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Original Investigation |

Evaluation of a Test Battery to Assess Perception of Music in Children With Cochlear Implants

Alexis T. Roy, MSc1; Lindsay Scattergood-Keepper, BA, BM1,2; Courtney Carver, AuD1; Patpong Jiradejvong, MSc1; Caty Butler1; Charles J. Limb, MD1,2
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
2Peabody Conservatory of Music, The Johns Hopkins University, Baltimore, Maryland
JAMA Otolaryngol Head Neck Surg. 2014;140(6):540-547. doi:10.1001/jamaoto.2014.341.
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Importance  A number of studies have investigated music perception in adult cochlear implant (CI) users. However, little is known about how pediatric CI users perceive and process music, in part because suitable methods for assessing music perception in this population are lacking. Therefore, we developed the Music in Children With Cochlear Implants (MCCI) battery to assess music perception in pediatric CI users younger than 9 years.

Objective  To pilot test the MCCI on a group of pediatric CI users to determine its feasibility for measuring music perception and to compare performance of CI users with that of normal-hearing (NH) control participants.

Design, Setting, and Participants  The pilot test was conducted in an academic tertiary care center. The MCCI evaluated rhythm, pitch, melody, harmony, and timbre perception. For each section, 10 pediatric CI users and 10 NH controls were presented with a pair of stimuli that possibly varied along a single musical element (eg, rhythm). Participants were required to indicate whether the stimuli in the pair were the same or different.

Interventions  Administration of the MCCI.

Main Outcomes and Measures  Percentage correct on each section of the MCCI and the aggregate score of all sections by group.

Results  The MCCI provided a basic characterization of musical perceptual abilities. In the aggregate, NH controls significantly outperformed CI users in music perception (mean [SD] accuracy for CI users vs NH controls: rhythm, 73% [20%] vs 78% [20%]; pitch, 84% [12%] vs 91% [13%]; melody, 65% [16%] vs 75% [18%]; harmony, 74% [13%] vs 75% [14%]; and timbre, 80% [17%] vs 90% [12%]; repeated-measures analysis of variance, F1,17 = 9.3; P < .01). Despite obtaining lower accuracies than NH controls, however, the CI users achieved above-chance accuracy in all sections of the MCCI (1-sample t test, P < .01), including pitch-based sections that are traditionally difficult for CI users. These results suggest that CI users can make use of temporal and spectral cues to discriminate between musical stimuli, although not to the extent of their NH peers.

Conclusions and Relevance  The MCCI provided an efficient and user-friendly assessment of music perception in pediatric CI users. This test battery may serve as a valuable tool to evaluate music perceptual abilities of pediatric CI users and measure the effects of interventions.

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Figure 1.
Representative Same and Different Pairs for Each Section of the Music in Children With Cochlear Implants (MCCI) Battery

The MCCI included rhythm, pitch, melody, harmony, and timbre sections. A different animal character guided participants through each section to help maintain attention.

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Figure 2.
Mean Performance Accuracy of Study Groups on Each Section of the Music in Children With Cochlear Implants (MCCI) Battery

Groups include 10 children with cochlear implants (CI users) and 10 controls with normal hearing (NH controls). Chance performance is 50% (dashed line). Error bars represent 1 SD of the mean.aP = .07 between groups.bP = .02 between groups.

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