Telephone Usage and Cochlear Implant: Auditory Training Benefits

Sousa, Aline Faria de; Carvalho, Ana Claudia Martinho de; Couto, Maria Ines Vieira; Tsuji, Robinson Koji; Goffi-Gomez, Maria Valéria Schmidt; Bento, Ricardo Ferreira; Matas, Carla Gentile; Befi-Lopes, Debora Maria

doi:10.1055/s-0034-1390301

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Case Reports • Int. Arch. Otorhinolaryngol. 19 (3) • July-Sept 2015 • https://doi.org/10.1055/s-0034-1390301 copy

Telephone Usage and Cochlear Implant: Auditory Training Benefits

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction

Difficulties with telephone use by adult users of cochlear implants (CIs) are reported as a limitation in daily life. Studies to improve the speech understanding of CI users on the telephone are scarce in the Brazilian scientific literature.

Objective

To develop and evaluate the effectiveness of a training program of auditory abilities on the telephone for an adult CI user.

Resumed Report

The subject was a 55-year-old woman with a degree in accounting who used a CI for 24 months. The program consisted of three stages: pretraining evaluation, eight sessions of advanced auditory abilities training, and post-training evaluation. Auditory abilities with CI were evaluated before and after training in three conditions: sound field, telephone with the speech processor in the microphone function, and telephone with the speech processor in the telecoil function. Speech recognition was assessed by three different lists: one with monosyllabic and dissyllabic words, another with nonsense syllables, and another one with sentences. The Client Oriented Scale of Improvement (COSI) was used to assess whether the needs established by the CI user in everyday telephone use situations improved after training. The auditory abilities training resulted in a relevant improvement in the percentage of correct answers in speech tests both in the telephone use conditions and in the sound field condition. Conclusion The results obtained with the COSI inventory indicated a performance improvement in all situations presented at the beginning of the program.

cochlear implants; adult; rehabilitation; hearing loss; telephone

Conditions	Tasks
Sound field	Threshold with modulated pulse tone at 500, 1,000, 2,000, 3,000, 4,000, and 6,000 Hz Speech recognition index with monosyllabic and disyllabic words⁶6 Momensohn- Santos TM, Russo ICP.. Prática da Audiologia Clínica. 5th ed. São Paulo, Brazil: Cortez editora; 2005 List of sentences⁷7 Costa MJ, Iorio MCM, Mangabeira-Albernaz PL. Reconhecimento de fala: desenvolvimento de uma lista de sentenças emportuguês. Acta AWHO 1997;16(4):164-173 and list of nonsense syllables⁸8 Grupo de Investigação Latino-Americano da Cochlear Corporation. Protocolo Latino Americano para Avaliação de candidatos ao Implante Coclear. Reunião do Grupo de Investigação Latino- Americano da Cochlear Corporation. Bogotá, Colômbia; 2000
On the telephone with the speech processor in microphone function	Speech recognition index were surveyed: monosyllabic and disyllabic words⁶6 Momensohn- Santos TM, Russo ICP.. Prática da Audiologia Clínica. 5th ed. São Paulo, Brazil: Cortez editora; 2005 List of sentences⁷7 Costa MJ, Iorio MCM, Mangabeira-Albernaz PL. Reconhecimento de fala: desenvolvimento de uma lista de sentenças emportuguês. Acta AWHO 1997;16(4):164-173 and list of nonsense syllables⁸8 Grupo de Investigação Latino-Americano da Cochlear Corporation. Protocolo Latino Americano para Avaliação de candidatos ao Implante Coclear. Reunião do Grupo de Investigação Latino- Americano da Cochlear Corporation. Bogotá, Colômbia; 2000
On the telephone with the speech processor in telecoil function	Speech recognition index were surveyed: monosyllabic and disyllabic words⁶6 Momensohn- Santos TM, Russo ICP.. Prática da Audiologia Clínica. 5th ed. São Paulo, Brazil: Cortez editora; 2005 List of sentences⁷7 Costa MJ, Iorio MCM, Mangabeira-Albernaz PL. Reconhecimento de fala: desenvolvimento de uma lista de sentenças emportuguês. Acta AWHO 1997;16(4):164-173 and list of nonsense syllables⁸8 Grupo de Investigação Latino-Americano da Cochlear Corporation. Protocolo Latino Americano para Avaliação de candidatos ao Implante Coclear. Reunião do Grupo de Investigação Latino- Americano da Cochlear Corporation. Bogotá, Colômbia; 2000

Session	Planning
1	Guidance on the appropriate use of communication strategies. A flyer with recommendations and examples of appropriate and maladaptive strategies was provided
2	Semiopen auditory recognition on speakerphone and simulation of the same situation on the telephone using the cochlear implant microphone (proposed theme: scheduling an appointment)
3	Practice using the telephone with the cochlear implant microphone and subsequently using the telecoil. Open set auditory recognition tasks with topics selected by the therapist (invitation to dinner and to watch a movie). In this condition, the therapist and one assistant switched turns on the telephone so that the patient would experience different voices
4	Practice using the telephone with the cochlear implant microphone and subsequently using the telecoil. Open set recognition of questions on several topics (everyday life and preferences) was performed. Reading of texts was initiated for further interpretation by the patient
5	Practice using the telephone with the cochlear implant microphone and subsequently using the telecoil. In this session, the patient was advised to write down a recipe dictated by the speech-language pathologist via telephone. Reading of texts with increased difficulty level and extent was initiated aiming subsequent interpretation
6	Practice using the telephone with the cochlear implant microphone and subsequently using the telecoil. The training was performed through dictation of lists of maximum pair words and rhymes
7	Training on the computer with the use of audio cable. Texts were read with the presence of white background noise and the task was to listen to the text and then answer specific questions related to it
8	Guidance on the use of cables available for cochlear implants and computer training of text with white background noise

Material	Condition	Pretraining (%)	Post-training (%)	Difference (%)
List of sentences	Sound attenuated booth at 70 dB	60	100	40
	Telephone with telecoil	60	100	40
	Telephone with microphone	50	100	50
Dissyllabic words	Sound attenuated booth at 70 dB	60	76	16
	Telephone with telecoil	80	72	-8
	Telephone with microphone	64	76	12
Monosyllabic words	Sound attenuated booth at 70 dB	52	80	28
	Telephone with telecoil	72	84	12
	Telephone with microphone	52	72	20
List of nonsense syllables	Sound attenuated booth at 70 dB	63	79	16
	Telephone with telecoil	74	89	15
	Telephone with microphone	53	63	10

Necessity
1	Talking on the phone with a particular friend whose voice and speech is difficult to understand even on the speaker phone
2	Schedule medical appointments
3	Schedule meetings with friends
4	Call customer services, such as telephone and gas companies

Fundação Otorrinolaringologia R. Teodoro Sampaio, 483, 05405-000 São Paulo/SP Brasil, Tel.: (55 11) 3068-9855, Fax: (55 11) 3079-6769 - São Paulo - SP - Brazil
E-mail: iaorl@iaorl.org

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[TFN01] Note: Results as reported by patient using the Client Oriented Scale of Improvement during the pretraining assessment.