RU82419U1 - COMPLEX FOR THE DEVELOPMENT OF BASIC Hearing Perception Skills in People with Hearing Impaired - Google Patents

Abstract

1. A complex for the development of basic auditory perception skills in people with hearing impairments, containing video display equipment, audio equipment, a manipulator and a computer tool with computer-readable storage media and providing coordinated presentation of audio and video signals to the patient, recording the results of classes and comparing the results with a given value for the percentage of correct auditory identifications, characterized in that it includes functional blocks for choosing a training regimen and multidirectional training nga of hearing skills with a preliminary definition of the conditions for signaling, receiving reports of different levels of complexity from express assessment to a complete lesson protocol to monitor the training procedure and adjust the individual patient training program. ! 2. The complex for the development of basic auditory perception skills in people with hearing impairments according to claim 1, characterized in that the training mode selection blocks include a training block that allows you to repeat signals with feedback indicators, and a test block that prohibits signal repeats and feedback communication. ! 3. The complex for the development of basic auditory perception skills in people with hearing impairments according to claim 1, characterized in that the preliminary determination of the conditions for the supply of signals is carried out by blocks for selecting the value of the pause between signals or arbitrary triggering of signals. ! 4. The complex for the development of basic auditory perception skills in people with hearing impairments according to claim 1, characterized in that the multidirectional training is carried out by program blocks for the development of invariant speech recognition, extra perception

Description

The invention relates to medicine, more specifically to audiology and audiopedagogy, and may find application in the treatment of people with hearing impairment.

One of the important features of the diagnosis and correction of violations in the functioning of human sensory systems is the need to use signals of the corresponding modality. For the auditory system, these are various sounds included in the standard audiometry procedure, game developmental techniques, and training programs.

During corrective and recovery measures and rehabilitation of people with hearing impairments or patients after cochlear implant surgery (electrode prosthetics for hearing), the role of sound stimulation and listening procedures is significantly increased.

However, the formation of an adequate methodological situation and acoustic environment, allowing to conduct not only directed, but also effective training of auditory-speech function, is a difficult task.

It is known that one of the necessary elements of hearing training is the repeated repetition of sound and, in the first place, speech signals. At the same time, the sound educator can pronounce words, phrases, syllables, individual phonemes on his own or use sound recordings

material, training the patient’s ability to recognize signals by ear, and fixing in his memory the corresponding sound standards [1].

Such a learning process ensures the formation of new and correction of previously formed auditory images. To enhance the impact, the repetition of acoustic signals is accompanied by visual information (showing pictures and inscriptions corresponding to the sound signal), as well as additional explanations of the sound educator, for whom conducting such exercises is a serious burden. It can be reduced by using modern technical means.

Known methods in which voice signals to a patient are served using a VCR or computer [2].

Special computer programs for training and evaluating the patient’s auditory perception provide different speech signals (syllables, words with different syllabic structures, sentences). Signals are given in the closed (the patient knows which signals will be given, and must choose a signal from a given set of answers) or in the open (patient does not know what signals will be) lists. As a response, the patient marks the desired signal — its image on the computer monitor screen (with a mouse button, cursor, or hand, if a special “touch-screen” screen is used). When evaluating the recognition of speech signals in an open list, the patient responds verbally, and his response is entered into the computer [3].

Closest to the claimed solution is a complex designed for the rehabilitation of acoustic orientation function and its evaluation in patients with a cochlear implant [4].

The complex contains video display facilities, audio equipment, a manipulator and a computing tool with computer-readable storage media. The complex provides a consistent presentation of audio and video signals to the patient, recording the results of classes and comparison

the results obtained with a given value for the percentage of correct auditory identifications.

The disadvantages of the above known devices are limited methodological capabilities, namely, there is no choice of conditions for signaling, training direction, protocol form. These complexes do not allow the use of an extended, thematically structured base of acoustic signals.

