The importance of "scaffolding" in clinical approach to deafness across the lifespan

Throughout the present work of thesis, the concept of scaffolding will be used as a fil rouge through the chapters. What I mean for “scaffolding approach”, therefore, is an integrated and multidisciplinary clinical and research methodology to hearing impairments that could take into account persons as a whole; an approach that needs to be continuously adapted and harmonized with the individuals, pursuant to their progress, their limits and resources, in consideration of their audiological, cognitive, emotional, personal, and social characteristics. The following studies of our research group will be presented: A study (2020) designed to assess the effects of parent training (PT) on enhancing children’s communication development (chapter two); Two studies of our research group (2016; 2020) concerning variables influencing comprehension of emotions and nuclear executive functions in deaf children with cochlear implant (chapter three and chapter four) In chapter five a presentation and description of our Mind-Active Communication program, main topics and aims, multidisciplinary organizations of group and individual sessions with a description of used materials and methodology is given. Finally, a preliminary evaluation to explore the use of this multidisciplinary rehabilitative program on quality of life, psychological wellbeing, and hearing abilities in a sample of cochlear implanted elderly persons is reported

Implant technology and TFS processing in relation to speech discrimination and music perception and appreciation

Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly deaf subjects to perceive sounds. Many CI users find language comprehension satisfactory in quiet and accessible in the presence of noise. However, music contains different dimensions which need to be approached in different ways. Whilst both language and music take advantage of the modulation of acoustic parameters to convey information, music is an acoustically more complex stimulus than language, demanding more complex resolution mechanisms. One of the most important aspects that contributes to speech perception skills, especially when listening in a fluctuating background, is Temporal Fine Structure processing. TFS cues are pre-dominant in conveying Low Frequency (LF) signals. Harmonic (HI) and Disharmonic (DI) In-tonation are tests of pitch perception in the LF domain which are thought to depend on avail-ability of TFS cues and which are included in the protocol on this group of adult CI recipients. One of the primary aims of this thesis was the production of a new assessment tool, the Italian STARR test which was based on the measurement of speech perception using a roving-level adaptive method where the presentation level of both speech and noise signals varied between each sentence presentation. The STARR test attempts to reflect a better representation of real world listening conditions where background noise is usually present and speech intensity var-ies according to vocal capacity as well as the distance of the speaker. The outcomes for the Italian STARR in NH adults were studied to produce normative data, as well as to evaluate inter-list variability and learning effects. (Chapter 4). The second aim was to investigate LF pitch perception outcomes linked to availability of TFS cues in a group of adult CI recipients including bimodal users in relation to speech perception, in particular Italian STARR outcomes. Here it was seen that age had a significant effect on performance especially in older adults. Similarly, CI recipients (even better performers) showed abnormal findings in comparison to NH subjects. On the other hand, the significant effect of CI thresholds re-emphasized the sensitivity of the test to low intensity speech which a CI user can often encounter under everyday listening conditions. Statistically significant correlations between HI/DI and STARR performance were found. Moreover, bimodal benefit was seen both for HI/DI and STARR tests. Overall findings confirmed the usefulness of evaluating both LF pitch and speech perception in noise in order to track changes in TFS sen-sitivity for CI recipients over time and across different listening conditions which might be provided by future technological progress. (Chapter 5) Finally, the last and main aspect taken into account in this thesis was the study of the difficul-ties experienced by CI users when listening to music. An attempt was made to correlate find-ings resulting from the previous phases of this study both to Speech in Noise and to the com-plex subjective aspects of Music Perception and Appreciation: correlation analysis between HI/DI tests and the main dimensions of Speech in Noise (STARR and OLSA) and Music Ap-preciation was performed. (Chapter 6). Interestingly, positive findings were found for the two most complex types of Music (Classical, Jazz), whereas Soul did not seem to require particular competence in Pitch perception for the appreciation of the subjective variables taken into con-sideration by this study

Emotion perception in pre-kindergarten school children at Central Institute for the Deaf

This paper studies the ability of pre-kindergarten students with both normal hearing and impaired hearing to identify emotions in speech through audition only. In addition, the study assesses whether a listener\u27s familiarity with a speaker\u27s voice has an effect on his/her ability to identify the emotion of the speaker

Exploring the psychosocial experiences of adolescents with sequential cochlear implants

Section A is a review of the literature on the psychological and social implications of cochlear implants (CIs) in deaf children and adolescents. The literature is critically evaluated in relation to health-related quality of life, quality of life, psychological and emotional well-being, social well-being and identity. Relevant theories are outlined and discussed. Methodological limitations and gaps in the literature are discussed, and the review concludes with recommendations for further research. Section B describes a study using Interpretative Phenomenological Analysis to explore adolescent experiences of receiving and living with sequential cochlear implants (SCIs). Semi-structured interviews were conducted with eleven adolescents. The master and sub-themes are presented and the results are discussed with consideration of previous research findings and theoretical, clinical and research implications. Most participants enjoyed improved confidence and social well-being following their SCI, and felt that two CIs were superior to one. The majority identified themselves as hearing and deaf, but not culturally Deaf, as they strived to live in the hearing world. However, this was not without challenges and many young people experienced feelings of difference in the hearing world. These findings have clinical implications in terms of the role of clinical psychologists in CI clinics, and in providing information to families making decisions about CIs. These findings add to the emergent deaf identity development literature in young people with CIs