Pitch-related auditory skills in children with cochlear implants : The role of auditory working memory, attention and music

The cochlear implant (CI) provides a sensation of hearing for deaf-born children. However, many CI children show poor language outcomes, which may be related to the deficiency of CIs in delivering pitch. This thesis studies the development of those neural processes and behavioural skills linked to the perception of pitch which may play a role in language acquisition. We measured with event-related brain potentials (ERPs) the neural discrimination of and attention shift to changes in music, the perception of word and sentence stress and related acoustic cues, and the auditory working memory (forward digit span) in 4̶ 13-year-old normally hearing (NH) and early-implanted children. We studied how the development of these aspects is related to musical activities known to advance brain development and perceptual skills in the NH population, and whether the perception of music is connected to word stress or visuospatial perception in NH adults. With regard to the development of neural responses, we found for the CI children usually well-formed ERP waveforms resembling those found for the NH children. However, some brain responses implied impoverished processing for the CI children, especially for timbre and pitch. The CI children who sang regularly at home were advantaged over the other CI children for the development of attention shift, which was linked to improved auditory working memory, implying better neural discrimination, an advantaged development of neural networks for attention and better updating of auditory working memory for the CI singers. For the CI children perception of word and sentence stress improved with improving discrimination of pitch (f0) and intensity and auditory working memory. Only the CI children participating in supervised musical activities performed and developed similarly to the NH children in these skills. The perception of musical rhythm improved with improving word stress and visuospatial perception for the NH adults. The results indicate that (i) perception of music and speech are connected not only via pitch and timbre, but also via rhythm, and (ii) the combination of singing at home and taking part in supervised musical activities, using also rhythmic exercises and visual cues, might be the best way to optimize pitch-related abilities, underlying cognitive functions, spoken language skills and quality of life for early-implanted children.Sisäkorvaistutteella (SI) kuulevien, kuurona syntyneiden lasten puhekielen taidot vaihtelevat paljon ja ovat usein heikompia kuin kuulevilla lapsilla. Tämä saattaa liittyä SI:n heikkoon kykyyn välittää äänten korkeuksia. Tässä väitöskirjassa tarkasteltiin puhekielen kehitystä tukevien, äänen korkeuksien havaitsemiseen liittyvien hermostollisten mekanismien, kuulomuistin ja kuuntelutaitojen kehitystä 4 13-vuotiailla kuulevilla ja SI-lapsilla. Musiikillisten äänten hermostollista erottelua ja kuulotarkkaavuutta tarkasteltiin mittaamalla kuuloherätevasteita aivosähkökäyrällä (EEG). Sana- ja lausepainon havaitsemista ja näihin liittyvien akustisten vihjeiden erottelukykyä tutkittiin kuuntelukokeilla ja kuulomuistia numerotoistotestillä. Musiikin harrastamisen tiedetään parantavan kuulevien lasten kuulohavaintotaitoja, kuulomuistia ja kuulotarkkaavuutta. Siksi tarkastelimme SI-lasten ryhmässä musiikkiaktiviteettien yhteyksiä mittaustuloksiimme. Tutkimme myös, onko musiikin havaitseminen yhteydessä sanapainon ja suuntien havaitsemiseen kuulevilla aikuisilla. SI-lasten kuuloherätevasteet olivat samantapaisia kuin kuulevien lasten, mutta vasteet erityisesti muutoksille musiikillisten äänten laadussa ja korkeudessa heijastivat SI-lasten heikkoa kuuloerottelukykyä ja -tarkkaavuutta. Säännöllisesti kotona laulavien SI-lasten kuulotarkkaavuusvasteet kehittyivät voimakkaammiksi ja nopeammiksi kuin muiden SI-lasten. Nämä vasteet olivat nopeampia paremman kuulomuistin myötä. Tulokset viittaavat laulavien SI-lasten hyvään hermostolliseen erottelukykyyn, kuulotarkkaavuuden aivoverkostojen kehitykseen ja kuulomuistin päivitykseen. Sana- ja lausepainon havaitseminen parantui hyvän äänen korkeuden (f0) ja voimakkuuden erottelun sekä kuulomuistin myötä, joissa vain ohjattuihin musiikkiaktiviteetteihin osallistuneet SI-lapset kehittyivät yhtä hyvin kuin kuulevat lapset. Musiikin rytmien havaitseminen parantui hyvän sanapainon ja suuntien havaitsemisen myötä. Tulokset korostavat musiikin havaitsemisen olevan yhteydessä musiikin rytmien havaitsemiseen, ei pelkästään äänen korkeuksien ja laatujen havaitsemiseen. Ne korostavat kotona laulamisen sekä äänen korkeuden, myös rytmin havaitsemisen harjoituksia ja suuntavihjeitä (kuten laululeikkejä), sisältävän ohjatun musiikkitoiminnan tärkeyttä SI lasten puhekielen ja elämänlaadun parantamisessa

