ABSTRACT
Hearing disorders are among the most common diseases. One treatment option for severe hearing loss is cochlear implantation.
Music has evolved in all cultures around the world. Music is no discursive form of communication and does not contain semantic meaning but is much more precise than speech when it comes to expressing emotions. Music supports human well-being, helps us to regulate the mood and fosters social cohesion.
Postlingually deaf adult cochlear implant (CI) users usually achieve good speech comprehension in silent surroundings but CI users often are unable to appreciate music. In auditory segregation, CI users rely on loudness cues rather than on pitch. This strategy works quite well with linguistic features but has clear limits when processing musical sounds that are based on fine-grained spectral changes. Consequently, the ability to perceive music is viewed as a pinnacle of achievement that may be possible through cochlear implants. This chapter will illustrate the differences in spectral and temporal resolution for speech and music and take a look behind the scenes of technical and psychophysiological challenges and restrictions in CI processing strategies.
Improving access to rehabilitation services and augmented rehabilitative strategies will help CI users to get the most out of their device. Aural rehabilitation is not standardized for adults after cochlear implantation. Comprehensive individual music training for adult in the early stages of rehabilitation are sparse. Most approaches use prerecorded or electronically produced (MIDI) files and often focus on single music aspects, such as timbre, pitch, or contours. Interactive music-based rehabilitation programs are a promising innovation. They can enhance musical pattern perception, stimulate the hearing performance of CI users and possibly extend to prompt better speech intelligibility.
As one example, the Heidelberg music therapy for postlingually deaf adult CI recipients will be presented. Apart from accuracy, the musical appraisal is of utmost importance for Heidelberg music therapy. CI users attend 5–10 individualized 50-min sessions during their first year of rehabilitation. The treatment is subdivided into five modules, each pursuing a specific therapeutic goal, taking into account the individual needs and problems of the CI users. Study results indicate a significant increase in hearing quality, in musical hearing performance, as well as prosodic elements, in speech. Further lines of research will be sketched out.
Speech recognition performance is no predictor of music perception but advances in hearing abilities of musical elements after cochlear implantation tend to improve linguistic features. Music-based trainings not only are “nice to have” but they have profound consequences not only on speech comprehension and vocal expression but also on improvements in quality of life and social engagement. We advocate that multidimensional, person-centered music-based trainings seem to be a fruitful and far-reaching completion and should become a cornerstone of CI rehabilitation.