Therefore, the scope of their application does not go beyond the scope of individual methods aimed at training a specific hearing skill. Moreover, the mechanical combination of the capabilities and advantages of these devices within the framework of one system does not solve the problem of providing multidirectional hearing training, its assessment and correction. To develop such a complex, it is necessary to introduce additional functional blocks that are responsible for the training regimen (training or testing), stimulation conditions (giving an audio signal on demand or in a given sequence) and working in concert with the direction selection blocks (perceptual tasks for each of the auditory skills) and training assessment. In turn, to ensure such coordination, it is necessary to create a qualitatively new control unit (a specialized control program) that can set and control the interaction of all elements of the complex, including an expanded base of acoustic (speech and non-speech) signals, structured in accordance with the sections of the training. The approach to the implementation of the identified problems and overcoming the limitations laid down in the prototype is presented in this development.

The technical result of the proposed solution is to create a single functional complex that provides combined and multidirectional training of basic hearing skills as a specialized training system.

To achieve the specified technical result, a complex for the development of basic auditory perception skills in people with hearing impairments, containing video display equipment, audio equipment, a manipulator and a computer tool with computer-readable storage media and providing coordinated presentation of audio and video signals to the patient, recording class results and comparing the results with a given value for the percentage of correct auditory identifications, according to the proposal, functional blocks for the choice of the training regimen and multidirectional training of hearing skills with preliminary determination of the conditions for signaling, the receipt of reports of various levels of difficulty from express assessment to the complete lesson protocol to monitor the training procedure and adjust the individual patient training program.

Also according to the proposal, the occupation mode selection blocks include a training unit that allows repeating signals with feedback indicators, and a testing unit that prohibits repeating signals and feedback. In addition, preliminary determination of the conditions for signal delivery is carried out by blocks for selecting the pause value between signals or arbitrary triggering of signals, and multidirectional training is carried out by program blocks for developing invariant speech recognition, perceiving extralinguistic characteristics of speech signals, distinguishing environmental sounds, localizing sound and speech sources, perception speech signals on different acoustic background.

The essence of the proposal is illustrated by drawings, where figure 1 shows a General view of the complex based on a laptop; figure 2 presents the General scheme of the complex; figure 3 shows an example of classes in the mode of "Training"; 4 is an example illustrating an evaluation form of listening results; figure 5 shows an example of the final protocol; figure 6 shows the basic directions of training auditory skills,

presented on the monitor screen.

It should be noted that for clarity, only those details are presented that are necessary for understanding the essence of the technical solution, and related equipment, well known to specialists in this field, is not shown in the drawings.

The complex can be implemented using a stationary or laptop computer. A general view of the laptop-based complex is shown in FIG. 1.

The complex is fully adapted for classes with native Russian speakers and can be used to train patients with hearing impairment, from the age of 4-5 years.

The complex contains a set of equipment: computer, monitor, keyboard, mouse, acoustic speakers. The complex also includes software (a special control program) and a number of separate functional blocks providing the opportunity to choose a training mode (training or testing), training areas (5 sections), signal conditions (sequence with a fixed pause, arbitrary start) and receiving reports of various difficulty levels (automatic express assessment, preservation of the complete lesson protocol).

The general scheme of the complex is presented in figure 2.

The circuit contains the following blocks.

Block 1 - control unit (control program).

Block 2 - block matching audio and video signals (images on a monitor screen).

Block 3 - block for setting the sequence of signals, where

- 3-1: selecting a sequence with “Pause” and setting its value;

- 3-2: selection of random triggering of signals at the user's command - click.

Block 4 - block setting the listening mode, where

- 4-1: Training mode with the possibility of repeating the signal and feedback;

- 4-2: "Testing" mode - prohibition of repetitions and feedback. Block 5 - block selection of the direction of training from 5 sections, where

- 5-1: the skill of invariant speech recognition;

- 5-2: the skill of perceiving extralinguistic signs - distinguishing the speaker's voice, determining phrasal intonation;

- 5-3: acoustic orientation skill - localization of stationary and moving sources of sound and speech;

- 5-4: the skill of distinguishing environmental sounds - the voices of animals, birds, musical sounds, sounds of a house, street, elements;

- 5-5: the skill of noise-tolerant perception - speech recognition on a different acoustic background - noise, speech, music - and in a competitive environment - simultaneous pronunciation.

Block 6 - block fixing and evaluation of results, where

- 6-1: providing feedback;

- 6-2: express assessment of the lesson;

- 6-3: saving the full lesson protocol. Block 7 - control unit of the base of audio signals, where

- 7-1: speech signal library;

- 7-2: non-speech sound library; further division on the subject of sections.

Block 8 - video display unit (control of signals to the monitor).

