Research Highlight: Music Therapy & Cochlear Implants

Written by Tess Vreeland, MT-BC, AMTAS Secretary

This week, we are beginning a blog series called “Research Highlights” where students and professionals are invited to promote research in specialized fields or types of music therapy practice! This week is focused on how music therapy can be beneficial to people with cochlear implants and types of interventions that may be used based on the individual’s goals. If you are interested in submitting a research blog or want to see a blog written on a specific topic, please fill out our Blog Interest Form or reach out to [email protected]!

Deafness and hearing loss can occur at any stage of life, and the choice to use assistive devices or not is determined by the individual’s needs and preferences. Cochlear implants are a type of assistive device for people with profound sensorineural hearing loss. Implantation requires surgery, and the device works by sending electrodes to stimulate the auditory nerve rather than a traditional amplification of a hearing aid (Gfeller, 2001). It is a common misconception that people who receive cochlear implants do not benefit from music therapy due to the possibility of distortion of sound quality through the device. However, the multisensory nature of music therapy can be beneficial to both pre-lingual and post-lingual recipients. Music therapists can also work collaboratively with speech-language pathologists, audiologists, and other professionals to achieve various goals.
Children who are pre-lingual recipients of CIs primarily focus on the goals of listening skills, speech production, and language development through movement, singing, and instrument play interventions with a music therapist (Gfeller et al., 2011). Within each type of intervention, considerations should be made to best facilitate the goals presented. Music therapists should use distinctly different instrument timbres to help with sound discrimination and listening objectives. The repetition within developmentally appropriate songs for children is beneficial to speech production and language development goals (Gfeller et al., 2011). Using musical cues to facilitate movement creates a multisensory approach that simultaneously promotes listening skills and motor-related goals. With this population, the integration of “musical elements (e.g., singing) and multisensory cues (e.g., visual and kinesthetic cues) may provide contextual cues for young children to attend to the presented auditory information more accurately” (Kim et al., 2016, p. 55). These strategies should also be applied when addressing development goals appropriate to children at this age and developmental level, regardless of hearing associated goals.
Though pre-lingual implantation is popular among recipients, adults can also make the informed decision to receive cochlear implants at any point in life as an assistive tool. Prosody, the patterns of inflection in spoken language, can be addressed using music because of the linguistic correlation between music and speech (Hutter et al., 2015). While the goals of improving listening and speech skills are still relevant to post-lingual CI recipients, the social-emotional goal domain associated with hearing loss is also commonly addressed with adults in music therapy sessions. Difficulty with speech comprehension can impact socialization with others when other forms of communication are not being utilized, which can have an impact on self-esteem in social settings (Magele et al., 2022). The post-implant transition can bring frustration with the learning curve and new perception of sounds. Music therapists can address both types of goals simultaneously with intentional interventions with a multisensory approach. 
Music perception and appreciation can also be included as goals for adults with cochlear implants; however, the importance of this goal should be left up to the individual because music is valued differently between each person. Typically, those who benefit from interventions focused on these goals are “post linguistically-deafened adults who embrace the cultural values of hearing people, even after many years of deafness” (Gfeller, 2001, p. 91). It is important to acknowledge that many musical qualities are not transmitted well through cochlear implants, so certain musical aspects should be taken into account to best accommodate the listener’s experience. Using familiar music with more simple structures supports the client in maintaining their attention throughout interventions and connecting previous experiences with the perceived sounds. Music therapy can be a helpful tool for cochlear implant recipients across the lifespan, with specified objectives to best serve the individual’s needs.

References
Gfeller, K. (2001). Aural rehabilitation of music listening for adult cochlear implant recipients: Addressing learner characteristics. Music Therapy Perspectives, 19(2), 88–95. https://doi.org/10.1093/mtp/19.2.88. 
Gfeller, K., Driscoll, V., Kenworthy, M., & Voorst Van, T. (2011). Music therapy for preschool cochlear implant recipients. Music Therapy Perspectives, 29(1), 39–49. https://doi.org/10.1093/mtp/29.1.39. 
Hutter, E., Argstatter, H., Grapp, M., & Plinkert, P. K. (2015). Music therapy as specific and complementary training for adults after cochlear implantation: A pilot study. Cochlear Implants International, 16(3). https://doi.org/10.1179/1467010015z.000000000261.  
Kim, S. J., Kim, E. Y., & Yoo, G. E. (2016). Music perception training for pediatric cochlear implant recipients ages 3 to 5 Years: A pilot study. Music Therapy Perspectives, 35(1), 50–57. https://doi.org/10.1093/mtp/miw009. 
Magele, A., Wirthner, B., Schoerg, P., Ploder, M., & Sprinzl, G. M. (2022). Improved music perception after music therapy following cochlear implantation in the elderly population. Journal of Personalized Medicine, 12(3), 443. https://doi.org/10.3390/jpm12030443.