Different evaluationsfor different kinds of hearingMatthew B. Winn Au.D., Ph.D.Waisman Center,UW-Madison Dept. of Surgery
Different kinds of hearing?• Using both ears together
• Listening for information / listening for clarity
• The ears as part of the brain & part of the whole person
The challenge of using a cochlear implant•Sound distortion•Pitch shifting•Abnormal loudness•Neural atrophy
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
In real life…
Listening for information,listening for clarity
Listening for information,listening for clarity
Restaurant
Restaurant
RestaurantRestaurant
Testing for clarity in hearing
Testing for clarity in hearing• Speech sounds are morphed from one sound to another• Listeners label each sound as it is heard• Labeling consistency and confidence is modeled statistically
Different listeners have different levels of clarity in their hearing
(clarity)
Context and adaptation
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Context and adaptation
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Some voices have predictable patterns of differences• Pitch, duration, voice quality, articulation, etc.
• We can form categories• High / low pitch • Creaky / smooth voice quality• “eee” / “ooo”• “sss” “sh”
Some voices have predictable patterns of differences
A “low” pitch for one voice may be higher than a “high” pitch for another voice
Testing adjustment to different voices• Low pitch / High pitch
“sh” “ss”
• The difference between low “sh” and high “ss” depends on whether the voice is female or male.
male voicesh ss
female voice
boundary
Testing for a boundaryFocus on a region of interest
Label the sounds
“sh” “ss”
Accommodation to talker voice
20(CI Listener data)
Accommodation to talker FACE
21(CI Listener data)
Accommodation to talker voice with face
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A change of [this context]is worth [this much change]in auditory frequency boundary
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Bou
ndar
y sh
ift (H
z)
Listeners with normal hearing adjust to the talker’s voice
Listeners with cochlear implants adjust to the talker’s voice and face
Adjusting on the fly• Listeners with normal hearing can adjust to the
speech of various talkers on-the-fly using their ears
• Listeners with cochlear implants can adjust using their ears AND their eyes,• So they may benefit from learning some audio+visual
associations between faces and vocal styles
Binaural and Bilateral• People with normal hearing enjoy binaural hearing,
which means the two ears work together and compare inputs.
• This lets us do many things, including locate a sound in space and separate speech from background noise
Using two cochlear implants
• Two cochlear implants are independent systems that may or may not work well together
Binaural and Bilateral• People with bilateral cochlear implants
generally report benefit from the second device• Better sound localization• Better hearing in noise
Some abilities are easily quantifiable…• Word recognition over the first two years
• Sound localization
Other abilities are not-so-easily quantifiable.(From the Cochlear Corp. website)Benefits of bilateral implantation:• More connected• More confident• More balanced and relaxed• Peace of mind
Bilateral implants make it “easier to hear everyday sounds… without the constant strain associated with a hearing loss.”
Listening fatigue and hearing loss:why it matters
• Individuals with hearing loss (HL) have to "work harder" cognitively to process sounds compared to people without hearing loss
• Increased reports of stress, tension & fatigue [1]
• Higher "need for recovery" from work [2]
• Individuals with HL are more likely to miss work due to "fatigue, strain or burnout" than individuals without HL working at a similar or the same job [3]
Effort Pupil dilation • Task-evoked pupil dilation corresponds to cognitive effort
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Listening effort test• Listen to sentences with the right implant only
• Listen to sentences with the left implant only
• Listen to sentences with both implants
• Hear the sentence, wait a moment, then repeat
• We measure pupil size as the sentence ends, and during the time before you repeat it back
Right ear CI only
Right and Left CIs
Bilateral CIs
New directions• Technology exists to improve sound clarity
• Efforts can be made to synchronize both ears
• CI recipients undergo auditory training
• We can evaluate the effects of these efforts on the listener’s experience of mental effort required to listen
Questions and comments are welcome!• Matthew Winn• [email protected]