Question
One of the tests in Sound and Beyond measures pitch discrimination. In our clinic, most CI users score close to 100% on this pretest. Occasionally, students will score at chance. These students tend to show very limited spoken language skills at the beginning of therapy and fail to progress.
Are there known cases of CI users who perform at a chance level on this test later developing pitch discrimination? In general, how would lack of pitch discrimination contribute to lack of progress in speech development, and are there any interventions recommended for such individuals?
Answer
Frequency discrimination is the basis of good pitch perception. Scoring at chance levels on the Sound and Beyond subtest essentially demonstrates poor pitch perception, which is more than likely due to reduced neural survival. Students with limited spoken language abilities tend to be congenitally deaf who were poor or non users of hearing aids. Often they are children who use ASL as their main mode of communication or may be children with auditory processing issues in addition to their deafness. They could also be children with auditory dys-synchrony/neuropathy. Their failure to progress is a result of any one of these factors. One intervention that has demonstrated some limited success is the use of Fast Forward (a computerized program for hearing children with auditory processing problems). My experiences in the past with working with children like this is to add the visual cue and permit them to use their limited auditory skills to enhance speechreading. Speech development in these children remains a huge challenge. Depending on their age at implantation and duration of deafness improvement is generally poor. Dr. Chute is a Professor and Interim Dean of the School of Health and Natural Sciences at Mercy College in Dobbs Ferry New York. She is also the former Editor of the Volta Review and a member of the Board of Scientific Trustees for the Deafness Research Foundation. She is the former director of the Cochlear Implant Center at Lenox Hill Hospital and Manhattan Eye Ear and Throat Hospital She has been active in the implant field since 1979 and has over 40 publications including three books entitled "Children with Cochlear Implants in Educational Settings," "A Parents Guide to Cochlear Implants," and most recently "School Professionals Working with Children with Cochlear ImplantsIn 1995, she was an invited speaker at the National Institute of Health Consensus Conference on Cochlear Implants in Children. She has received funding for her research from the Deafness Research Foundation, the Danziger Foundation, the Lounsbery Foundation, and the National Science Foundation.
Dr. Chute's research has focused on children and adults with severe to profound hearing loss as well as the educational needs of deaf children. She is known both nationally and internationally for her work in this area and organizes workshops around the globe to train speech, hearing and educational professionals.
Patricia Chute, EdD, CCC-A
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