Pitch- and language related skills: from theory to rehabilitation of hearing-impaired children

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The development of cortical processing of speech differs between children with cochlear implants and normal hearing and changes with parental singing

Objective: The aim of the present study was to investigate speech processing development in children with normal hearing (NH) and cochlear implants (CI) groups using a multifeature event-related potential (ERP) paradigm. Singing is associated to enhanced attention and speech perception. Therefore, its connection to ERPs was investigated in the CI group. Methods: The paradigm included five change types in a pseudoword: two easy- (duration, gap) and three difficult-to-detect (vowel, pitch, intensity) with CIs. The positive mismatch responses (pMMR), mismatch negativity (MMN), P3a and late differentiating negativity (LDN) responses of preschoolers (below 6 years 9 months) and schoolchildren (above 6 years 9 months) with NH or CIs at two time points (T1, T2) were investigated with Linear Mixed Modeling (LMM). For the CI group, the association of singing at home and ERP development was modeled with LMM. Results: Overall, responses elicited by the easy- and difficult to detect changes differed between the CI and NH groups. Compared to the NH group, the CI group had smaller MMNs to vowel duration changes and gaps, larger P3a responses to gaps, and larger pMMRs and smaller LDNs to vowel identity changes. Preschoolers had smaller P3a responses and larger LDNs to gaps, and larger pMMRs to vowel identity changes than schoolchildren. In addition, the pMMRs to gaps increased from T1 to T2 in preschoolers. More parental singing in the CI group was associated with increasing pMMR and less parental singing with decreasing P3a amplitudes from T1 to T2. Conclusion: The multifeature paradigm is suitable for assessing cortical speech processing development in children. In children with CIs, cortical discrimination is often reflected in pMMR and P3a responses, and in MMN and LDN responses in children with NH. Moreover, the cortical speech discrimination of children with CIs develops late, and over time and age, their Frontiers in Neuroscience 01 frontiersin.org Torppa et al. 10.3389/fnins.2022.976767 speech sound change processing changes as does the processing of children with NH. Importantly, multisensory activities such as parental singing can lead to improvement in the discrimination and attention shifting toward speech changes in children with CIs. These novel results should be taken into account in future research and rehabilitation.Peer reviewe

Screen Time of Preschool-Aged Children and Their Mothers, and Children’s Language Development

Although children’s increased screen time has been found to associate with poorer language development, it is open to question which part of language ability screen time specifically associates with. Our aim was to examine the association between children’s screen time (alone and together with a parent), mothers’ screen time, and the different domains of children’s language skills. Mothers reported their children’s (N = 164, aged 2.5 to 4.1 years) screen time and their own on a weekday and a day off. Children’s lexical, phonological, morphological, receptive, and general language abilities were measured using validated tests. The connections between children’s and mothers’ screen time and children’s language skills were analyzed using correlation analyses and linear regression models. The more the children used screen time alone, or the greater the amount of the mothers’ screen time, the weaker the children’s lexical and general language abilities when the children’s age, maternal education level, and birth order were controlled for. We also found cumulative, negative links to the children’s lexical and general language abilities when the amount of their screen time alone and the amount of the mothers’ screen time were simultaneously included in the regression model. The results suggest that it is important to restrict both children’s screen time spent alone and mothers’ screen time