Block 9 - block audio broadcasting (control the supply of audio signals to the speakers).

Block 10 - block receiving control signals (selection of conditions and tasks) and patient responses (keyboard or mouse).

The complex works as follows

The operation of all units and equipment of the complex is controlled by a control program that receives control signals (tasks) and responses in an interactive mode.

Coordination of audio and video information is carried out by fixing (in the control program) the connection between a specific sound signal and its visual display on the monitor screen - a picture, an inscription. When using a set of different sounds (from 2 to 12), the user sees on the screen the entire block of images corresponding to them and the auditory task (recognition, discrimination). Giving an answer, the patient clicks on one of these “pictures”.

In the case of classes in the "Training" mode, the answer is accompanied by the highlighting of the selected image with a colored frame and the appearance of feedback elements. With positive reinforcement (the correct answer), they include a funny picture with a smile (“smiley”) and a red column in the diagram of answers; if negative (error) - the absence of an emoticon and a gray bar of the response diagram. An example is shown in figure 3.

When working in the "Testing" mode, the patient sees only the highlighting of the active response with a frame.

Upon completion of the lesson, an additional window appears on the screen with a general express assessment of the lesson. It includes the following indicators - the number of correct answers, the number of erroneous reactions of the patient, average response time (speed) and the final grade of the lesson. The final assessment is presented in a simple and understandable way for the patient - in the form of a “+” sign (condition - the number of correct answers exceeds 70% of auditory identifications) or a “-” sign (condition - recognition level is below 70%). This assessment is supportive, but helps to increase the patient's level of motivation for classes. Its design is done by the complex

automatically (without user request) with the output to the monitor screen immediately after the lesson. An example illustrating this form of evaluating listening results is shown in FIG.

For a more detailed analysis of the results, correction and decision-making on the completion of the training for different sections of the program, another form of recording the results is used - a special response protocol. Its saving is made with a positive response from the user to the corresponding request. Confirming the choice of this report form, you must enter the patient's full name in a special window that appears on the monitor screen. The remaining information - the date and time of the lesson, the training section, the listening mode, the order of the signals and the corresponding answers - are recorded automatically in the EXCEL program format, convenient for further statistical processing and analysis of the data obtained. At the same time, the primary processing of the results - the calculation of average indicators (correct answers, errors, reaction time) is also done automatically and can be printed immediately after classes. An example of the final protocol is shown in Fig.5.

A protocol of this degree of detail makes it possible to reasonably (based on a fixed objective assessment and analysis) carry out the correction of the rehabilitation process, draw up an individual lesson plan for the development of individual auditory skills of the patient.

The complex provides auditory skills training in five basic areas:

1 - speech recognition (conditionally. Speech);

2 - perception of extralinguistic features of speech (conditionally, Prosodica);

3 - distinguishing environmental sounds (conditionally, sounds around us);

4 - orientation in space (conditionally, Orientation);

5 - noise immunity perception (conditionally, perception on the background

interference).

On the monitor screen they are presented in accordance with the illustration in Fig.6.

These specialized sections of the training correspond to thematically structured sets of sound and speech material recorded in the computer's memory. Combining them within the framework of a single functional training system allowed us to significantly expand the range of complex applications and to obtain a new result in the form of combined multidirectional training of auditory function, which, combined with detailed recording of the results, provides an objective picture of the dynamics and degree of rehabilitation (development) of both individual skills and auditory-speech function of the patient as a whole.

The use of the complex with its training sections, multi-level assessment of answers and the possibility of correcting individual training programs significantly improves the auditory training procedure and increases the effectiveness of the rehabilitation and correction process in patients with hearing impairment, reduces the time for their social adaptation, as well as the burden on the hearing care professional responsible for auditory work with the patient.

The complex is applicable in clinical practice (rehabilitation course) and a specialized educational process. With its help, hearing training can be carried out under the guidance of a specialist in sound education or in the mode of completing independent tasks by the patient.

The whole complex - a software and hardware system, a control program, training directions, acoustic signal bases, forms of listening protocols, a comparative analysis of the results - was tested in the rehabilitation of patients after cochlear surgery

implantation (on the basis of the Research Institute of ENT, St. Petersburg) and remedial and rehabilitation classes with students with hearing impairment. The test involved 25 people of different ages (from 4 to 54 years) and various hearing loss.

