Introduction

The cultural, emotional, and psychological importance of music to all human beings, young and old, is indisputable; references to music in literature and history go as far back as Plato who said: ‘Music gives a soul to the universe, wings to the mind, flight to the imagination, and life to everything’. Perhaps even more relevant to the topic of music perception and enjoyment by people with a hearing loss are the words of Heinrich Heine: ‘Where words leave off, music begins.’ The evidence of the benefits of music for mental and physical health has accumulated over recent years, as well as the potential benefits for intellectual development; many studies have reported correlations between musical participation and intellectual performance and IQ (e.g. Schellenberg, 2004). Many hearing people, if asked how they would feel if they lost their hearing, might say that they would miss music more than anything; there is no doubt that music perception and enjoyment is critically important both to individuals and as a group activity in all cultures.

However, the focus when evaluating the benefits and outcomes of cochlear implantation for children and adults has almost universally been on the perception of speech; until recently, scant attention has been given to the possibility that cochlear implant listeners could gain any enjoyment from listening to music at all. Indeed, it is routine to counsel patients considering having cochlear implant surgery that they should not expect to hear music well; that implants are designed to convey speech and cannot convey music well at all; and that if music is heard, it is likely to sound poor and enjoyment of it is not typical. There are sound scientific reasons underlying these assumptions. It is correct to say that the sound processing regimes used by cochlear implant systems have been developed to maximize the potential for speech discrimination, and are not aimed at hearing of music and other non-speech sounds. The comprehensive review by McDermott (2004) listed in some detail the limitations of cochlear implants in conveying music: this included the somewhat bleak statement that ‘Even with technically sophisticated multiple-channel sound processors, recognition of melodies, especially without rhythmic or verbal cues, is poor, with performance at little better than chance levels for many implant users’ and ‘Perception of timbre, which is usually evaluated by experimental procedures that require subjects to identify musical instrument sounds, is generally unsatisfactory’. Many other papers have confirmed that by the very nature of how cochlear implant systems process sounds and convert them into patterns of electrical stimulation, the perception of musical pitch, harmonics, melody, and other features important for musical perception would be predicted to be poor.

Despite this, the fact is that many thousands of cochlear implant users of all ages do gain enormous pleasure from music listening, and the papers collated in this supplement confirm that. Now that it is well established that current implant systems can provide amazingly good speech recognition abilities for the majority of implant users, much attention has quite rightly switched recently to music perception, and the authors who have contributed here are the leading lights in this exciting new area of research.

The supplement opens with the first-person experiences of Richard Reed, who combines being a top-notch musician with being a cochlear implant recipient and so is living proof of how cochlear implants can convey music astonishingly well. The papers by Geoff Plant, Elizabeth Hutter and colleagues, Kate Gfeller and colleagues, and Rachel von Besouw and colleagues describe varied and innovative ways of introducing music to adult cochlear implant listeners; Christine Rocca, Christine Barton, and Amy McConkey Robbins both report on effective ways to boost communication and listening skills and auditory learning through music in children. The study by Graham Welch and co-workers, focussing on how singing can be used to nurture children's hearing, adds a new and fascinating dimension. The value of hearing aids for music perception by implant listeners is described by Nathaniel Peterson and Tonya R. Bergeson, while the papers by Mary L. Grasmeder, Carl A. Verschuur, and Valerie Looi and colleagues describe specific aspects of pitch perception by implant users. Finally, the papers by Alexis Roy, Meredith Caldwell, and Tina Munjal and their colleagues focus on the impact of reverberation (a daily reality in real-life listening conditions) on musical sound quality, the importance of tempo more than pitch in perception of musical emotion (possibly one of the most important aspects of musical enjoyment) and how novel modifications to electrical stimulation might be used to improve bass perception, and so enhance the quality of music for implant listeners.

Overall, this is an important gathering of fascinating and up to date information covering varied aspects of this growing area of interest, including both the personal, the practical, and the scientific; I hope all readers of this supplement are as ‘turned on’ to the potential for musical enjoyment by cochlear implant users as I have been. Thank you to all the invited authors for their willingness to contribute and the high quality of their papers.