Cochlear Implant

 

Overview

There are two lines of research conducted in the Cochlear Implant Research Laboratory. The first project is “Physiology as a Potential Predictor of Perception.” The second is “Telepractice for Cochlear Implants.”

Physiology as a Potential Predictor of Perception

This research is aimed at investigating how subjective and objective measures obtained with a cochlear implant (CI) are related to each other. Subjective measures require active participation on the part of the research participant. Examples include listening to sounds and making judgments about certain aspects of the sound (e.g., loudness or pitch) or listening to speech presented in different conditions and repeating words or sentences. In contrast, objective measures do not require active participation from the participant. The objective measures are made from the auditory pathway in response to electrical stimulation from the CI.

The goal of this research is to determine whether certain objective measures can be used to predict certain behavioral measures. We hope to use this information to find better ways to program CI sound processors for children and adults. CI recipients are invited to participate in some or all of the experiments. Participants are needed for approximately 4-9 hours per experiment, which can be scheduled over several visits. For this study, participants will (1) read, sleep, or watch a movie while sounds are played through the CI; (2) listen to sounds played through the CI and make judgments about the sounds; and/or (3) listen to speech through the CI and repeat back what is heard. Participants will be paid $15 per hour, plus an additional travel stipend. You do not need to be a patient at Boys Town to participate.

You may be eligible for this study if:

  • You are 11 years of age or older.
  • You have used a CI for 3 months or more.
  • Your CI has telemetry capabilities (please inquire if unsure).
  • Click here to see our study brochure

Telepractice for Cochlear Implants

The purpose of this research is to investigate ways to expand CI service delivery to individuals who live far away from a CI center. Telepractice refers to clinical services delivered via the internet and/or videoconferencing technology with the patient and clinician in separate geographical locations. Tests and procedures similar to those performed at regular clinical visits will be performed as part of this study. Some visits will take place in the traditional in-person condition, while some visits will take place remotely using telepractice. This research project will target three areas of clinical CI services that have not yet been validated for telepractice: 1) sound processor programming for young children, 2) speech-perception testing, and 3) aural rehabilitation for adults. Participants will be paid $15 per hour, plus an additional travel stipend. You do not need to be a patient at Boys Town to participate.

You may be eligible for this study if:

1. Programming Young Children:

  • Approximately 1-6 years of age.
  • No additional disabilities.
  • At least 6 months device use.

2. Speech Perception Testing:

  • Adults and children approximately 9 years of age or older.
  • Proficient in spoken English.
  • At least 6 months device use.

3. Adult Aural Rehabilitation:

  • Age 19 years and older.
  • No additional disabilities that affect communication.
  • Proficient in spoken English.

Time commitments for each experiment.

  1. Programming Young Children: 3-4 visits within a 4-6 week period; each visit will be up to 2 hours.
  2. Speech Perception Testing: 1-5 visits; each visit will be 1-3 hours.
  3. Adult Aural Rehabilitation: 4 test sessions lasting up to 2 hours each, and 10 rehabilitation sessions lasting 1 hour each over a 5-week period.

Facilities

The laboratory consists of three rooms: (1) a large sound-attenuating booth equipped with a sound field system, recliner, television, VCR/DVD player, impedance bridge, and touch-screen monitor; (2) an adjacent control room equipped with an audiometer, a networked color printer, laptops, one PC, and cochlear implant speech processor interfaces for controlling psychophysical and physiological experiments; (3) general lab space equipped with a pediatric table and chairs, toy chest, desk space and computer for a research assistant, file storage, and lab meeting space.

Staff

The laboratory is directed by Michelle L. Hughes, Ph.D., CCC-A. Lab staff are Jenny Goehring, Au.D., CCC-A, Jacquelyn Baudhuin, Au.D., CCC-A, and Rachel Scheperle, Au.D., Ph.D., CCC-A. All staff members are certified audiologists.

Summary of Research Program

For Clinicians and Scientists

Physiology as a Potential Predictor of Perception

The overall goal of this research project is to better understand how physiological measures of temporal and spatial interaction in cochlear implants (CIs) relate to performance on psychophysical and speech-perception tasks. Speech-processor program parameters such as stimulation rate, number of electrodes, or stimulus timing (i.e., simultaneous or sequential stimulation) can be manipulated to some extent to reduce interaction in either the temporal or spatial domain. However, it is not clear what the relative contributions of temporal and spatial interaction are to speech-perception ability and how these effects vary across individual CI users. It is possible that interaction affects CI recipients in different ways based on differences in peripheral physiology. Further, differences in peripheral physiology may account for differences in performance as a function of programming choices across individual CI recipients. It is anticipated that research findings from this project may translate into objective methods that can be used to choose specific CI speech-processor programming parameters to maximize performance on an individual basis.