The results were positively evaluated by specialists and confirmed its methodological advantages compared with the old training procedures, as well as high efficiency and effectiveness in terms of achieving the main goal - the development and restoration of basic auditory perception skills in people with hearing impairment.

This is confirmed by the presented examples.

Example 1. Patient K., 28 years old, lost hearing 2 years ago after suffering meningoencephalitis. The hearing aid was not used because of low efficiency for speech perception. The age of the patient at the time of implantation is 28 years.

The first lesson using the complex was conducted on day 1 2 hours after turning on the cochlear implant processor. Considering that the patient’s auditory perception skills with the implant are still very limited, the simplest task was chosen - recognizing words with different syllabic structure pronounced by one speaker.

To assess the dynamics of development of perception, a test mode without feedback was chosen. At the first listening, the patient made several mistakes (the number of correct answers is 80%, the average reaction time is 3.7 seconds according to the express assessment).

After this, the patient was asked to undergo training. For training, a more complex mode was immediately chosen - listening to these words spoken by different speakers. According to our observations, this paradigm helps patients quickly learn to distinguish linguistically relevant characters in new auditory images of words. During the training, the patient, receiving visual confirmation

correct answers and having the opportunity to re-listen to the word in case of an incorrect answer, quickly learned to recognize the words. After training, re-testing was carried out for 10 minutes. Testing showed that the number of correct answers when performing a more complex task with the perception of the words of different speakers was 100% with a reaction time of 1.9 seconds.

Given this result, an even more difficult task was immediately chosen - recognition of monosyllabic words spoken by different speakers, without prior familiarization. When completing this task, the number of correct answers was 90%, and the reaction time was 3.3 seconds. Subjectively, the patient noted that she quickly learns the words that she listened to during training, and also, most importantly, that it has become much easier for her to learn to learn new words.

Example 2. Patient P., 11 years old, hearing loss is presumably congenital. Before implantation she used a hearing aid. The age at the time of implantation is 11 years. 2 weeks after the implant processor was turned on, the first lesson was held to develop the ability to recognize the sound of musical instruments.

At the first listening, given the lack of formation of auditory perception and the absence of auditory images in the child’s memory (it was previously found out that the girl never heard most musical instruments and only knows the sound of the piano and drum), a small set of sounds (5 instruments) and a learning procedure with arbitrary triggering of signals. First, the child 3 times listened to all the sounds in the familiarization mode, when he could correlate all the sounds with the video image of the corresponding instrument.

After the girl confirmed that she can already recognize the sounds, a test was conducted in a non-feedback mode. results

listening with express assessment - 75% and a reaction time of 2.8 seconds. After that, we started training in feedback mode. Several training sessions were held over 15 minutes, after each of which the girl received information about the number of correct and erroneous answers, which allowed her to track the dynamics of training and stimulated to improve performance.

The next step included listening in test mode without feedback. According to testing after training, the number of correct answers was 100%, but the reaction time even increased and amounted to 3.4 seconds. To teach the girl to quickly analyze signals and respond, a mode with a fixed short pause between stimuli was chosen. This required the child to make a quick decision after listening to the signal, because the next stimulus followed very quickly, whether the child answered already or not. Performing tasks in this mode contributed to teaching the child to quickly analyze signals not only in this, but also in other tasks.

Example 3. Patient K., congenital hearing loss. Before implantation, the boy constantly wore 2 hearing aids. At the time of implantation, the child was 11 years old. Classes at the complex were conducted with the child at different stages of using the cochlear implant - within 3 weeks after the first inclusion of the implant processor, 6 and 14 months after its use.

During the first 3 weeks, as the child develops auditory perception skills, the following learning exercises were chosen - recognizing words with different and equal numbers of syllables pronounced by one or several speakers, recognizing environmental sounds when choosing from 5 sounds, recognizing vowel phonemes. As a result of 4 training sessions, the number of correct answers for a child in these tasks increased from 10-40% to 70-100% (in different tasks), and the reaction time significantly decreased.

Recognizing vowel phonemes and monosyllabic words presented the greatest difficulty for the child; he also had difficulty recognizing signals made by a low female voice.

