Professional Quick Tips.pdf - For professionals - Cochlear Americas

Turn
on
the music
TM
Quick Tips for
optimizing a recipient's
experience with music

• SmartSound TM
2 allows personalized customization to meet a
recipient’s specific needs in optimizing music enjoyment
• Cochlear’s Music Program which consists of a combination
of ADRO ® + Whisper TM
is the first choice recommended for
listening to live or recorded music via any audio source.
C
T
Programming Rehabilitation
• How Does a Music Program Work?
Sound "boosted" by ADRO
Sound reduced by ADRO
• Biological Factors
- Presence of residual hearing 1
- Length of profound sensorineural
hearing loss
- Age
- Patent cochlea with full insertion
1 Gfeller, Kate, Oleson, Jacob, Knutson, John F, Breheny, Patrick, Driscoll, Virginia, Olszewski, Carol; Multivariate
predictors of music perception and appraisal by adult cochlear implant users; JAAA 19(1):120-134 Feb 2008
2 Gfeller, Kate, PhD, F.Wendell Miller Distinguished Professor; Piecing the Puzzle Together; June 2008
www.cochlear.com
Music: Whisper TM + ADRO ®
C Maximum comfort level T Threshold of audibility
Whisper
Whisper lifts quieter
sounds into the
audible range
ADRO
ADRO boosts dynamic
signals (e.g. bass beat +
vocal) while reducing those
which are more constant
Counseling Adult Recipients on Factors
that Can Influence Music Appreciation
• Realistic Expectations
- Set realistic expectations; music
may not sound like it did before the
recipient’s hearing loss.
- Capabilities vary with respect to music.
Even people with normal hearing
have personal music preferences
and varying abilities for music
While the Music Setting is our first recommendation
for recipients to enjoy music, we recognize that music
perception and enjoyment is unique for each environment
and each individual. Custom Sound TM Suite software offers
you the flexibility to customize music programs to meet each
individual’s needs. You can create multiple Music programs, and
encourage recipients to try using different MAPs when listening
to music to see what works best. A recipients MAP can easily
be customized for their individual needs, for example:
- When using an iPod or other accessory, adjust the accessory
mixing ratio to 10:1. Remember, this will change the IIDR
from 40 to 30 dB.
- SmartSound Focus is an excellent choice for recipients who
want to hear music and their dance partner
- The default Music map incorporates Whisper + ADRO
technology. Experiment with the other options in the Music
environment as well: Autosensitivity TM + ADRO and ADRO.
Each option works in slightly different ways.
o Whisper + ADRO: Whisper boosts the level of soft
signals without increasing loud sounds. The ADRO
component then dynamically optimizes the level of signals
in each channel.
o ASC + ADRO: ASC minimizes the effects of noise in the
changing acoustic environment, then ADRO dynamically
optimizes the level of signals in each of up to 22 channels.
o ADRO: An input processing algorithm designed to make
soft sounds more audible while maintaining comfort for
loud sounds in dynamic environments.
• Listening Conditions
- Recipients should avoid music played
at a loud volume
- Recipients should avoid listening
conditions where there
is a lot of echo or competing noise
• Research suggests that with practice and training CI recipients do
report improvements in music performance and enjoyment. 2
- Ask an AV therapist for ideas.
- Take a music class
- Learn the scales
• Practice, Practice, Practice. Patience, persistence, practice and
a positive attitude will go a long way!
• If the recipient wears a hearing aid in the unimplanted ear,
encourage hearing aid use when listening to music as it can
improve the sound quality.
• Recipients should start by choosing familiar music like lullabies
or the birthday song. Use simple melodies in the beginning and
stay away from harmonized complex tones of classical music.
• Encourage them to listen to some of their old favorites over
and over and over again! Sound quality will improve over
time. It’s a great idea to experiment with different types of
music from classical, soft rock, pop, country, etc. Recipients
can go to a music store to sample the music. Most music
What Helps Children Enjoy Music
• Listen in quiet environments with good acoustics
• Keep the music volume down
• Obtain the words to songs and teach them to the child
before playing the music
• Certain kinds of music or instruments may be more enjoyable
• Try different kinds of music
• Try different music activities:
- Listening to music
- Moving to music
- Singing
- Playing musical instruments
• Watch how the child responds to music and take cues
from them
stores provide headsets that can be placed over the
processor or an accessory can be plugged into their audio jack.
- Many recipients enjoy country and rock due to the
strong beat
- Cochlear implants transmit rhythm (beat), timbre (tone),
and lyrics effectively
- Hearing individual notes and melodies are more challenging.
• Encourage recipients to sample songs for free before
purchasing them at the iPod iTunes website.
• Understanding the lyrics will be difficult. Encourage recipients
to have the lyrics in front of them to follow along. Lyrics can
be printed from the internet by “googling” the song name.
• Encourage recipients to have a partner “sing along” with the
song so they can lip read and learn placement of lyrics.
• Ask recipients to keep a log of their progress. It will give you
an idea of what’s working, what’s not working, and how
they are progressing.
• Remind recipients to relax and have fun as they explore the
world of music with their cochlear implant.
Conclusions
• Many children enjoy informal music activities (i.e., sing
alongs, etc.)
• Some children may ask for a formal music experience
(i.e., taking lessons)
• Capabilities vary with children
• Know that certain activities and music styles may be difficult
• If they enjoy it – regardless of their skill or ability – go for it!

