Music Perception and Appraisal: Cochlear Implant Users and Simulated Cochlear Implant Listening

Background: The inability to hear music well may contribute to decreased quality of life for cochlear implant (CI) users. Researchers have reported recently on the generally poor ability of Cl users to perceive music, and a few researchers have reported on the enjoyment of music by CI users. However, the relation between music perception skills and music enjoyment is much less explored. Only one study has attempted to predict CI users' enjoyment and perception of music from the users' demographic variables and other perceptual skills (Gfeller et al, 2008). Gfeller's results yielded different predictive relationships for music perception and music enjoyment, and the relationships were weak, at best. Purpose: The first goal of this study is to clarify the nature and relationship between music perception skills and musical enjoyment for CI users, by employing a battery of music tests. The second goal is to determine whether normal hearing (NH) subjects, listening with a CI simulation, can be used as a model to represent actual CI users for either music enjoyment ratings or music perception tasks. Research Design: A prospective, cross-sectional observational study. Original music stimuli (unprocessed) were presented to CI users, and music stimuli processed with CI-simulation software were presented to 20 NH listeners (Clsim). As a control, original music stimuli were also presented to five other NH listeners. All listeners appraised 24 musical excerpts, performed music perception tests, and filled out a musical background questionnaire. Music perception tests were the Appreciation of Music in Cochlear Implantees (AMICI), Montreal Battery for Evaluation of Amusia (MBEA), Melodic Contour Identification (MCI), and University of Washington Clinical Assessment of Music Perception (UW-CAMP). Study Sample: Twenty-five NH adults (22-56 yr old), recruited from the local and research communities, participated in the study. Ten adult CI users (46-80 yr old), recruited from the patient population of the local adult cochlear implant program, also participated in this study. Data Collection and Analysis: Musical excerpts were appraised using a seven-point rating scale, and music perception tests were scored as designed. Analysis of variance was performed on appraisal ratings, perception scores, and questionnaire data with listener group as a factor. Correlations were computed between musical appraisal ratings and perceptual scores on each music test. Results: Music is rated as more enjoyable by CI users than by the NH listeners hearing music through a simulation (CIsim), and the difference is statistically significant. For roughly half of the music perception tests, there are no statistically significant differences between the performance of the Cl users and of the CIsim listeners. Generally, correlations between appraisal ratings and music perception scores are weak or nonexistent. Conclusions: NH adults listening to music that has been processed through a CI-simulation program are a reasonable model for actual CI users for many music perception skills, but not for rating musical enjoyment. For CI users, the apparent independence of music perception skills and music enjoyment (as assessed by appraisals) indicates that music enjoyment should not be assumed and should be examined explicitly.