Benefits of music training for children with hearing loss

Children with hearing loss report difficulties in a range of challenging listening situations such as music and speech-in-noise perception and have poorer psychosocial outcomes compared to their typical-hearing peers. Music training has been proposed as a suitable form of habilitation; driven primarily by typical-hearing music training studies that indicate a speech-in-noise enhancement for adults and children. The number of studies investigating the benefits of music training for children with hearing loss is modest, though recent studies have shown improvement for some elements of speech perception such as emotional prosody and lexical tone recognition. This thesis aimed to investigate the music, speech, and psychosocial benefits of a 12-week music training program for children with hearing loss. Eleven children aged between 6.13 and 9.24 years (M = 7.48, SD = 1.07) with moderate to profound prelingual hearing loss (5 bilateral cochlear implant recipients, 4 bimodal users, 2 bilateral hearing aid users) participated in this study. The design was a pseudo-randomised, longitudinal study (half the cohort was waitlisted, initially serving as a passive control group). Music training was 12 weeks in duration, consisting of weekly face-to-face group-based music therapy sessions with activities such as drumming, singing, dancing, and improvisation; and a suite of online music apps 3 times a week that consisted of activities such as creating compositions, and identification of high, low, fast, or slow sounds. Children were tested at the following timepoints: double baseline (pre-training), mid-training, post-training, and at follow-up (12-weeks after training ceased). The test battery consisted of the Clinical Assessment of Music Perception to assess pitch and timbre perception, a Music Appreciation Questionnaire, the Australian Sentences Test in Noise, the Spectral-temporally Modulated Ripple Test, the Macquarie Battery of Emotional Prosody, a Question/Statement Prosody Test, the Strengths and Difficulties Questionnaire that provides an overview of behaviours, emotion, and relationships, the Paediatric Quality of Life Inventory—a generic measure of health-related quality of life, the Hearing Environments and Reflection on Quality of Life, and the Glasgow Children’s Benefit Inventory. Statistical analyses for the main hypotheses were conducted with linear mixed models, controlling for hearing age, device, and prior formal music training. Double baseline measures (separated by 1-week) were not significantly different, indicating high test-retest validity; additionally, the waitlist group (separated by 12-weeks) were not significantly different, indicating no improvement from natural maturation and development. At the post-training point, statistically significant results were found for: speech-in-noise perception (speech reception thresholds improved by 1.1 dB (p = .036), timbre perception by 8 percentage points (p = .028), spectral resolution by 2 rpo (p < .001), and question/statement prosody by 14 percentage points (p = .004), and various music appreciation measures. Psychosocial outcomes also improved significantly for internalising behavioural problems (p = .001), and total scores (p = .012). Non-significant results were found for emotional prosody, pitch perception, all domains for the Paediatric Quality of Life Inventory and the Hearing Environments and Reflection on Quality of Life. The findings suggest even a modest amount of music training has benefits for music, speech and psychosocial outcomes. The results provide further evidence that music training is an excellent complementary means of habilitation to improve the outcomes for children with hearing loss.