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Updated: Jun 4, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
From fragments to the whole: a comparison between cochlear implant users and normal-hearing listeners in music
Ashlin J Alexander1, Lee Bartel, Lendra Friesen
1Department of Otolaryngology–Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario.
Background:
Cochlear implants (CIs) allow many profoundly deaf individuals to regain speech understanding. However, the ability to understand speech does not necessarily guarantee music enjoyment. Enabling a CI user to recover the ability to perceive and enjoy the complexity of music remains a challenge determined by many factors.
Objectives:
(1) To construct a novel, attention-based, diagnostic software tool (Music EAR) for the assessment of music enjoyment and perception and (2) to compare the results among three listener groups.
Methods:
Thirty-six subjects completed the Music EAR assessment tool: 12 normal-hearing musicians (NHMs), 12 normal-hearing nonmusicians (NHnMs), and 12 CI listeners. Subjects were required to (1) rate enjoyment of musical excerpts at three complexity levels; (2) differentiate five instrumental timbres; (3) recognize pitch pattern variation; and (4) identify target musical patterns embedded holistically in a melody.
Results:
Enjoyment scores for CI users were comparable to those for NHMs and superior to those for NHnMs and revealed that implantees enjoyed classical music most. CI users performed significantly poorer in all categories of music perception compared to normal-hearing listeners. Overall CI user scores were lowest in those tasks requiring increased attention. Two high-performing subjects matched or outperformed NHnMs in pitch and timbre perception tasks.
Conclusions:
The Music EAR assessment tool provides a unique approach to the measurement of music perception and enjoyment in CI users. Together with auditory training evidence, the results provide considerable hope for further recovery of music appreciation through methodical rehabilitation.
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