Exercises were begun to develop the ability to recognize the voice of the announcer, but the child could not cope with this task and the exercises were suspended, because the failures very upset the child. Based on the results, the boy’s mother was recommended to continue classes on the development of auditory perception in the community. Particular attention was recommended to be paid to the development of the ability to recognize individual speech sounds in isolated pronunciations and syllables, as well as the training of recognizing words and phonemes pronounced by different people - men and women with different pitch.

After 6 months, when the boy came for a second course of auditory-speech rehabilitation, the perception of non-speech and speech signals was tested. It turned out that the boy easily completed tasks for recognizing words with different and identical syllabic structures, as well as phonemes, regardless of who said them. He also quickly found out whether a man or woman spoke these words.

At this stage, the child also decided to start teaching the child to localize the sound source in space and recognize words against the background of interference. Within 5 days, 4 training sessions were conducted using the complex. If in the first lesson the child could not determine the position of the sound source, then after 4 lessons the number of correct answers when determining the position of the sound source to the right or left, the number of correct answers was 80%, he also learned to determine whether the sound source is moving or it is motionless.

When perceiving words against the background of interference, the child successfully coped with the task when broadband noise was used as interference, and this skill improved from 60% to 100% during training. At

using speech noise as a noise, the number of correct answers was low. Mom was given recommendations on the development of speech perception on the background of interference, as well as the ability to localize the sound source.

14 months after turning on the implant processor, the child came to the next course of correction of the implant processor settings, testing the level of development of auditory perception and receiving recommendations for further rehabilitation at the place of residence. Testing of auditory-speech perception with the help of the complex showed that the child easily recognizes familiar words against the background of various hindrances, he also successfully coped with the most difficult task of recognizing a word uttered in a certain (female or male) voice, sounding simultaneously with another word uttered by another speaker. He also easily performed tasks to distinguish the speaker's intonation.

These results allowed us to conclude that the child has formed all the processes of auditory analysis necessary for the perception of speech. Further development of speech perception in a child and rehabilitation are associated with the accumulation of vocabulary and the development of the grammatical system of the mother tongue. In accordance with this, further recommendations were given to the mother of the child.

Information sources:

1 Lantsov A.A., Koroleva I.V., Pudov V.I., Zhukova O.S. Problems of cochlear implantation. News of otorhinolaryngology and logopathology. 1999. No4. p. 4-9.

2 Strauss-Schier A., Rost U. Rehabilitation in adult cochlear implant patients. In: Cochlear implant rehabilitation in children and adults. Ed D. Allum. Whurr publishers Ltd. England. 1996. P.254-265.

3 Parkinson A.J., Parkinson W. D., Tyier R.S., Lowder M.W., Gantz B.J. Speech perception performance in experienced cochlear-implant patients receiving

the SPEAK processing strategy in the Nucleus Spectra-22 cochlear implant. J. Speech, Language and hearing research. 1998. Vol. 41. No. 5 / P.1073-1087.

4 RU patent for the invention No. 2265426, A61F 11/04, 2005.

Claims (4)

1. A complex for the development of basic auditory perception skills in people with hearing impairments, containing video display equipment, audio equipment, a manipulator and a computer tool with computer-readable storage media and providing coordinated presentation of audio and video signals to the patient, recording the results of classes and comparing the results with a given value for the percentage of correct auditory identifications, characterized in that it includes functional blocks for choosing a training regimen and multidirectional training nga of hearing skills with a preliminary definition of the conditions for signaling, receiving reports of different levels of complexity from express assessment to a complete lesson protocol to monitor the training procedure and adjust the individual patient training program. 2. The complex for the development of basic auditory perception skills in people with hearing impairments according to claim 1, characterized in that the training mode selection blocks include a training block that allows you to repeat signals with feedback indicators, and a test block that prohibits signal repeats and feedback communication. 3. The complex for the development of basic auditory perception skills in people with hearing impairments according to claim 1, characterized in that the preliminary determination of the conditions for the supply of signals is carried out by blocks for selecting the value of the pause between signals or arbitrary triggering of signals. 4. The complex for the development of basic auditory perception skills in people with hearing impairments according to claim 1, characterized in that the multidirectional training is carried out by program blocks for the development of invariant speech recognition, perception of extralinguistic characteristics of speech signals, distinguishing environmental sounds, localization of sound and speech sources , perception of speech signals on a different acoustic background.