Transcript Different evaluations for different kinds of hearing

Different evaluations
for
different kinds of hearing
Matthew 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
Middle notes
High notes
Imagine the inner ear
as a piano…
Low notes
Middle notes
High notes
Imagine the inner ear
as a piano…
Low notes
Middle notes
High notes
Imagine the inner ear
as a piano…
Low notes
Middle notes
High notes
In real life…
Listening for information,
listening for clarity
Listening for information,
listening for clarity
Restaurant
Restaurant
Restaurant
Restaurant
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.
sh
male voice
ss
boundary
female voice
Testing for a boundary
“sh”
“ss”
Focus on a region of interest
Label the
sounds
Accommodation to
talker voice
(CI Listener data)
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Accommodation to
talker FACE
(CI Listener data)
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Accommodation to
talker voice with face
(CI Listener data)
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Boundary shift (Hz)
A change of [this context]
is worth [this much change]
in auditory frequency boundary
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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]