The Effect of Auditory Device, Onset of Hearing Loss, and Chronologic Age on Music Perception and Appreciation in Adult Listeners

Adults with hearing loss perceive music through a degraded auditory filter initially designed for enhanced speech perception. Although they exhibit difficulty perceiving musical characteristics in research and clinic, adults with hearing loss do not exhibit a consistent decrease in appreciation of musical activities. Poor perception, in general, does not result in lower appreciation of music. Previous studies have assessed the perceptual skills of cochlear implant (CI) listeners, hearing aid (HA) listeners, and typical hearing (TH) adults, as well as the subjective music experiences of these groups. To date, few studies have investigated these groups on both subjective and objective measures together; assessed the distinct music experiences of pre- and postlingual adults; or determined how chronologic age influences music experiences. This project aims to understand the differences in objective music perception and self-reported music experiences among (a) TH, CI, and HA listeners; (b) pre-lingual (i.e., onset of deafness before age three) and post-lingual (i.e., onset of deafness after age three) CI listeners; and (c) younger compared to older (≥ 60 years) adult CI listeners. Sixty participants 18 years or older were grouped according to device status, onset of deafness, and age. Participants with a bimodal configuration used only one of their devices during testing. Demographic and audiologic characteristics were obtained from an ad hoc survey. The Clinical Assessment of Music Perception (CAMP) assessed behavioral perception of pitch, familiar melody, and instrument identification. In addition, one subtest of the Profile of Musical Skills (PROMS) assessed behavioral perception of unfamiliar melodies. These four subtests comprise the objective evaluation of music perception. The Music-Related Quality of Life (MuRQoL) assessed subjective exposure to musical characteristics and situations and their relative importance. Two domains (Music Abilities and Music Importance) comprise the subjective evaluation of music appreciation. Participants with TH discriminated pitches, recognized familiar melodies, recognized instruments, and discriminated unfamiliar melodies better than postlingual CI listeners, but not those with HAs. CI listeners stratified by age at diagnosis of hearing loss and chronologic age performed in similar ways on all objective measures, and large variability was present. Overall, all groups with and without hearing loss reported similar levels of music importance. Across all participants grouped together, objective and subjective measures were correlated, such that individuals who scored well on objective measures also tended to self-report higher music abilities, in general. Furthermore, across all participants grouped together, subjective self-report of music skills tended to correlate with objective performance on that specific skill. However, when examined within each group, objective measures largely did not correlate with subjective measures. Because auditory devices have thus far been optimized for speech, research regarding the musical experiences of those who use them is extremely limited. However, participants in this study report that music remains important in their lives and that hearing loss and auditory devices diminish the perceptual characteristics necessary for access to typical music experiences. There remains a need to develop clinically feasible measures of real-world musical experiences and develop interventions to improve access to music.