Speech Recognition Materials and Ceiling Effects: Considerations for Cochlear Implant Programs

Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly m...

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Published inAudiology & neurotology Vol. 13; no. 3; pp. 193 - 205
Main Authors Gifford, René H., Shallop, Jon K., Peterson, Anna Mary
Format Journal Article
LanguageEnglish
Published Basel, Switzerland Karger 01.01.2008
S. Karger AG
Subjects
Online AccessGet full text
ISSN1420-3030
1421-9700
1421-9700
DOI10.1159/000113510

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Abstract Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly more residual hearing receiving implants. Despite this evolution, the same recommendations for pre- and postimplant speech recognition testing have been in place for over 10 years in the United States. To determine whether new recommendations are warranted, speech perception performance was assessed for 156 adult, postlingually deafened implant recipients as well as 50 hearing aid users on monosyllabic word recognition (CNC) and sentence recognition in quiet (HINT and AzBio sentences) and in noise (BKB-SIN). Results demonstrated that for HINT sentences in quiet, 28% of the subjects tested achieved maximum performance of 100% correct and that scores did not agree well with monosyllables (CNC) or sentence recognition in noise (BKB-SIN). For a more difficult sentence recognition material (AzBio), only 0.7% of the subjects achieved 100% performance and scores were in much better agreement with monosyllables and sentence recognition in noise. These results suggest that more difficult materials are needed to assess speech perception performance of postimplant patients – and perhaps also for determining implant candidacy.
AbstractList Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly more residual hearing receiving implants. Despite this evolution, the same recommendations for pre- and postimplant speech recognition testing have been in place for over 10 years in the United States. To determine whether new recommendations are warranted, speech perception performance was assessed for 156 adult, postlingually deafened implant recipients as well as 50 hearing aid users on monosyllabic word recognition (CNC) and sentence recognition in quiet (HINT and AzBio sentences) and in noise (BKB-SIN). Results demonstrated that for HINT sentences in quiet, 28% of the subjects tested achieved maximum performance of 100% correct and that scores did not agree well with monosyllables (CNC) or sentence recognition in noise (BKB-SIN). For a more difficult sentence recognition material (AzBio), only 0.7% of the subjects achieved 100% performance and scores were in much better agreement with monosyllables and sentence recognition in noise. These results suggest that more difficult materials are needed to assess speech perception performance of postimplant patients - and perhaps also for determining implant candidacy.Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly more residual hearing receiving implants. Despite this evolution, the same recommendations for pre- and postimplant speech recognition testing have been in place for over 10 years in the United States. To determine whether new recommendations are warranted, speech perception performance was assessed for 156 adult, postlingually deafened implant recipients as well as 50 hearing aid users on monosyllabic word recognition (CNC) and sentence recognition in quiet (HINT and AzBio sentences) and in noise (BKB-SIN). Results demonstrated that for HINT sentences in quiet, 28% of the subjects tested achieved maximum performance of 100% correct and that scores did not agree well with monosyllables (CNC) or sentence recognition in noise (BKB-SIN). For a more difficult sentence recognition material (AzBio), only 0.7% of the subjects achieved 100% performance and scores were in much better agreement with monosyllables and sentence recognition in noise. These results suggest that more difficult materials are needed to assess speech perception performance of postimplant patients - and perhaps also for determining implant candidacy.
Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly more residual hearing receiving implants. Despite this evolution, the same recommendations for pre- and postimplant speech recognition testing have been in place for over 10 years in the United States. To determine whether new recommendations are warranted, speech perception performance was assessed for 156 adult, postlingually deafened implant recipients as well as 50 hearing aid users on monosyllabic word recognition (CNC) and sentence recognition in quiet (HINT and AzBio sentences) and in noise (BKB-SIN). Results demonstrated that for HINT sentences in quiet, 28% of the subjects tested achieved maximum performance of 100% correct and that scores did not agree well with monosyllables (CNC) or sentence recognition in noise (BKB-SIN). For a more difficult sentence recognition material (AzBio), only 0.7% of the subjects achieved 100% performance and scores were in much better agreement with monosyllables and sentence recognition in noise. These results suggest that more difficult materials are needed to assess speech perception performance of postimplant patients – and perhaps also for determining implant candidacy.
Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly more residual hearing receiving implants. Despite this evolution, the same recommendations for pre- and postimplant speech recognition testing have been in place for over 10 years in the United States. To determine whether new recommendations are warranted, speech perception performance was assessed for 156 adult, postlingually deafened implant recipients as well as 50 hearing aid users on monosyllabic word recognition (CNC) and sentence recognition in quiet (HINT and AzBio sentences) and in noise (BKB-SIN). Results demonstrated that for HINT sentences in quiet, 28% of the subjects tested achieved maximum performance of 100% correct and that scores did not agree well with monosyllables (CNC) or sentence recognition in noise (BKB-SIN). For a more difficult sentence recognition material (AzBio), only 0.7% of the subjects achieved 100% performance and scores were in much better agreement with monosyllables and sentence recognition in noise. These results suggest that more difficult materials are needed to assess speech perception performance of postimplant patients - and perhaps also for determining implant candidacy. [PUBLICATION ABSTRACT]
Author Shallop, Jon K.
Peterson, Anna Mary
Gifford, René H.
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  fullname: Shallop, Jon K.
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  givenname: Anna Mary
  surname: Peterson
  fullname: Peterson, Anna Mary
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Issue 3
Keywords Ceiling effects
Cochlear implants
Implant candidacy
Speech recognition
Cochlear implant
ENT
Language English
License Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
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References Tillman T, Olsen W: Speech audiometry; in Jerger J (ed): Modern Developments in Audiology. New York, Academic Press, 1973.
Van der Putten JJMF, Hobart JC, Freeman JA, Thompson AJ: Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the Barthel Index and the Functional Independence Measure. J Neurol Neurosurg Psychiatry 1999;66:480-484.1020142010.1136%2Fjnnp.66.4.480
Bassim MK, Buss E, Clark MS, Kolln KA, Pillsbury CH, Pillsbury HC, Buchman CA: MED EL Combi40+ cochlear implantation in adults. Laryngoscope 2005;115:1568-1573.1614869610.1097%2F01.mlg.0000171023.72680.95
Helms J, Muller J, Schon F, Moser I, Arnold W, Janssen T, Ramsden R, von Ilberg C, Kiefer J, Pfennigdorf T, Gstoettner W, Baumgartner W, Ehrenberger K, Skarzynski H, Ribari O, Thumfart W, Stephan K, Mann W, Heinemann M, Zorowka P, Lippert KL, Zenner HP, Bohndord M, Huttenbrink K, Hochmair-Desoyer I: Evaluation of performance with the COMBI40 cochlear implant in adults: a multicentric clinical study. ORL J Otorhinolaryngol Relat Spec 1997;59:23-35.9104746
Nilsson MJ, Soli SD, Sullivan J: Development of the hearing in noise test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 1994;95:1085-1099.813290210.1121%2F1.408469
Litovsky R, Parkinson A, Arcaroli J, Sammeth C: Simultaneous bilateral cochlear implantation in adults: a multicenter clinical study. Ear Hear 2006;27:714-731.1708608110.1097%2F01.aud.0000246816.50820.42
Peterson GE, Lehiste I: Revised CNC lists for auditory tests. J Speech Hear Disord 1962;27:62-70.14485785
Centers for Medicare and Medicaid Services (CMS): CMS Manual System, Medicare National Coverage Determination, Subject: Cochlear Implantation. Transmittal 42, July 1, 2005, Pub 100-03.
Nilsson MJ, McCaw VM, Soli SD: Minimum Speech Test Battery for adult Cochlear Implant Users: User Manual. Los Angeles, House Ear Institute, 1996.
