Dissertation
An investigation of adult cochlear implant recipients’ experiences and accuracy in listening tasks involving music and speech
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Autumn 2019
DOI: 10.17077/etd.005211
Abstract
The overarching purpose of this study was to examine the experiences and desires of individuals who use cochlear implants (CIs) regarding music. A sequential exploratory mixed methods design (Qual→Quan) was used to address the research questions and was conducted in two phases. Phase 1 used a qualitative approach to examine CI user perspectives in situations where speech and music are present. This examination included speech with background music, music as the focus of listening, and sung lyrics with background accompaniment. The second phase employed a quantitative, experimental design to evaluate and identify issues related to the desires reported by participants in Phase 1: to improve lyric perception.
The first phase of the study consisted of a online questionnaire completed by a diverse group of 40 adult cochlear implant recipients from 13 CI centers to elicit responses related to four questions: (a) What are their negative or positive experiences in listening environments involving music, and how do they define them? (b)What strategies do they use to improve or cope with listening experiences involving music? (c) What difficulties or barriers do they experience in listening environments involving music? (d) What are desires of adult CI recipients for enhancing listening environments involving music? Data were gathered through written responses collected via open-ended questions. Thematic analysis revealed the general categories of “environmental factors,” “linguistic properties,” “musical properties,” “technology,” “listener characteristics,” and “social support” as contributing to perceived effectiveness of an experience, with a large proportion of participants expressing the desire for “improved ability to recognize sung lyrics.” From the initial phase of the study, a conceptual framework was developed to guide the second phase.
Phase 2 of the study comprised the modification of a sung sentence recognition test, previously developed for use with hearing aid users, to investigate the perception of lyrics with and without background accompaniment. For the purposes of this study, the Modified Sung Sentence Recognition Test (SSRT-M) was used to evaluate recognition of sung words with and without background accompaniment. Testing was conducted at two rates of presentation. A total of 15 adult CI users and 15 normal hearing (NH) adults between the ages of 21 and 70 participated in the study. Results indicated that CI participants had significantly poorer sung lyrics recognition than NH listeners in quiet and in background accompaniment. While background accompaniment had a significant negative impact on accuracy of both the NH and CI group, the negative impact of background accompaniment was significantly greater for the CI group. A slower rate of presentation did not result in significantly improved performance for CI users, but did decrease the variability of the group. Increased age was associated with a significant decline in accuracy for the combined NH and CI groups, while greater music experience did not contribute to improved performance.
An analysis of psychometric properties of the SSRT-M revealed that it had “good” to “excellent” test-retest reliability. Ten of the twelve sentence lists in the SSRT-M were found to be equivalent, and content validity was established for the SSRT-M in quiet by comparing to outcomes scores of the AzBio sentence lists in quiet. A moderate, but insignificant correlation was found for the SSRT-M in background accompaniment with the AzBio in noise. Clinical implications included situations with speech in background music and music focused music listening. Strategies and recommendations for addressing listening situations with music that emerged from Phase 1 participants and related literature are discussed.
Details
- Title: Subtitle
- An investigation of adult cochlear implant recipients’ experiences and accuracy in listening tasks involving music and speech
- Creators
- Virginia Darnell Driscoll
- Contributors
- Kate E Gfeller (Advisor)Carolyn J Brown (Committee Member)Mary S Adamek (Committee Member)Jacob J Oleson (Committee Member)Pamela Wesely (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Music
- Date degree season
- Autumn 2019
- DOI
- 10.17077/etd.005211
- Publisher
- University of Iowa
- Number of pages
- xvi, 301 pages
- Copyright
- Copyright 2019 Virginia Darnell Driscoll
- Comment
- This thesis has been optimized for improved web viewing. If you require the original version, contact the University Archives at the University of Iowa: https://www.lib.uiowa.edu/sc/contact/
- Language
- English
- Description illustrations
- illustrations (some color)
- Description bibliographic
- Includes bibliographical references (pages 269-301)
- Public Abstract (ETD)
Cochlear implants (CI) are assisted listening devices for individuals who have severe-to-profound sensorineural hearing loss and for whom hearing aids provide little to no benefit. While CIs provide good access to sound for the purposes of speech perception, particularly in quiet listening environments, they are less effective in conveying several key elements of music. Laboratory studies indicate that music is hard to understand and significantly less pleasant for many CI recipients than it was before their hearing loss.
Limited research has been conducted regarding the lived experience of individuals when in everyday situations where music is present, whether as the target sound or when it is combined with speech. This two-phase study aimed to 1) learn about the experiences of individuals with CIs in such circumstances, to identify the strategies used to improve their experiences, the barriers they still face in everyday life, and their desires for the overall improvement of music and 2) evaluate how well their reported desire–improved ability to recognize lyrics in music–could be assessed.
Using CI recipient feedback, a model was developed regarding music listening and speech in music and a test of sung lyrics was modified and evaluated. Results of Phase 1 identified four core areas that impact music and speech. Results of Phase 2 measured recognition of sung lyrics with and without background accompaniment and influential listener characteristics. Suggestions are provided that can assist individuals with CIs and the professionals who serve them to address challenging listening situations with music.
- Academic Unit
- School of Music
- Record Identifier
- 9983779599302771
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