Improving music perception outcomes for children with hearing impairments: a baseline longitudinal study

Although speech perception and production outcomes are remarkably good for most cochlear implant and hearing aid users, music perception is often problematic. Many adult CI users are unsatisfied with the quality of music, avoid social situations where music is present, and no longer enjoy listening to music. However, children, especially those implanted at an early age, typically find music enjoyable and engaging. Despite this, their outcomes on music perception and singing tests remain well below those of normal-hearing children. Three primary attributes of music are rhythm, pitch, and timbre. Rhythm perception depends mainly on gross amplitude variations in the acoustic signal. These amplitude variations are transmitted well by hearing devices, and rhythm perception has shown to be relatively intact in people with hearing impairments. Discriminations in pitch and timbre, on the other hand, rely on the accurate perception of fine details in the evolving frequency spectrum. Current cochlear implant sound processing schemes do not allow for the encoding or transmission of these fine spectral details, with the consequence that cochlear implant users find pitch and timbre discriminations particularly difficult. Hearing aid sound processors operate in a different fashion, and although hearing aid users still have more difficulty with pitch and timbre discriminations than normal-hearing listeners, the problem is less than in cochlear implant users. Structured music training has been shown to improve timbre perception in children with cochlear implants, however it is unknown whether these benefits will extend to other aspects of music perception such as pitch or rhythm, and what level of improvement can be expected over different time periods