The family oriented musical training for children with cochlear implants: speech and musical perception results of two year follow-up.
OBJECTIVE
The purpose of this study is to determine whether children can gain benefit from training on pitch and music perception. Our main goals were to prepare a tool for training pitch and rhythm perception and evaluate musical attitude in children, to determine whether pitch and rhythm perception improve more rapidly through training and to assess the impact of training on speech perception.


METHODS
A family centred habilitation program based on musical training is developed. Nine newly implanted children who were switched on in HiRes and trained from the outset and 9 children using HiRes strategy who did not receive training both undergo assessments to determine pitch and rhythm perception skills and speech perception assessments. Music group was formed by the children who were implanted consecutively. As a control group, children who are being followed for another study which examines "the changes of sound quality perception, speech understanding, speech production, and communication mode" are included. The speech perception test battery contains a comprehensive range of age appropriate tasks covering detection, discrimination, identification, recognition and comprehension abilities. Also meaningful auditory integration scale (MAIS) or infant-toddler MAIS (if more appropriate) and the meaningful use of speech scale (MUSS) were administered in order to collect information about children's use of sound in everyday situations such as device bounding, alerting to sound and deriving meaning from auditory stimuli. Musical training program was based on a take-home electric keyboard which is used for listening to different pairs of notes. For this study, three octaves and one extra note at the high end of the keyboard were used. Children were expected to discriminate a pair of notes. Assessments of speech perception at pre-implant, 1-, 3-, 6-, 12-, 24-months post switch-on. By the end of the first and second years, parents were given the 'musical stages questionnaire' which covers some of the key areas of musical development to compare both groups' musical development.


RESULTS
Children who were involved in music study demonstrated significant familiarity in both determining pitch differences. No significant difference was found between music group compared with the non-trained group in terms of speech perception (p>0.05). However, by the end of 3rd month, music group came into prominence particularly at the rate of being linguistically/developmentally ready to carry out formal modified open-set speech perception evaluation (p<0.05). Both groups seemed to be developed similarly in sound awareness and general reaction, differentiating melody, dynamic, rhythmical changes and emotional aspects of musical development (p>0.05) whereas music group had more exposure to music at the end of the first year (p<0.05). However, by the end of the second year music group developed more than the control group in all aspects of musical skills (p<0.05).


CONCLUSIONS
Music training program helps appreciation of music and may enhance their progress in other auditory domains after cochlear implantation in children. While, effects of the musical training program on daily listening attitudes and social aspects such as closer parent-child relationship were significantly observed future training programs that should strive to improve satisfaction with music listening and its effect on auditory perception.
Yucel
Esra
E
Department of Otolaryngology Head and Neck Surgery, Audiology and Speech Pathology Section, Hacettepe University Medical Faculty, Turkey. esyucel@yahoo.com
Sennaroglu
Gonca
G
Belgin
Erol
E
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000534:rehabilitation*; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D009147:Music Therapy / Q000379:methods*; D010898:Pitch Perception; D013067:Speech Perception; D016896:Treatment Outcome