Skip to main content

Binaural and Spatial Hearing in Implanted Children

  • Chapter
  • First Online:
Pediatric Cochlear Implantation
  • 1792 Accesses

Abstract

Children with normal hearing (NH) utilize information that arrives at the two ears in order to perform a multitude of tasks in their everyday listening environments. In the field of audiology, the question regarding provision of auditory input to one vs. two ears has been around for many years. This chapter has three objectives. First, the potential benefits from having two ears are described, with a focus on binaural cues that are available to listeners when using acoustic hearing, or electric hearing through cochlear implants (CIs). While NH children can access fine-grained binaural cues, bilateral CI users face a number of limitations in the binaural processing domain. A second objective is the discussion of measures that are used to evaluate binaural and bilateral hearing. Binaural sensitivity measures are obtained with acoustic stimuli over headphones or with direct electrical stimulation. Spatial hearing acuity provides a measure of the extent to which children know whether sounds are presented to the right vs. left, but sound localization indicates whether children can map acoustic space to perceived locations. Finally spatial release from masking indicates how well children can understand speech that is within their vocabulary, in the presence of maskers that are spatially co-located or separated from the target. A third objective is to highlight outcomes in children with bilateral CIs, focusing on the emergence of binaural and spatial hearing spanning the range of ~2 years of age to late childhood. Findings in NH and bilaterally implanted children are compared, and the role of auditory deprivation vs. early stimulation is considered.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ashmead DH, Davis DL, Whalen T, Odom RD. Sound localization and sensitivity to interaural time differences in human infants. Child Dev. 1991;62(6):1211–26.

    Article  CAS  PubMed  Google Scholar 

  • Blauert J. Spatial hearing: the psychophysics of human sound localization. Revised edition. Cambridge, MA: MIT Press; 1987.

    Google Scholar 

  • Ching TY, Hill M, Brew J, Incerti P, Priolo S, Rushbrook E, Forsythe L. The effect of auditory experience on speech perception, localization, and functional performance of children who use a cochlear implant and a hearing aid in opposite ears. Int J Audiol. 2005;44(12):677–90.

    Article  PubMed  Google Scholar 

  • Ching TY, van Wanrooy E, Hill M, Incerti P. Performance in children with hearing aids or cochlear implants: bilateral stimulation and binaural hearing. Int J Audiol. 2006;45 Suppl 1:S108–12.

    Article  PubMed  Google Scholar 

  • Clifton RK, Gwiazda J, Bauer JA, Clarkson MG, Held RM. Growth in head size during infancy: implications for sound localization. Dev Psychol. 1988;24(4):477–83.

    Article  Google Scholar 

  • Durlach NI, Mason CR, Shinn-Cunningham BG, Arbogast TL, Colburn HS, Kidd Jr G. Informational masking: counteracting the effects of stimulus uncertainty by decreasing target-masker similarity. J Acoust Soc Am. 2003;114(1):368–79.

    Article  PubMed  Google Scholar 

  • Ehlers E, Zheng Y, Kan A, Godar S, Litovsky, RY. Sensitivity to binaural cues in normal hearing children and children who use cochlear implants. Presented at the Conference for Implantable Auditory Prosthesis, Tahoe City, CA; 2013.

    Google Scholar 

  • Garadat SN, Litovsky RY. Speech intelligibility in free field: spatial unmasking in preschool children. J Acoust Soc Am. 2007;121(2):1047–55.

    Article  PubMed  PubMed Central  Google Scholar 

  • Godar SP, Litovsky RY. Experience with bilateral cochlear implants improves sound. Otol Neurotol. 2010;31(8):1287–92.

    Article  PubMed  PubMed Central  Google Scholar 

  • Good MD, Gilkey RH. Sound localization in noise: the effect of signal-to-noise ratio. J Acoust Soc Am. 1996;99(2):1108–17.

    Article  CAS  PubMed  Google Scholar 

  • Grieco-Calub TM, Litovsky RY, Werner LA. Using the observer-based psychophysical procedure to assess localization acuity in toddlers who use bilateral cochlear implants. Otol Neurotol. 2008;29(2):235–9.

