ABSTRACT
This investigation was designed to evaluate the aerodynamic characteristics of the speech of adult multichannel cochlear implant (Nucleus, 21-channel) recipients. Five adults with an acquired profound sensorineural hearing loss were tested before implantation, immediately following implantation, and 3, 6, 9, and 12 months after implantation. A commercially available computerized pressure-flow instrumentation system was employed to assess the respiratory, laryngeal, velopharyngeal, and oral articulatory subsystems of speech of the implantees. The results of the investigation indicated 1) a slight increase in airflow rate values for sustained vowel /a/phonation after implantation, 2) a slight increase in duration of sustained vowel phonation from the preimplant period to the last postimplant period, 3) an increase in laryngeal airway resistance after implantation that resulted from a larger increase in estimated transglottal pressure than in transglottal airflow, 4) maintenance of normal velopharyngeal closure in oral-nasal contrastive contexts, and 5) slight increases in oral orifice area for fricative syllable utterances following implantation. Individual strategies for coordinated control of the speech mechanism appear to be potent variables to consider when assessing speech production.
Subject(s)
Cochlear Implants , Hearing Loss, Bilateral/physiopathology , Hearing Loss, Bilateral/surgery , Hearing Loss, Sensorineural/physiopathology , Hearing Loss, Sensorineural/surgery , Speech/physiology , Adult , Airway Resistance , Female , Follow-Up Studies , Hearing Loss, Bilateral/complications , Hearing Loss, Sensorineural/complications , Humans , Male , Middle Aged , Postoperative Care , Pulmonary Ventilation , Speech Production MeasurementABSTRACT
Most pediatric cochlear implant programs support a team approach for post-implant services. However, individuals directly involved in the care of these children often have differing opinions on the child's performance. We describe our experience with four children, aged 3 to 10 at the time of implantation, who have used the Nucleus 22-channel cochlear implant device for at least nine months. A questionnaire, focusing on the individual's observations of the child's speech and hearing performance in their particular setting (i.e., clinic, home, school), was completed by the child's parent(s), therapist and classroom teacher. Overall, performance in structured settings (i.e., testing and therapy sessions) was not in agreement with performance in unstructured settings (i.e., classroom and home environments). The results suggest that different individuals interacting with the same child in different environments often have differing perceptions of the child's performance. Based on the information obtained on the four cases, we discuss factors to consider in assessing the real-life performance of pediatric cochlear implant recipients.
Subject(s)
Cochlear Implants , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Male , Observer Variation , Speech Discrimination Tests , Surveys and QuestionnairesABSTRACT
A staggered multiple baseline single-subject experimental design was used to assess the effectiveness of a postimplant intensive aural rehabilitation program. Four adults with an acquired profound hearing loss were provided with a Nucleus 22-channel cochlear implant. The subjects completed a speech perception test protocol once before their cochlear implant operation and at 3-month intervals for a period of 12 months postimplantation. Each subject participated in a 12-week postimplant intensive aural rehabilitation program. A comparison of the prerehabilitation and postrehabilitation results failed to reveal any systematic improvements in performance on the speech perception tests that could be attributed unequivocally to the aural rehabilitation program.