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Localisation and speech perception UK National Paediatric Bilateral Audit. Helen Cullington 11 April 2013 Slide 2 Results 2 THE RESULTS Slide 3 Results 3 THE RESULTS Slide 4 Notes about results This is not a research project This was not designed to answer questions This is a real picture of what children in the UK with bilateral CI can do 4 Slide 5 Localisation. Slide 6 6 Localisation Judgement about direction and distance of sound Main method is comparison of signals received at each ear level difference time difference Slide 7 7 vital Slide 8 Can my child localise? Parent report of real life Test in clinic Slide 9 9 Scoring localisation Slide 10 10 Speech Scoring localisation Slide 11 11 Speech Slide 12 12 Child answers Scoring localisation Speech Error = 45 degrees Slide 13 Localisation error = average error over 25 trials 13 Slide 14 14 n= 8 230 44 221 41 124 25 30 chance Lower is better Slide 15 What is standard deviation? A measure of how spread out numbers are how tightly the results are clustered around the average 15 Slide 16 16 Slide 17 17 About 2/3 of the results are in this range Slide 18 18 n= 8 230 44 221 41 124 25 30 chance Lower is better Slide 19 Bilateral Slide 20 Unilateral Slide 21 Time in sound Sequential/Unilateral: time from first implant to test Simultaneous/Bilateral: time from bilateral implants to test 21 Slide 22 22 n= 44 3 41 8 25 24 chance Lower is better n= 44 3 41 8 25 24 Slide 23 23 Higher is better seq Slide 24 24 n= 35 55 13 Higher is better seq Slide 25 Caution These are average results Individual results will vary 25 Slide 26 26 Higher is better seq Slide 27 14 year old Age at first CI = 6, age at second CI = 13 1 year after 2 nd CI, localisation improved from 51 to 13 degrees 27 Slide 28 28 Slide 29 Speech perception Slide 30 30 Automated Toy Test (ATT) BKB for children with language age of 6 or more Speech perception in quiet and noise Slide 31 Speech perception in quiet Speech goes quieter and quieter to reach threshold of where child can still understand it Results is speech level where child can just understand speech (lower is better) 31 Slide 32 32 n= 7 199 57 249 53 151 37 35 Lower is better Slide 33 33 n= 23 48 10 Higher is better seq Slide 34 Speech perception in noise Noise stays at a constant level; speech goes quieter and quieter to reach threshold of where child can still understand it Result is signal to noise ratio where child can just understand speech (lower is better) 34 Slide 35 BKB sentences in noise 35 Slide 36 36 Speech and noise in front Speech perception noise centre Slide 37 37 n= 11 36 8 Higher is better seq Slide 38 38 Slide 39 39 Slide 40 40 Slide 41 41 Slide 42 42 Speech always in front Noise Improvement from moving noise to 1 st side 1 st side seq Slide 43 43 Speech always in front Noise Improvement from moving noise to non- implanted/new side new side seq Slide 44 44 n= 40 38 62 65 33 31 7 8 Higher is better seq Slide 45 45 n= 32 91 19 Higher is better seq Slide 46 Localisation - simultaneous Children with bilateral CI localise significantly better than children with unilateral CI 46 sim Slide 47 Localisation - sequential 1 year after receiving the 2 nd CI, on average children can localise significantly better This localisation improvement appears to decrease as the gap between the implants increases 47 seq Slide 48 Speech perception in noise - sequential After receiving the 2 nd CI, childrens listening in noise improves This improvement appears to decrease as the gap between the implants increases As time progresses, children begin to use the 2 nd ear to help when noise is separated from speech 48 seq Slide 49 49