    Article  PubMed  Google Scholar 

  • Grieco-Calub TM, Litovsky RY. Spatial acuity in 2-to-3-year-old children with normal acoustic hearing, unilateral cochlear implants, and bilateral cochlear implants. Ear Hear. 2012;33(5):561–72.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grieco-Calub T, Litovsky RY. Sound localization skills in children who use bilateral cochlear implants and in children with normal acoustic hearing. Ear Hear. 2010;31(5):645–56.

    PubMed  PubMed Central  Google Scholar 

  • Hartmann WM, Rakerd B. On the minimum audible angle--a decision theory approach. J Acoust Soc Am. 1989;85:2031–41.

    Article  CAS  PubMed  Google Scholar 

  • Hawley ML, Litovsky RY, Culling JF. The benefit of binaural hearing in a cocktail party: effect of location and type of interferer. J Acoust Soc Am. 2004;115:833–43.

    Article  PubMed  Google Scholar 

  • Hess CL. Speech discrimination and spatial hearing in toddlers with bilateral cochlear implants. Unpublished PhD Dissertation, University of Wisconsin-Madison; 2013.

    Google Scholar 

  • Jones GL, Litovsky RY. Effects of uncertainty in a cocktail party environment in adults. J Acoust Soc Am. 2008;124:3818–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jones GL, Litovsky RY. A cocktail party model of spatial release from masking by both noise and speech interferers. J Acoust Soc Am. 2011;130(3):1463–74.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kan A, Stoelb C, Litovsky RY, Goupell MJ. Effect of mismatched place-of-stimulation on binaural fusion and lateralization in bilateral cochlear-implant users. J Acoust Soc Am. 2013;134(4):2923–36.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kan A, Litovsky RY. Binaural hearing with electrical stimulation. Hear Res. 2014;322:127–37.

    Article  PubMed  PubMed Central  Google Scholar 

  • Litovsky RY. Learning to hear with bilateral cochlear implants: Effect of degraded signals on spatial hearing and auditory development. Presented at the Conference for Implantable Auditory Prosthesis, Tahoe City, CA; 2013.

    Google Scholar 

  • Levitt H. Transformed up-down methods in psychoacoustics. J Acoust Soc Am. 1971;49 Suppl 2:467.

    Article  Google Scholar 

  • Litovsky RY, Macmillan NA. Sound localization precision under conditions of the precedence effect: effects of azimuth and standard stimuli. J Acoust Soc Am. 1994;96:752–8.

    Article  CAS  PubMed  Google Scholar 

  • Litovsky RY. Developmental changes in the precedence effect: estimates of Minimal Audible Angle. J Acoust Soc Am. 1997;102:1739–45.

    Article  CAS  PubMed  Google Scholar 

  • Litovsky RY. Speech intelligibility and spatial release from masking in young children. J Acoust Soc Am. 2005;117:3091–9.

    Article  PubMed  Google Scholar 

  • Litovsky RY, Johnstone PM, Godar S, Agrawal SS, Parkinson A, Peters R, Lake J. Bilateral cochlear implants in children: localization acuity measured with minimum audible angle. Ear Hear. 2006a;27:43–59.

    Article  PubMed  PubMed Central  Google Scholar 

  • Litovsky RY, Parkinson A, Arcaroli J, Peters R, Lake J, Johnstone P, Yu G. Bilateral cochlear implants in adults and children. Arch Otol Head Neck Surg. 2004;130:648–55.

    Article  Google Scholar 

  • Litovsky RY. Review of recent work on spatial hearing skills in children with bilateral cochlear implants. Cochlear Implants Int. 2011a;12 Suppl 1:S30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Litovsky RY. Development of binaural and spatial hearing. Springer handbook of auditory research. New York: Springer; 2011b. p. 163–95.

    Google Scholar 

  • Litovsky RY, Johnstone PM, Godar SP. Benefits of bilateral cochlear implants and/or hearing aids in children. Int J Audiol. 2006b;45 Suppl 1:S78–91.

    Article  PubMed  PubMed Central  Google Scholar 

  • Litovsky RY, Godar SP. Difference in precedence effect between children and adults signifies development of sound localization abilities in complex listening tasks. J Acoust Soc Am. 2010;128(4):1979–91.