Firszt JB, Holden LK, Skinner MW, Tobey EA, Peterson A, Gaggl W, Runge-Samuelson CL, Wackym PA: Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear Hear 2004;25:375-387.1529277710.1097%2F01.AUD.0000134552.22205.EE
Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL: Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke 2002;33:1022-1027.1193505510.1161%2F01.STR.0000012516.63191.C5
Bench J, Kowal A, Bamford J: The BKB (Bamford-Kowal-Bench) sentence lists for partially-hearing children. Br J Audiol 1979;13:108-112.48681610.3109%2F03005367909078884
Dorman MF: Combining electric and acoustic stimulation. AudiologyNOW!, Denver, April 2007.
Spahr AJ, Dorman MF: Effects of minimum stimulation setting for the Med El Tempo+ speech processor on speech understanding. Ear Hear 2005;26:2S-6S.1608226210.1097%2F00003446-200508001-00002
Luxford WM, Allum D, Balkany T, Brimacombe J, Cohen N, Gantz B, Hodges A, Kessler D, Maltan A, Miyamoto R, Niparko J, Osberger MJ, Skinner M, Staller S, Tobey E, Tyler R, Waltzman S: Minimum speech test battery for postlingually deafened adult cochlear implant patients. Otolaryngol Head Neck Surg 2001;124:125-126.1122694410.1067%2Fmhn.2001.113035
Koch DB, Osberger MJ, Segel P, Kessler D: HiResolution and conventional sound processing in the HiResolution Bionic Ear: using appropriate outcome measures to assess speech recognition ability. Audiol Neurotol 2004;9:214-223.1520554910.1159%2F000078391
Mackersie CL: Tests of speech perception abilities. Curr Opin Otolaryngol Head Neck Surg 2002;10:392-397.10.1097%2F00020840-200210000-00012
Parkinson AJ, Arcaroli J, Staller SJ, Arndt PL, Cosgriff A, Ebinger K: The Nucleus 24 contour cochlear implant system: adult clinical trial results. Ear Hear 2002;23:41S-48S.1188376610.1097%2F00003446-200202001-00005
Boothroyd A, Hanin L, Hnath T: A Sentence Test of Speech Perception: Reliability, Set Equivalence, and Short Term Learning (Internal report RCI 10). New York, City University of New York, 1985.
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References_xml – reference: Luxford WM, Allum D, Balkany T, Brimacombe J, Cohen N, Gantz B, Hodges A, Kessler D, Maltan A, Miyamoto R, Niparko J, Osberger MJ, Skinner M, Staller S, Tobey E, Tyler R, Waltzman S: Minimum speech test battery for postlingually deafened adult cochlear implant patients. Otolaryngol Head Neck Surg 2001;124:125-126.1122694410.1067%2Fmhn.2001.113035
– reference: Nilsson MJ, Soli SD, Sullivan J: Development of the hearing in noise test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 1994;95:1085-1099.813290210.1121%2F1.408469
– reference: Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL: Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke 2002;33:1022-1027.1193505510.1161%2F01.STR.0000012516.63191.C5
– reference: Peterson GE, Lehiste I: Revised CNC lists for auditory tests. J Speech Hear Disord 1962;27:62-70.14485785
– reference: Firszt JB, Holden LK, Skinner MW, Tobey EA, Peterson A, Gaggl W, Runge-Samuelson CL, Wackym PA: Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear Hear 2004;25:375-387.1529277710.1097%2F01.AUD.0000134552.22205.EE
– reference: Tillman T, Olsen W: Speech audiometry; in Jerger J (ed): Modern Developments in Audiology. New York, Academic Press, 1973.