The development of cortical processing of speech differs between children with cochlear implants and normal hearing and changes with parental singing

Objective: The aim of the present study was to investigate speech processing development in children with normal hearing (NH) and cochlear implants (CI) groups using a multifeature event-related potential (ERP) paradigm. Singing is associated to enhanced attention and speech perception. Therefore, its connection to ERPs was investigated in the CI group. Methods: The paradigm included five change types in a pseudoword: two easy- (duration, gap) and three difficult-to-detect (vowel, pitch, intensity) with CIs. The positive mismatch responses (pMMR), mismatch negativity (MMN), P3a and late differentiating negativity (LDN) responses of preschoolers (below 6 years 9 months) and schoolchildren (above 6 years 9 months) with NH or CIs at two time points (T1, T2) were investigated with Linear Mixed Modeling (LMM). For the CI group, the association of singing at home and ERP development was modeled with LMM. Results: Overall, responses elicited by the easy- and difficult to detect changes differed between the CI and NH groups. Compared to the NH group, the CI group had smaller MMNs to vowel duration changes and gaps, larger P3a responses to gaps, and larger pMMRs and smaller LDNs to vowel identity changes. Preschoolers had smaller P3a responses and larger LDNs to gaps, and larger pMMRs to vowel identity changes than schoolchildren. In addition, the pMMRs to gaps increased from T1 to T2 in preschoolers. More parental singing in the CI group was associated with increasing pMMR and less parental singing with decreasing P3a amplitudes from T1 to T2. Conclusion: The multifeature paradigm is suitable for assessing cortical speech processing development in children. In children with CIs, cortical discrimination is often reflected in pMMR and P3a responses, and in MMN and LDN responses in children with NH. Moreover, the cortical speech discrimination of children with CIs develops late, and over time and age, their Frontiers in Neuroscience 01 frontiersin.org Torppa et al. 10.3389/fnins.2022.976767 speech sound change processing changes as does the processing of children with NH. Importantly, multisensory activities such as parental singing can lead to improvement in the discrimination and attention shifting toward speech changes in children with CIs. These novel results should be taken into account in future research and rehabilitation.Peer reviewe

Acquisition of focus by normal hearing and Cochlear implanted children : The role of musical experience

Two experiments investigated the perception of compound vs. phrasal stress and narrow focus in normally hearing children and children with Cochlear Implants (CI). Additionally, we investigated whether musical experience would predict children’s performance in these tasks. The results showed no difference between CI and normal-hearing (NH) children in either experiment. However, whereas we found no clear effect of age in the children’s stress detection, there was a clear age related trajectory in the ability to recognise (narrow) focus. Moreover, this trend was similar to what has been found previously for English children. Importantly, prior music experience was significantly linked to CI children’s perception of focus.Peer reviewe

