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J Am Acad Audiol 2020; 31(03): 195-208
DOI: 10.3766/jaaa.18092
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sound Localization in Toddlers with Normal Hearing and with Bilateral Cochlear Implants Revealed Through a Novel “Reaching for Sound” Task

Erica E. Bennett
*   Henry Ford Health System, Detroit, MI
†   Waisman Center, University of Wisconsin-Madison, Madison, WI
,
Ruth Y. Litovsky
†   Waisman Center, University of Wisconsin-Madison, Madison, WI
› Author Affiliations
Further Information

Publication History

02 June 2019

09 June 2019

Publication Date:
24 May 2020 (online)

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Abstract

Background:

Spatial hearing abilities in children with bilateral cochlear implants (BiCIs) are typically improved when two implants are used compared with a single implant. However, even with BiCIs, spatial hearing is still worse compared to normal-hearing (NH) age-matched children. Here, we focused on children who were younger than three years, hence in their toddler years. Prior research with this age focused on measuring discrimination of sounds from the right versus left.

Purpose:

This study measured both discrimination and sound location identification in a nine-alternative forced-choice paradigm using the “reaching for sound” method, whereby children reached for sounding objects as a means of capturing their spatial hearing abilities.

Research Design:

Discrimination was measured with sounds randomly presented to the left versus right, and loudspeakers at fixed angles ranging from ±60° to ±15°. On a separate task, sound location identification was measured for locations ranging from ±60° in 15° increments.

Study Sample:

Thirteen children with BiCIs (27–42 months old) and fifteen age-matched (NH).

Data Collection and Analysis:

Discrimination and sound localization were completed for all subjects. For the left–right discrimination task, participants were required to reach a criterion of 4/5 correct trials (80%) at each angular separation prior to beginning the localization task. For sound localization, data was analyzed in two ways. First, percent correct scores were tallied for each participant. Second, for each participant, the root-mean-square-error was calculated to determine the average distance between the response and stimulus, indicative of localization accuracy.

Results:

All BiCI users were able to discriminate left versus right at angles as small as ±15° when listening with two implants; however, performance was significantly worse when listening with a single implant. All NH toddlers also had >80% correct at ±15°. Sound localization results revealed root-mean-square errors averaging 11.15° in NH toddlers. Children in the BiCI group were generally unable to identify source location on this complex task (average error 37.03°).

Conclusions:

Although some toddlers with BiCIs are able to localize sound in a manner consistent with NH toddlers, for the majority of toddlers with BiCIs, sound localization abilities are still emerging.

Key Words

bilateral - children - cochlear implants - localization

This research was funded by a grant from the NIH-NIDCD (Grant No. 5R01DC00835) to Ruth Litovsky and in part by a core grant to the Waisman Center from the NIH-NICHD (Grant No. P30 HD03352).


 

