Vocal Emotion Perception in Children Using Cochlear Implant

Abstract

The significance of emotional prosody in social communication is well-established, yet research on emotion perception among cochlear implant (CI) users is less extensive. This study aims to explore vocal emotion perception in children using CI and bimodal hearing devices and compare them with their normal hearing (NH) peers. The study involved children aged 4-10 years with unilateral CI and contralateral hearing aid (HA), matched with NH peers by gender and listening age. Children were selected using snowball sampling for the CI group and purposive sampling for the NH group. Vocal emotion perception was assessed for semantically neutral sentences in "happy," "sad," and "angry" emotions using a 3 alternate forced choice test. The NH group demonstrated significantly superior emotion perception (P=.002) compared to the CI group. Both groups accurately identified the "happy" emotion. However, the NH group had higher scores for the "angry" emotion compared to the "sad" emotion, while the CI group showed better scores for "sad" than "angry" emotion. Bimodal hearing devices improved recognition of "sad"and "angry" emotions, with a decrease in confusion percentages. The unbiased hit (Hu) value provided more substantial insight than the hit score. Bimodal hearing devices enhance the perception of "sad" and "angry" vocal emotions compared to using a CI alone, likely due to the HA providing the temporal fine structure cues, thereby better representing fundamental frequency variations. Children with unilateral CI benefit significantly in the perception of emotions by using a HA in the contralateral ear, aiding in better socio-emotional development.

Figure 1.

Box plot depicting emotion scores for (A) NH group, (B) CI group in CI alone condition, and (C) CI group in CI and HA condition. It shows median, first quartile, and third quartile.