Pitch Accuracy of Vocal Singing in Deaf Children With Bimodal Hearing and Bilateral Cochlear Implants.
Pitch Accuracy of Vocal Singing in Deaf Children With Bimodal Hearing and Bilateral Cochlear Implants.
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双耳双耳聋儿童双耳人工耳蜗术后发声的音高准确性研究
DOI：
10.1097/aud.0000000000001189
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发表时间：
2022-07-01
期刊：
影响因子：
3.7
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中科院分区：
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本研究的目的是研究重度至重度听力损失儿童在使用双侧人工耳蜗（CIs）或双模装置（CI在一只耳朵，助听器（HA）在另一只耳朵）的情况下，与同龄正常听力儿童（NH）相比，声乐演唱的音高准确性。参与者分为四组：(1)NH患儿26例，(2)双峰装置患儿13例，(3)顺序植入双侧CIs患儿31例，(4)同时植入双侧CIs患儿10例。所有参与者的年龄都在7到11岁之间。每个参与者都被录制了一首自己选择的熟悉的歌曲。提取单个歌唱音符的基本频率（F0）并进行归一化，以便于跨主题比较。通过参考目标音符计算的四个基于音高的指标：平均音符偏差、轮廓方向、平均音程偏差和F0方差比来量化音高精度。采用单因素方差分析比较每个音高度量的听众组差异。主成分分析表明，平均音符偏差最能说明声乐中的音高准确性。回归分析以平均音符偏差为因变量，人口统计学和听力学因素为自变量，检验CI儿童歌唱熟练程度的潜在预测因素。结果显示，与NH儿童相比，三组CIs儿童在所有四个基于音高的指标上的表现明显较差。三个CI组间无显著差异。在患有CIs的儿童中，声乐熟练程度的差异很大。在13名双峰用户组中，平均音符偏差与他们独立的纯音平均阈值显著相关（r = 0.582, p = 0.037）。然而，对所有CI儿童的回归分析显示，这些CI儿童的声乐演唱表现没有显著的人口统计学或听力学预测因子。双侧CIs和双峰装置患儿的声乐表现在组内无显著差异。与患有NH的儿童相比，儿童双模和双侧CI使用者通常表现出明显的声乐演唱能力缺陷。人口统计学和听力学因素，从先前的研究中已知与CIs的语言前聋儿童良好的言语和语言发展有关，但与这些儿童的歌唱准确性无关。人口统计学和听力学因素与双侧助听器儿童歌唱准确性的关系尚不清楚。
The purpose of the present study was to investigate the pitch accuracy of vocal singing in children with severe-to-profound hearing loss who use bilateral cochlear implants (CIs) or bimodal devices [CI at one ear, hearing aid (HA) at the other] in comparison to similarly-aged children with normal-hearing (NH). The participants included four groups: (1) 26 children with NH, (2) 13 children with bimodal devices, (3) 31 children with bilateral CIs that were implanted sequentially, and (4) 10 children with bilateral CIs that were implanted simultaneously. All participants were aged between 7 and 11 years old. Each participant was recorded singing a self-chosen song that was familiar to him or her. The fundamental frequencies (F0) of individual sung notes were extracted and normalized to facilitate cross-subject comparisons. Pitch accuracy was quantified using four pitch-based metrics calculated with reference to the target music notes: mean note deviation, contour direction, mean interval deviation, and F0 variance ratio. A one-way ANOVA was used to compare listener-group difference on each pitch metric. A principal component analysis showed that the mean note deviation best accounted for pitch accuracy in vocal singing. A regression analysis examined potential predictors of CI children’s singing proficiency using mean note deviation as the dependent variable and demographic and audiological factors as independent variables. The results revealed significantly poorer performance on all four pitch-based metrics in the three groups of children with CIs in comparison to children with NH. No significant differences were found among the three CI groups. Among the children with CIs, variability in the vocal singing proficiency was large. Within the group of 13 bimodal users, the mean note deviation was significantly correlated with their unaided pure-tone average thresholds (r = 0.582, p = 0.037). The regression analysis for all children with CIs, however, revealed no significant demographic or audiological predictor for vocal singing performance in these CI children. Vocal singing performance in children with bilateral CIs or bimodal devices were not significantly different from each other on a group level. Compared to children with NH, the pediatric bimodal and bilateral CI users, in general, demonstrated significant deficits in vocal singing ability. Demographic and audiological factors, known from previous studies to be associated with good speech and language development in prelingually-deafened children with CIs, were not associated with singing accuracy for these children. Demographic and audiological factors associated with singing accuracy of children with bilateral hearing devices are still unknown.