Music perception and training for pediatric cochlear implant users

ABSTRACT

Introduction

Cochlear implants (CIs) are biomedical devices that restore sound perception for people with severe-to-profound sensorineural hearing loss. Most postlingually deafened CI users are able to achieve excellent speech recognition in quiet environments. However, current CI sound processors remain limited in their ability to deliver fine spectrotemporal information, making it difficult for CI users to perceive complex sounds. Limited access to complex acoustic cues such as music, environmental sounds, lexical tones, and voice emotion may have significant ramifications on quality of life, social development, and community interactions.

Areas covered

The purpose of this review article is to summarize the literature on CIs and music perception, with an emphasis on music training in pediatric CI recipients. The findings have implications on our understanding of noninvasive, accessible methods for improving auditory processing and may help advance our ability to improve sound quality and performance for implantees.

Expert opinion

Music training, particularly in the pediatric population, may be able to continue to enhance auditory processing even after performance plateaus. The effects of these training programs appear generalizable to non-trained musical tasks, speech prosody and, emotion perception. Future studies should employ rigorous control groups involving a non-musical acoustic intervention, standardized auditory stimuli, and the provision of feedback.

KEYWORDS:

• Auditory system
• cochlear implants
• melody
• music training
• music perception
• pediatric Cochlear implant users
• pitch
• rehabilitation
• rhythm
• timbre

Article Highlights

• Cochlear implants are biomedical devices that electrically stimulate the auditory nerve to deliver sound to people with severe-to-profound sensorineural hearing loss. Over the past several decades, these devices have evolved and been tremendously successful in restoring speech perception in quiet environments and improving quality of life for implantees.

• Cochlear implant users, however, have poor complex sound perception due to processing limitations with fine spectrotemporal cues. These deficits affect their ability to process music, voice emotion, lexical tones, environmental sounds, and speech in the presence of background noise.

• In-person and at-home music training interventions have been shown to improve pediatric music perception performance on untrained stimuli. These benefits also seem to be generalizable to speech perception tasks – particularly those where detection of pitch inflections may have greater weight.

• Large study design variability makes it difficult for inter-study music training comparisons between implanted participants. Future studies should continue to employ rigorous controls, to conduct meaningful task paradigms, and to identify barriers to participation and engagement.

Declaration of interest

C.J. Limb serves as a member of the Medical Advisory Board and receives research funding and support from Advanced Bionics Corporation, Oticon Medical, and MED-EL Corporation. C.J. Limb has served as Scientific Chair of the Music Advisory Board for MED-EL Corporation. C.J. Limb also serves as Chief Medical Officer and consultant for Spiral Therapeutics. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.