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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 14 Context and adaptation 15 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) 20 Accommodation to talker FACE (CI Listener data) 21 Accommodation to talker voice with face (CI Listener data) 22 Boundary shift (Hz) A change of [this context] is worth [this much change] in auditory frequency boundary 23 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 33 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]