Accessories
• Adjustment of the mixing options for accessories.
- Trial different ratios depending on patient preference
• Try accessories that provide direct input
- Nucleus Personal Audio Cable (PAC) to iPod or any
MP3 player
- Nucleus TV/HiFi Cable with stereos, TV, & computers
- Silhouettes: Hatis, Noiz-Free, etc
- Headphones
Additional Resources
• UW-CAMP: Order from website, $150.00 http://depts.washington.edu/
ventures/UW_Technology/Express_Licenses/CAMP.php
• Kimberly Sena, Jenny Rogers Kruse, Carol Olszewski and Kate Gfeller “Music
Enjoyment and Activities for Children with Cochlear Implants.” CONTACT.
2001, Vol 15, No 1-2, pg 11-14
• Fujita, S. and Ito, J. (1999). Ability of nucleus cochlear implantees to
recognize music. Annals of Otology, Rhinology and Laryngology
108: 634-640.
• Gfeller, K. (2001). Aural rehabilitation of music listening for adult cochlear
implant recipients: Addressing learner characteristics. Music Therapy
Perspectives, 19, 88-95
• Gfeller KE, “Accommodating children who use cochlear implants in the
music therapy or educational setting.” Music Therapy Perspective. 2000, Vol
18, No 2, pg 122-130
• Gfeller, KE, Mehr M, Witt S, “Aural rehabilitation of music perception
and enjoyment of adult cochlear implant users.” Journal of Academy for
Rehabilitative Audiology. 2001, Vol 34, pg 17-27
• Gfeller, K., and Lansing, C. R. (1991). Melodic, rhythmic, and timbral
perception of adult cochlear implant users. Journal Speech Hearing
Research. 34, 916-920.
• Gfeller, K. and Lansing C.R. (1992). Musical perception of cochlear implant
users as measured by the primary measures of music audiation: An item
analysis. Journal of Music Therapy, 29: 18-39.
• Gfeller, K., Woodworth, G., Robin, D. A., Witt, S., and Knutson, J. F. (1997).
Perception of rhythmic and sequential pitch patterns by normally hearing
adults and adult cochlear implant users. Ear & Hearing, 18, 252-260.
www.cochlear.com
Cochlear Americas
13059 East Peakview Avenue
Centennial, CO 80111 USA
Tel: 1 303 790 9010
Fax: 1 303 792 9025
Toll Free: 1 800 523 5798
• HOPE Music Series:
- Tips for Improving Music Listening Skills
- Nucleus Sound Processor Accessories Guide
- Music and Implants: Piecing the Puzzle Together
Author: Kate Gfeller, and F. Wendell Miller,
Iowa Cochlear Implant Clinical Research Center,
University of Iowa
• Sound and Way Beyond
• www.cochlearamericas.com/turnthemusicon
Visit www.cochlear.com/hope to view all of our latest educational tools and materials
Website: www.cochlearamericas.com/turnthemusicon
FUN963 ISS1 JAN09
Music Resources from Cochlear
• Gfeller, K., Knutson, J. F., Woodworth, G., Witt, S., and DeBus, B. (1998).
Timbral recognition and appraisal by adult cochlear implant users and
normal-hearing adults. Journal American Academy of Audiology, 9, 1-19.
• Gfeller, K., Christ, A., Knutson, J. F., Witt, S., Murray, K. T., and Tyler, R. S.
(2000). Musical backgrounds, listening habits, and aesthetic enjoyment of
adult cochlear implant recipients. Journal American Academy of Audiology,
11, 390-406.
• Leal MC, Shin YJ, Laborde ML, Calmels MN, Verges S, Lugardon S, Andrieu
S, Deguine O, Fraysse B. (2003). Music perception in adult cochlear implant
recipients. Acta Otolaryngology, 123(7):826-35.
• Mirza, S., Douglas, S. A., Lindsey, P., Hildreth, T., and Hawthorne, M. (2003).
Appreciation of music in adult patients with cochlear implants: a patient
questionnaire. Cochlear Implants International, 4 (2), 85-95.
• Kong, Y-Y., Stickney G.S., Zeng F-G. (2005): Speech and melody recognition
in binaurally combined acoustic and electric hearing. Journal of Acoustical
Society of America, 117 (3), 1351-1361
• Pijl, S., and Schwarz, D. W. F. (1995). Melody recognition and musical interval
perception by deaf subjects with electrical pulse trains through single
cochlear implant electrodes. Journal of Acoustical Society of America,
98, 886-894.
• Pijl, S., and Schwarz, D. W. F. (1995). Intonation of musical intervals by deaf
subjects stimulated with single bipolar cochlear implant electrodes. Hearing
Research, 89, 203-211.
• Pijl, S. (1997). Labeling of musical interval size by cochlear implant patients
and normally hearing subjects. Ear & Hearing, 18, 364-372.