  • REFERENCES

  • Ashmead D, Clifton RK, Perris E. 1987; Precision of auditory localization in human infants. Dev Psychol 23 (05) 641-647
    CrossrefGoogle Scholar
  • Ashmead D, Davis D, Whalen T, Odom R. 1991; Sound localization and sensitivity to interaural time differences in human infants. Child Dev 62: 1211-1226
    CrossrefPubMedGoogle Scholar
  • Baumgärtel R, Hu H, Kollmeier B, Dietz M. 2017; Extent of lateralization at large interaural time differences in simulated electric hearing and bilateral cochlear implant users. J Acoust Soc Am 141 (04) 2338-2352
    CrossrefPubMedGoogle Scholar
  • Blauert J. 1987; Spatial hearing: the psychophysics of human sound localization by Jens Blauert. J Acoust Soc Am 77 (01) 334-335
    Google Scholar
  • Chadha N, Papsin B, Jiwani S, Gordon K. 2011; Speech detection in noise and spatial unmasking in children with simultaneous versus sequential bilateral cochlear implants. Otol Neurotol 32 (07) 1057-1064
    CrossrefPubMedGoogle Scholar
  • Clifton R, Morrongiello B, Kulig J, Dowd J. 1981; Newborns’ orientation toward sound: possible implications for cortical development. Child Dev 52 (03) 833-838
    CrossrefPubMedGoogle Scholar
  • Clifton R, Gwiazda J, Bauer J, Clarkson MG, Held RM. 1988; Growth in head size during infancy: implications for sound localization. Dev Psychol 24: 477-483
    CrossrefGoogle Scholar
  • Cullington HE, Bele D, Brinton JC, Cooper S, Daft M, Harding J, Hatton N, Humphries J, Lutman ME, Maddocks J, Maggs J, Millward K, O’Donoghue G, Patel S, Rajput K, Salmon V, Sear T, Speers A, Wheeler A, Wilson K. 2017; United Kingdom national paediatric bilateral project: results of professional rating scales and parent questionnaires. Cochlear Implants Int 18 (01) 23-35
    CrossrefPubMedGoogle Scholar
  • Dorman M, Loizou P, Rainey D. 1997; Speech intelligibility as a function of the number of channels of stimulation for signal processors using sine-wave and noise-band outputs. J Acoust Soc Am 102 (04) 2403-2411
    CrossrefPubMedGoogle Scholar
  • Dorman MF, Loiselle LH, Cook SJ, Yost WA, Gifford RH. 2016; Sound source localization by normal-hearing listeners, hearing-impaired listeners and cochlear implant listeners. Audiol Neurotol 21 (03) 127-131
    CrossrefPubMedGoogle Scholar
  • Godar SM, Litovsky RY. 2010; Experience with bilateral cochlear implants improves sound localization acuity in children. Otol Neurotol 31 (08) 1287
    CrossrefPubMedGoogle Scholar
  • Gordon K, Deighton M, Abbasalipour P, Papsin B. 2014; Perception of binaural cues develops in children who are deaf through bilateral cochlear implantation. PLoS One 9 (12) e114841
    CrossrefPubMedGoogle Scholar
  • Gordon K, Jiwani S, Papsin B. 2013; a Benefits and detriments of unilateral cochlear implant use on bilateral auditory development in children who are deaf. Front Psychol 4: 719
    PubMedGoogle Scholar
  • Gordon K, Wong D, Papsin C. 2013; b Bilateral input protects the cortex from unilaterally-driven reorganization in children who are deaf. Brain 136 (05) 1609-1625
    CrossrefPubMedGoogle Scholar
  • Grieco-Calub T, Litovsky R. 2010; Sound localization skills in children who use bilateral cochlear implants and in children with normal acoustic hearing. Ear Hear 31: 645-656
    CrossrefPubMedGoogle Scholar
  • Grieco-Calub T, Litovsky R. 2012; Spatial acuity in 2-to-3-year-old children with normal acoustic hearing, unilateral cochlear implants, and bilateral cochlear implants. Ear Hear 33 (05) 561-572
    CrossrefPubMedGoogle Scholar
  • Grieco-Calub T, Litovsky R, Werner L. 2008; Using the observer-based psychophysical procedure to assess localization acuity in toddlers who use bilateral cochlear implants. Otol Neurotol 29 (02) 235-239
    CrossrefPubMedGoogle Scholar
  • Grieco-Calub T, Saffran J, Litovsky RY. 2009; Spoken word recognition in toddlers who use cochlear implants. J Speech Lang Hear Res 52 (06) 1390-1400
    CrossrefPubMedGoogle Scholar
  • Hess C, Misurelli S, Litovsky R. 2018; Spatial release from masking in 2-year-olds with normal hearing and with bilateral cochlear implants. Trends Hear 22: 233121651877556
    CrossrefPubMedGoogle Scholar
  • Kan A, Litovsky R. 2015; Binaural hearing with electrical stimulation. Hear Res 322: 127-137
    CrossrefPubMedGoogle Scholar
  • Litovsky R. 1997; Developmental changes in the precedence effect: estimates of minimum audible angle. J Acoust Soc Am 102: 1739-1745
    CrossrefPubMedGoogle Scholar
  • Litovsky R. 2011; Review of recent work on spatial hearing skills in children with bilateral cochlear implants. Cochlear Implants Int 12 (1, Suppl) S30-S34
    PubMedGoogle Scholar
  • Litovsky R.. 2015 Development of the auditory system.. In: Handbook of Clinical Neurology. Waltham, MA: Elsevier, pp. 55–72.
    PubMedGoogle Scholar
