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Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception

机译：儿童双边耳蜗植入物：听觉经验和剥夺对听觉感知的影响

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Spatial hearing skills are essential for children as they grow, learn and play. These skills provide critical cues for determining the locations of sources in the environment, and enable segregation of important sounds, such as speech, from background maskers or interferers. Spatial hearing depends on availability of monaural cues and binaural cues. The latter result from integration of inputs arriving at the two ears from sounds that vary in location. The binaural system has exquisite mechanisms for capturing differences between the ears in both time of arrival and intensity. The major cues that are thus referred to as being vital for binaural hearing are: interaural differences in time (ITDs) and interaural differences in levels (ILDs). In children with normal hearing (NH), spatial hearing abilities are fairly well developed by age 4-5 years. In contrast, most children who are deaf and hear through cochlear implants (CIs) do not have an opportunity to experience normal, binaural acoustic hearing early in life. These children may function by having to utilize auditory cues that are degraded with regard to numerous stimulus features. In recent years there has been a notable increase in the number of children receiving bilateral CIs, and evidence suggests that while having two CIs helps them function better than when listening through a single CI, these children generally perform worse than their NH peers. This paper reviews some of the recent work on bilaterally implanted children. The focus is on measures of spatial hearing, including sound localization, release from masking for speech understanding in noise and binaural sensitivity using research processors. Data from behavioral and electrophysiological studies are included, with a focus on the recent work of the authors and their collaborators. The effects of auditory plasticity and deprivation on the emergence of binaural and spatial hearing are discussed along with evidence for reorganized processing from both behavioral and electrophysiological studies. The consequences of both unilateral and bilateral auditory deprivation during development suggest that the relevant set of issues is highly complex with regard to successes and the limitations experienced by children receiving bilateral cochlear implants.
机译：空间听证能力对孩子们的成长，学习和发挥至关重要。这些技能提供了用于确定环境中的来源位置的关键提示，并使重要声音的分离，例如语音，从背景掩蔽者或干扰。空间听证依赖于单声道线索和双耳线的可用性。后者导致输入到达在位置不同的声音的两个耳朵的输入。双耳系统具有精致的机制，用于捕获到达和强度两次耳朵之间的差异。因此称为双耳听力至关重要的主要提示是：时间（ITDS）和间隔差异（ILD）的间隔差异。在患有正常听力（NH）的儿童中，空间听力能力在4 - 5岁年龄相当开发。相比之下，大多数聋人和通过耳蜗植入物（CIS）的孩子没有机会在生活中早期体验正常的双耳声音听证。这些儿童可以通过必须利用关于许多刺激特征的听觉线索来起作用。近年来，接收双边CIS的儿童人数有一个值得注意的增加，证据表明，在有两个CIS的同时，他们的功能比通过单一CI聆听更好，这些孩子通常比他们的NH同龄人更糟糕。本文审查了最近有些关于双边植入儿童的工作。重点是空间听证措施，包括声音定位，从屏蔽中释放用于使用研究处理器的噪声和双耳灵敏度的语音理解。包括来自行为和电生理学研究的数据，重点关注作者及其合作者的最新工作。讨论了听觉可塑性和剥夺对孤独和空间听证的出现的影响以及来自行为和电生理学研究的重组处理的证据。发展过程中单方面和双边听觉剥夺的后果表明，关于成功和接受双边耳蜗植入者的儿童所经历的限制，相关问题的相关问题非常复杂。

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