Carhart Memorial LectureCommunicating Emotional Prosody with Cochlear Implants: Predictors and Mechanisms Understanding a conversational partner’s intended emotion from their tone and manner of speaking (emotional prosody) is important for social communication, but many patients with cochlear implants have deficits in identifying emotional prosody. Evidence-based clinical tools and protocols to diagnose or treat deficits in prosodic communication in cochlear implant patients do not currently exist. Strong unexplained variability has been observed in emotional communication with cochlear implants: some patients perform at par with typically hearing peers, while others show significant impairment in both perception and production of emotional prosody. Predictors and mechanisms underlying the high individual variability are not well understood. Without better understanding of the factors that explain the observed variability in outcomes, appropriate diagnostic and rehabilitative tools cannot be developed. Challenges in emotional/social communication may lead to social isolation in the elderly, which in turn has been linked with cognitive decline in the literature. In school-age children who are still developing social cognition, difficulties in understanding and/or expressing emotions in speech may constrain their social networks, increase anxiety and lead to psychosocial behavioral challenges. Emotional communication includes the production of emotional prosody in speech. We found that school-age, prelingually deaf children with cochlear implants produced emotional prosody with smaller acoustic contrasts between emotions than normally hearing peers. The emotions produced by children with cochlear implants were also less well identified by normally-hearing listeners than productions by children with normal hearing. Within the small cohort tested, earlier implanted children with CIs produced more identifiable emotions than later implanted children with CIs. Postlingually deaf adults with cochlear implants, however, all produced emotional prosody with a high degree of accuracy. These results support the idea that the presence of some acoustic hearing at birth and during development is important for children to acquire the ability to produce identifiable emotional prosody, even after the hearing is lost and the patient is listening through a cochlear implant. Predictors and mechanisms underlying the perception and production of emotional prosody are likely different from predictors of outcomes in standard clinical speech tests in individuals with cochlear implants. Our present studies are testing several working hypotheses, e.g., i) that listeners’ utilization of prosodic cues such as voice pitch inflections for emotion identification accounts significantly for variation in their emotional prosody identification; ii) cognitive measures such as fluid intelligence estimates predict outcomes in emotional prosody identification; iii) early acoustic input in childhood, or early electric input through a cochlear implant, have beneficial effects on emotional prosody production. In this presentation, I will present an overview of our work investigating predictors of individual variability in emotional communication by pediatric and adult cochlear implant recipients, the data supporting our emerging hypotheses about mechanisms underlying emotional communication in these populations, and implications for the development of effective interventions targeting emotion perception and production.
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