Telepractice in Cochlear Implants

The goal of this project is to test methods for expanding the use of telepractice for clinical service delivery for CI recipients. Because CIs are a specialty area, implant centers are more sparsely located and are more likely to be in larger metropolitan areas. CI recipients may live several hours from the implant center. This distance can limit access to clinical services and can be burdensome to families (i.e., missed school or work, transportation expenses). Such limitations are particularly an issue within the first year of CI use when as many as 7-10 visits are routinely required for proper follow-up. Lack of proper follow-up may result in sub-optimal outcomes or even non-use of the device. Remote CI service delivery could provide an avenue for increased access to clinical services and potentially better outcomes for recipients. This study has three main experiments: 1) Programming Young Children: For children with CIs, we will measure map levels obtained using traditional play techniques; 2) Speech-Perception Testing: For older children and adults with CIs, we will measure speech understanding in different listening situations such as quiet, background noise, or reverberation; 3) Adult Aural Rehabilitation: For adults with CIs, we will measure communication outcomes with the implant before, during, and after participation in a rehabilitation program.

For cochlear implant recipients

Click here for more information on our current studies.

If you are interested in participating please contact Jenny Goehring at (402) 452-5087 or Jenny.Goehring@boystown.org or Jacquelyn Baudhuin at (402)-452-5041 or Jacquelyn.Baudhuin@boystown.org.

Professional Resources

Recent Publications

Bournique JL, Hughes ML, Baudhuin JL & Goehring JL (2013). Effect of ECAP-based choice of stimulation rate on speech-perception performance. Ear and Hearing, 34(4), 437-446.

Goehring JL, Hughes ML, Baudhuin JL, & Lusk RP (2013). How well do cochlear implant intraoperative impedance measures predict postoperative electrode function? Otology & Neurotology, 34, 239-244.

Glassman EK & Hughes ML (2013). Determining electrically evoked compound action potential thresholds: A comparison of computer versus human analysis methods. Ear and Hearing, 34(1), 96-109.

Goehring JL, Hughes ML, & Baudhuin, JL (2012). Evaluating the feasibility of using remote technology for cochlear implants. The Volta Review, 112(3), 255-265.

Goehring JL, Hughes ML, Baudhuin JL, Valente DL, McCreery RW, Diaz GR, Sanford T, & Harpster R. (2012). The effect of technology and testing environment on speech perception using telehealth with cochlear implant recipients. Journal of Speech, Language, and Hearing Research, 55(5), 1373-1386.

Hughes ML, Goehring JL, Baudhuin JL, Diaz GR, Sanford T, Harpster R, & Valente DL (2012). Use of telehealth for research and clinical measures in cochlear implant recipients: A validation study. Journal of Speech, Language, and Hearing Research, 55, 1112-1127.

Hughes ML, Castioni EE, Goehring JL, & Baudhuin JL (2012). Temporal response properties of the auditory nerve: Data from human cochlear-implant recipients. Hearing Research, 285, 46-57.

Hughes ML (2012). Receiving and maintaining a cochlear implant: What Nurse Life Care Planners need to know. Journal of Nurse Life Care Planning, 12(2), 618-630.

Wiley S, Meinzen-Derr J, Grether S, Choo DI, Hughes ML (2012). Longitudinal functional performance among children with cochlear implants and disabilities: A prospective study using the Pediatric Evaluation of Disability Inventory. International Journal of Pediatric Otorhinolaryngology, 76, 693-697.

Hughes ML & Goulson AM (2011). Electrically evoked compound action potential measures for virtual channels versus physical electrodes. Ear and Hearing, 32, 323-330.

Hughes ML & Stille LJ (2010). Effect of stimulus and recording parameters on spatial spread of excitation and masking patterns obtained with the electrically evoked compound action potential in cochlear implants. Ear and Hearing, 31 (5), 679-692.

Saoji AA, Litvak LM & Hughes ML (2009). Excitation patterns of simultaneous and sequential dual electrode stimulation in cochlear implant recipients. Ear and Hearing, 30 (5), 559-567.

Hughes ML & Stille LJ (2009). Psychophysical and physiological measures of electrical-field interaction in cochlear implants. Journal of the Acoustical Society of America, 125 (1), 247-260.

Hughes ML (2008). A re-evaluation of the relation between physiological channel interaction and electrode pitch ranking in cochlear implants. Journal of the Acoustical Society of America, 124 (5), 2711-2714.

Hughes ML & Stille LJ. (2008). Psychophysical versus physiological spatial forward masking and the relation to speech perception in cochlear implants. Ear and Hearing, 29 (3), 435-452.

Hughes, M. L., Stille, L. J., Baudhuin, J. B., Goehring, J. L. (2013). ECAP spread of excitation with virtual channels and physical electrodes. Hearing Research, 306, 93-103.

Hughes, M. L., Neff, D. L., Simmons, J. L., Moeller, M. P. (2014). Performance outcomes for borderline cochlear implant recipients with substantial preoperative residual hearing. Otology & Neurotology, in press.