MUSIIKIN MERKITYS KUULOVIKAISEN LAPSEN KUNTOUTUKSESSA

Tässä artikkelissa esittelemme musiikin harrastamisen ja puhekielenkehityksen yhtymäkohtia. Tuomme esille myös alustavia tuloksia omastaseurantatutkimuksestamme, jossa tutkitaan puheen havaitsemistasisäkorvaistutetta (SI) käyttävillä lapsilla suhteessa musiikilliseenharrastuneisuuteen. Tärkeäksi havainnoksi nousi vanhempien laulamisenmerkitys kuulovikaiselle lapselle: mitä enemmän vanhemmat olivat laulaneetsisäkorvaistutetta käyttävälle lapselle, sitä paremmin lapsi havaitsi sana- jalausepainon. Aikuisjohtoinen, aktiivinen musiikkitoiminta näyttää vaikuttavankuulohavaintotaitoja edistävästi. Alustava johtopäätöksemme on, ettälaulamisen vaikutus perustuu sen taipumukseen herättää lapsen huomio sekälaulujen toistuviin ja kuulovikaiselle lapselle helpommin havaittaviin sävel-,voimakkuus- ja kestomuutoksiin. Tämä auttaa kuulovikaista lasta kiinnittämäänhuomion puheen prosodisiin piirteisiin vaikuttaen todennäköisesti puhekielenoppimiseen. Musiikkitoiminnan ja etenkin laulamisen pitäisikin kuuluakuulovikaisen lapsen kuntoutukseen ja arkielämään.Avainsanat: kuntoutus, laulaminen, musiikki, prosodia, puheen havaitseminen, sisäkorvaistute, kuulovikaKeywords: cochlear implant, hearing impairment, music, perception of speech, prosody,rehabilitation, singin

Acquisition of focus by normal hearing and Cochlear implanted children : The role of musical experience

Two experiments investigated the perception of compound vs. phrasal stress and narrow focus in normally hearing children and children with Cochlear Implants (CI). Additionally, we investigated whether musical experience would predict children’s performance in these tasks. The results showed no difference between CI and normal-hearing (NH) children in either experiment. However, whereas we found no clear effect of age in the children’s stress detection, there was a clear age related trajectory in the ability to recognise (narrow) focus. Moreover, this trend was similar to what has been found previously for English children. Importantly, prior music experience was significantly linked to CI children’s perception of focus.Peer reviewe

Developmental links between speech perception in noise, singing, and cortical processing of music in children with cochlear implants

THE PERCEPTION OF SPEECH IN NOISE IS challenging for children with cochlear implants (CIs). Singing and musical instrument playing have been associated with improved auditory skills in normal-hearing (NH) children. Therefore, we assessed how children with CIs who sing informally develop in the perception of speech in noise compared to those who do not. We also sought evidence of links of speech perception in noise with MMN and P3a brain responses to musical sounds and studied effects of age and changes over a 14-17 month time period in the speech-in-noise performance of children with CIs. Compared to the NH group, the entire CI group was less tolerant of noise in speech perception, but both groups improved similarly. The CI singing group showed better speech-in-noise perception than the CI non-singing group. The perception of speech in noise in children with CIs was associated with the amplitude of MMN to a change of sound from piano to cymbal, and in the CI singing group only, with earlier P3a for changes in timbre. While our results cannot address causality, they suggest that singing and musical instrument playing may have a potential to enhance the perception of speech in noise in children with CIs.Peer reviewe

The MMN as a viable and objective marker of auditory development in CI users

In the present article, we review the studies on the use of the mismatch negativity (MMN) as a tool for an objective assessment of cochlear-implant (CI) functioning after its implantation and as a function of time of CI use. The MMN indexes discrimination of different sound stimuli with a precision matching with that of behavioral discrimination and can therefore be used as its objective index. Importantly, these measurements can be reliably carried out even in the absence of attention and behavioral responses and therefore they can be extended to populations that are not capable of behaviorally reporting their perception such as infants and different clinical patient groups. In infants and small children with CI, the MMN provides the only means for assessing the adequacy of the CI functioning, its improvement as a function of time of CI use, and the efficiency of different rehabilitation procedures. Therefore, the MMN can also be used as a tool in developing and testing different novel rehabilitation procedures. Importantly, the recently developed multi-feature MMN paradigms permit the objective assessment of discrimination accuracy for all the different auditory dimensions (such as frequency, intensity, and duration) in a short recording time of about 30 min. Most recently, such stimulus paradigms have been successfully developed for an objective assessment of music perception, too. (C) 2017 Elsevier B.V. All rights reserved.Peer reviewe