    Article  PubMed  PubMed Central  Google Scholar 

  • Litovsky RY, Jones GL, Agrawal S, van Hoesel R. Effect of age at onset of deafness on binaural sensitivity in electric hearing in humans. J Acoust Soc Am. 2010;127(1):400–14.

    Article  PubMed  PubMed Central  Google Scholar 

  • Litovsky R, Clifton R. Use of sound-pressure level in auditory distance discrimination by 6-month old infants and adults. J Acoust Soc Am. 1992;92(2):794–802.

    Article  CAS  PubMed  Google Scholar 

  • Litovsky RY, Harris S, Ehlers E, Hess C. Reaching for sound: ecologically valid estimate of spatial hearing in 2-3 year old children with bilateral cochlear implants. Otol Neurotol. 2013;34(3):429–35.

    Article  PubMed  PubMed Central  Google Scholar 

  • Middlebrooks JC, Green DM. Sound localization by human listeners. Annu Rev Psychol. 1991;42:135–59.

    Article  CAS  PubMed  Google Scholar 

  • Mills A. On the minimum audible angle. J Acoust Soc Am. 1958;30:237–46.

    Article  Google Scholar 

  • Misurelli SM, Litovsky RY. Spatial release from masking in children with normal hearing and with bilateral cochlear implants: effect of interferer asymmetry. J Acoust Soc Am. 2012;132(1):380–91.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moore JM, Thompson G, Thompson M. Auditory localization of infants as a function of reinforcement conditions. J Speech Hear Disord. 1975;40(1):29–34.

    Article  CAS  PubMed  Google Scholar 

  • Muir DW, Clifton RK, Clarkson MG. The development of a human auditory localization response: a U-shaped function. Can J Psychol. 1989;43(2):199–216.

    Article  CAS  PubMed  Google Scholar 

  • Perris EE, Clifton RK. Reaching in the dark toward sound as a measure of auditory localization in 7-month-old infants. Infant Behav Dev. 1988;11:477–95.

    Article  Google Scholar 

  • Populin LC. Human sound localization: measurements in untrained, head-unrestrained subjects using gaze as a pointer. Exp Brain Res. 2008;190(1):11–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salloum CA, Valero J, Wong DD, Papsin BC, van Hoesel R, Gordon KA. Lateralization of interimplant timing and level differences in children who use bilateral cochlear implants. Ear Hear. 2010;31(4):441–56.

    Article  PubMed  Google Scholar 

  • Van Deun L, van Wieringen A, Van den Bogaert T, Scherf F, Offeciers FE, Van de Heyning PH, Desloovere C, Dhooge IJ, Deggouj N, De Raeve L, Wouters J. Sound localization, sound lateralization, and binaural masking level differences in young children with normal hearing. Ear Hear. 2009;30:178–90.

    Article  PubMed  Google Scholar 

  • Van Deun L, van Wieringen A, Scherf F, Deggouj N, Desloovere C, Offeciers FE, Van de Heyning PH, Dhooge IJ, Wouters J. Earlier intervention leads to better sound localization in children with bilateral cochlear implants. Audiol Neurootol. 2010;15(1):7–17.

    Article  PubMed  Google Scholar 

  • van Hoesel R. Exploring the benefits of bilateral cochlear implants. Audiol Neurootol. 2004;9:234–46.

    Article  PubMed  Google Scholar 

  • Wightman FL, Kistler DJ. Headphone simulation of free-field listening. I: stimulus synthesis. J Acoust Soc Am. 1989;85(2):858–67.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The author is very grateful to students, postdoctoral fellows, and collaborators whose participation in the cited studies was important to the success of this chapter, and to the research participants for their dedication to the understanding of bilateral and binaural hearing in children. The author received support for her work from the National Institutes of Health (R01 DC 003083 and 5R01 DC 008365).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ruth Y. Litovsky .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media LLC

About this chapter

Cite this chapter

Litovsky, R.Y. (2016). Binaural and Spatial Hearing in Implanted Children. In: Young, N., Iler Kirk, K. (eds) Pediatric Cochlear Implantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2788-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2788-3_10

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2787-6

  • Online ISBN: 978-1-4939-2788-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics