title: The perception of stress and intonation in children with a cochlear implant and a hearing aid.
abstract: OBJECTIVE
  This study investigated whether low frequency information from a hearing aid improved the perception of stress and intonation by English-speaking children with cochlear implants. As pitch information is limited for cochlear implant users, this study also investigated if users rely more on the cues of duration and amplitude to perceive stress and intonation.
  
  
  METHODS
  Nine children with bimodal stimulation (cochlear implant and hearing aid) participated in two experiments. The first measured the just audible change in F0 (pitch) and amplitude for a speech-like word 'baba'. The second experiment examined the children's ability to identify focus in natural and manipulated sentences.
  
  
  RESULTS
  Overall, group results did not show a bimodal advantage in perceiving stress and intonation. However, the children were significantly better at perceiving focus in sentences with natural speech compared with manipulated speech in both the CI and bimodal conditions. The results suggest that in the absence of pitch cues, amplitude and duration cues are used to perceive stress and intonation. However, the majority of children only perceived amplitude changes greater than the changes typically found in speech, implying duration cues were the most valuable.
  
  
  CONCLUSIONS
  Taken together the findings suggest that for children with cochlear implants, cues to F0 may not be essential for prosody perception and in the absence of cues to F0 and amplitude, duration may offer an alternative cue.
  
  
  CONCLUSIONS
  Although a bimodal advantage was not demonstrated for all participants, it is recommended that if clinically appropriate, a contralateral hearing aid is fitted and trialled to exploit any residual hearing.
authors.forename: Lauren
authors.initials: L
authors.lastname: Hegarty
authors.forename: Andrew
authors.initials: A
authors.lastname: Faulkner
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D001309:Auditory Threshold; D002648:Child; D002663:Child Language; D019929:Cochlear Implantation / Q000523:psychology*; D003054:Cochlear Implants / Q000523:psychology*; D003131:Combined Modality Therapy; D003463:Cues; D004644:Emotions; D005260:Female; D006310:Hearing Aids / Q000523:psychology*; D006801:Humans; D007804:Language Development; D008297:Male; D010898:Pitch Perception; D011578:Psycholinguistics; D013061:Speech Acoustics; D013067:Speech Perception
keywords: Children; Cochlear implant; Hearing aid; Intonation; Pitch; Stress