Reliability measure of a clinical test: Appreciation of Music in Cochlear Implantees (AMICI).

PURPOSE: The goals of this study were (1) to investigate the reliability of a clinical music perception test, Appreciation of Music in Cochlear Implantees (AMICI), and (2) examine associations between the perception of music and speech. AMICI was developed as a clinical instrument for assessing music perception in persons with cochlear implants (CIs). The test consists of four subtests: (1) music versus environmental noise discrimination, (2) musical instrument identification (closed-set), (3) musical style identification (closed-set), and (4) identification of musical pieces (open-set). To be clinically useful, it is crucial for AMICI to demonstrate high test-retest reliability, so that CI users can be assessed and retested after changes in maps or programming strategies. RESEARCH DESIGN: Thirteen CI subjects were tested with AMICI for the initial visit and retested again 10-14 days later. Two speech perception tests (consonant-nucleus-consonant [CNC] and Bamford-Kowal-Bench Speech-in-Noise [BKB-SIN]) were also administered. DATA ANALYSIS: Test-retest reliability and equivalence of the test's three forms were analyzed using paired t-tests and correlation coefficients, respectively. Correlation analysis was also conducted between results from the music and speech perception tests. RESULTS: Results showed no significant difference between test and retest (p > 0.05) with adequate power (0.9) as well as high correlations between the three forms (Forms A and B, r = 0.91; Forms A and C, r = 0.91; Forms B and C, r = 0.95). Correlation analysis showed high correlation between AMICI and BKB-SIN (r = -0.71), and moderate correlation between AMICI and CNC (r = 0.4). CONCLUSIONS: The study showed AMICI is highly reliable for assessing musical perception in CI users.

Perception of environmental sounds by experienced cochlear implant patients.

OBJECTIVES: Environmental sound perception serves an important ecological function by providing listeners with information about objects and events in their immediate environment. Environmental sounds such as car horns, baby cries, or chirping birds can alert listeners to imminent dangers as well as contribute to one's sense of awareness and well being. Perception of environmental sounds as acoustically and semantically complex stimuli may also involve some factors common to the processing of speech. However, very limited research has investigated the abilities of cochlear implant (CI) patients to identify common environmental sounds, despite patients' general enthusiasm about them. This project (1) investigated the ability of patients with modern-day CIs to perceive environmental sounds, (2) explored associations among speech, environmental sounds, and basic auditory abilities, and (3) examined acoustic factors that might be involved in environmental sound perception. DESIGN: Seventeen experienced postlingually deafened CI patients participated in the study. Environmental sound perception was assessed with a large-item test composed of 40 sound sources, each represented by four different tokens. The relationship between speech and environmental sound perception and the role of working memory and some basic auditory abilities were examined based on patient performance on a battery of speech tests (HINT, CNC, and individual consonant and vowel tests), tests of basic auditory abilities (audiometric thresholds, gap detection, temporal pattern, and temporal order for tones tests), and a backward digit recall test. RESULTS: The results indicated substantially reduced ability to identify common environmental sounds in CI patients (45.3%). Except for vowels, all speech test scores significantly correlated with the environmental sound test scores: r = 0.73 for HINT in quiet, r = 0.69 for HINT in noise, r = 0.70 for CNC, r = 0.64 for consonants, and r = 0.48 for vowels. HINT and CNC scores in quiet moderately correlated with the temporal order for tones. However, the correlation between speech and environmental sounds changed little after partialling out the variance due to other variables. CONCLUSIONS: Present findings indicate that environmental sound identification is difficult for CI patients. They further suggest that speech and environmental sounds may overlap considerably in their perceptual processing. Certain spectrotemproral processing abilities are separately associated with speech and environmental sound performance. However, they do not appear to mediate the relationship between speech and environmental sounds in CI patients. Environmental sound rehabilitation may be beneficial to some patients. Environmental sound testing may have potential diagnostic applications, especially with difficult-to-test populations and might also be predictive of speech performance for prelingually deafened patients with cochlear implants.

Development of a clinical test of musical perception: appreciation of music in cochlear implantees (AMICI).

The purpose of this study was to develop a test to assess the ability of persons with cochlear implants (CIs) to interpret musical signals. Up to this time, the main direction in outcomes studies of cochlear implantation has been in relation to speech recognition abilities. With improvement in CI hardware and processing strategies, there has been a growing interest in musical perception as a dimension that could improve greatly users' quality of life. The Appreciation of Music in Cochlear Implantees (AMICI) test was designed to measure the following abilities: discrimination of music versus noise; identification of musical instruments (from a closed set); identification of musical styles (from a closed set); and recognition of individual musical pieces (open set). The first phase of the study was test development and recording. The second phase entailed presentation of a large set of stimuli to normal listeners. Based on phase 2 findings, an item analysis was performed to eliminate stimuli that were confusing or resulted in high error rates in normals. In phase 3, hearing-impaired participants, using cochlear Implants, were assessed using the beta version of the AMICI test.