: IH VEMP response parameters (response rates, latency, cVEMP pre-stimulus SCM Electromyography [EMG], and peak-to-peak amplitude) were assessed per force level. Subjective reporting for patient comfort was also assessed. RESULTS: VEMP response rates ranged from 92 to 100%. Force had a linear relationship with VEMP amplitude. SCM contraction had a linear relationship with raw cVEMP amplitude; however, dissipated with amplitude normalization. Force level did not impact the number of taps needed. A minimum peak force of 15 to 20 N, accounting for SCM contraction, and using a lower EMG monitoring limit for cVEMP is recommended to elicit reliable responses. CONCLUSIONS: Overall, IH VEMP is appropriate and comfortable to use in adults and pediatrics and can be useful when an air conduction stimulus is contraindicated or not preferred.