Tone, rhythm, and timbre perception in school-age children using cochlear implants and hearing aids.
Level 3 - non-randomized controlled study
Non-randomized prospective controlled cohort study comparing hearing-impaired and normal-hearing children over time
PubMed 24224987 · doi:10.3766/jaaa.24.9.4
What was done
The study evaluated baseline musical perception and the effect of structured music training in 20 children aged 9–13 years from a single school in Melbourne, Australia. The cohort included 11 hearing-impaired children (6 using a unilateral cochlear implant [CI] or CI plus hearing aid [HA]; 5 using bilateral HAs) and 9 age- and gender-matched normal-hearing controls. All participants attended weekly 45-minute "Music Club" sessions throughout the school year. Standardized Intermediate Measures of Music Audiation (IMMA) Tonal and Rhythmic subtests were administered four times at 6-week intervals alongside an instrument timbre identification task. Outcomes were compared across groups, across sessions, and modeled against degree of hearing loss.
What was found
At baseline, normal-hearing children achieved a mean percentile rank of approximately 50 in both IMMA Tonal and Rhythmic subtests. Children using CIs showed trends toward lower scores on Tonal subtests, but not on Rhythmic subtests. No statistically significant test score improvements were found across the four sessions. On the timbre identification task, children made fewer errors identifying percussive instruments compared to nonpercussive instruments. Hearing loss level partially predicted performance on Tonal tasks (but not Rhythmic tasks) and had a stronger predictive effect for nonpercussive than percussive instruments. Numerical test statistics and effect sizes were not provided in the abstract.
Why it matters
This study indicates that children utilizing CIs and HAs can leverage temporal cues to maintain rhythm and percussive timbre perception comparable to normal-hearing peers, even when pitch processing is compromised. It also highlights that modest weekly music instruction may not produce detectable gains on standardized psychoacoustic audiation tests within a single school year.
Limits
The sample size was small (n=20 total, with subgroups of only 5–6 children), limiting statistical power. All children participated in the music intervention, meaning there was no non-intervention hearing-impaired control group to isolate intervention effects from test-retest learning. Psychosocial and engagement benefits were noted only through anecdotal reports.
Cited by
- supports On average, individuals with cochlear implants can perceive rhythm but cannot appreciate tonality or music, though musically trained patients tend to perform better.