  • Litovsky R, Godar S. 2010; Difference in precedence effect between children and adults signifies development of sound localization abilities in complex listening tasks. J Acoust Soc Am 128 (04) 1979-1991
    CrossrefPubMedGoogle Scholar
  • Litovsky RY, Gordon K.. 2016; Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception. Hear Res 338: 76-87
    CrossrefPubMedGoogle Scholar
  • Litovsky R, Ehlers E, Hess C, Harris S. 2013; Reaching for sound measures: an ecologically valid estimate of spatial hearing in 2- to 3-year-old children with bilateral cochlear implants. Otol Neurotol 34: 429-435
    CrossrefPubMedGoogle Scholar
  • Litovsky R, Goupell MJ, Godar S, Grieco-Calub T, Jones GL, Garadat SN, Agrawal S, Kan A, Todd A, Hess C, Misurelli S. 2012; Studies on bilateral cochlear implants at the University of Wisconsin’s Binaural Hearing and Speech Laboratory. J Am Acad Audiol 23 (06) 476-494
    Article in Thieme ConnectPubMedGoogle Scholar
  • Litovsky R, Johnstone PM, Godar S, Agrawal S, Parkinson A, Peters R, Lake J. 2006; a Bilateral cochlear implants in children: localization acuity measured with minimum audible angle. Ear Hear 27: 43-59
    CrossrefPubMedGoogle Scholar
  • Litovsky R, Parkinson A, Arcaroli J, Sammeth C. 2006; b Simultaneous bilateral cochlear implantation in adults: a multicenter clinical study. Ear Hear 27: 714-731
    CrossrefPubMedGoogle Scholar
  • Middlebrooks J, Green D. 1991; Sound localization by human listeners. Annu Rev Psychol 42: 135-159
    CrossrefPubMedGoogle Scholar
  • Misurelli S.. 2014 An investigation of spatial hearing in children with normal hearing and with cochlear implants and the impact of executive function (dissertation). University of Wisconsin-Madison, Madison, WI
    PubMedGoogle Scholar
  • Misurelli S, Litovsky R. 2012; Spatial release from masking in children with normal hearing and with bilateral cochlear implants: effect of interferer asymmetry. J Acoust Soc Am 132: 380-391
    CrossrefPubMedGoogle Scholar
  • Mok M, Galvin K, Dowell R, McKay C. 2009; Speech perception benefit for children with a cochlear implant and a hearing aid in opposite ears and children with bilateral cochlear implants. Audiol Neurotol 15: 44-56
    PubMedGoogle Scholar
  • Morrongiello B, Rocca P. 1990; Infants’ localization of sounds within hemifields: estimates of minimum audible angle. Child Dev 61 (04) 1258-1270
    CrossrefPubMedGoogle Scholar
  • Muir D, Clifton R, Clarkson M. 1989; The development of a human auditory localization response: A u-shaped function. Can J Psychol 43 (02) 199-216
    CrossrefPubMedGoogle Scholar
  • Murphy J, Summerfield Q, O’Donoghue G, Moore R. 2011; Spatial hearing of normally hearing and cochlear implanted children. Int J Pediatr Otorhinolaryngol 75 (04) 489-494
    CrossrefPubMedGoogle Scholar
  • Olsho L, Koch E, Halpin C, Carter E. 1987; An observer-based psychoacoustic procedure for use with young infants. Dev Psychol 23 (05) 627-640
    CrossrefGoogle Scholar
  • Peng ZE, Hess C, Saffran JR, Edwards JR, Litovsky RY. 2019; Assessing fine-grained speech discrimination in young children with bilateral cochlear implants. Otol Neurotol 40 (03) e191-e197
    CrossrefPubMedGoogle Scholar
  • Perris E, Clifton R. 1988; Reaching in the dark toward sound as a measure of auditory localization in infants. Infant Behav Dev 11 (04) 473-491
    CrossrefGoogle Scholar
  • Reeder R, Firszt J, Cadieux J, Strube M. 2017; A longitudinal study in children with sequential bilateral cochlear implants: time course for the second implanted ear and bilateral performance. J Speech Lang Hear Res 60 (01) 276-287
    CrossrefPubMedGoogle Scholar
  • Steel M, Papsin B, Gordon K. 2015; Binaural fusion and listening effort in children who use bilateral cochlear implants: a psychoacoustic and pupillometric study. PLoS One 10 (02) e0117611
    CrossrefPubMedGoogle Scholar
  • Van Deun L, Van Wieringen A, Scherf F, Deggouj N, Desloovere C, Offeciers FE, Van de Heyning PH, Dhooge IJ, Wouters J. 2009; Earlier intervention leads to better sound localization in children with bilateral cochlear implants. Audiol Neurotol 15 (01) 7-17
    PubMedGoogle Scholar
  • Van Deun L, van Wieringen A, Van den Bogaert T, Scherf F, Offeciers F, Van de Heyning P, Desloovere C, Dhooge I, Deggouj N, Raeve L, Wouters J. 2009; Sound localization, sound lateralization, and binaural masking level differences in young children with normal hearing. Ear Hear 30 (02) 178-190
    CrossrefPubMedGoogle Scholar
  • Van Hoesel R. 2004; Exploring the benefits of bilateral cochlear implants. Audiol Neuro-Otol 9: 234-246
    CrossrefPubMedGoogle Scholar
  • Zheng Y, Godar S, Litovsky R. 2015; Development of sound localization strategies in children with bilateral cochlear implants. PLoS One 10 (08) e0135790
    CrossrefPubMedGoogle Scholar