– reference: Spahr AJ, Dorman MF: Effects of minimum stimulation setting for the Med El Tempo+ speech processor on speech understanding. Ear Hear 2005;26:2S-6S.1608226210.1097%2F00003446-200508001-00002
– reference: Koch DB, Osberger MJ, Segel P, Kessler D: HiResolution and conventional sound processing in the HiResolution Bionic Ear: using appropriate outcome measures to assess speech recognition ability. Audiol Neurotol 2004;9:214-223.1520554910.1159%2F000078391
– reference: Boothroyd A, Hanin L, Hnath T: A Sentence Test of Speech Perception: Reliability, Set Equivalence, and Short Term Learning (Internal report RCI 10). New York, City University of New York, 1985.
– reference: Bassim MK, Buss E, Clark MS, Kolln KA, Pillsbury CH, Pillsbury HC, Buchman CA: MED EL Combi40+ cochlear implantation in adults. Laryngoscope 2005;115:1568-1573.1614869610.1097%2F01.mlg.0000171023.72680.95
– reference: Mackersie CL: Tests of speech perception abilities. Curr Opin Otolaryngol Head Neck Surg 2002;10:392-397.10.1097%2F00020840-200210000-00012
– reference: Bench J, Kowal A, Bamford J: The BKB (Bamford-Kowal-Bench) sentence lists for partially-hearing children. Br J Audiol 1979;13:108-112.48681610.3109%2F03005367909078884
– reference: Parkinson AJ, Arcaroli J, Staller SJ, Arndt PL, Cosgriff A, Ebinger K: The Nucleus 24 contour cochlear implant system: adult clinical trial results. Ear Hear 2002;23:41S-48S.1188376610.1097%2F00003446-200202001-00005
– reference: Centers for Medicare and Medicaid Services (CMS): CMS Manual System, Medicare National Coverage Determination, Subject: Cochlear Implantation. Transmittal 42, July 1, 2005, Pub 100-03.
– reference: Helms J, Muller J, Schon F, Moser I, Arnold W, Janssen T, Ramsden R, von Ilberg C, Kiefer J, Pfennigdorf T, Gstoettner W, Baumgartner W, Ehrenberger K, Skarzynski H, Ribari O, Thumfart W, Stephan K, Mann W, Heinemann M, Zorowka P, Lippert KL, Zenner HP, Bohndord M, Huttenbrink K, Hochmair-Desoyer I: Evaluation of performance with the COMBI40 cochlear implant in adults: a multicentric clinical study. ORL J Otorhinolaryngol Relat Spec 1997;59:23-35.9104746
– reference: Dorman MF: Combining electric and acoustic stimulation. AudiologyNOW!, Denver, April 2007.
– reference: Nilsson MJ, McCaw VM, Soli SD: Minimum Speech Test Battery for adult Cochlear Implant Users: User Manual. Los Angeles, House Ear Institute, 1996.
– reference: Litovsky R, Parkinson A, Arcaroli J, Sammeth C: Simultaneous bilateral cochlear implantation in adults: a multicenter clinical study. Ear Hear 2006;27:714-731.1708608110.1097%2F01.aud.0000246816.50820.42
– reference: Van der Putten JJMF, Hobart JC, Freeman JA, Thompson AJ: Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the Barthel Index and the Functional Independence Measure. J Neurol Neurosurg Psychiatry 1999;66:480-484.1020142010.1136%2Fjnnp.66.4.480
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Snippet Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due...
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SubjectTerms Audiology
Biological and medical sciences
Cochlear Implantation
Cochlear implants
Deafness
Functional Laterality
Hearing Aids
Hearing Loss - classification
Hearing Loss - etiology
Hearing Loss - therapy
Humans
Medical sciences
Original Paper
Otorhinolaryngology. Stomatology
Pattern Recognition, Physiological - physiology
Postoperative Period
Speech Discrimination Tests
Speech Perception
Speech Reception Threshold Test
Treatment Outcome
Voice recognition
Title Speech Recognition Materials and Ceiling Effects: Considerations for Cochlear Implant Programs
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Volume 13
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