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Updated: Apr 26, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Melodic pitch perception and lexical tone perception in Mandarin-speaking cochlear implant users
Duoduo Tao1, Rui Deng, Ye Jiang
11Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China; 2Division of Communication and Auditory Neuroscience, House Research Institute, Los Angeles, California, USA; and 3Department of Head and Neck Surgery, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
Objectives:
To examine the relationship between lexical tone perception and melodic pitch perception in Mandarin-speaking cochlear implant (CI) users and to investigate the influence of previous acoustic hearing on CI users' speech and music perception.
Design:
Lexical tone perception and melodic contour identification (MCI) were measured in 21 prelingual and 11 postlingual young (aged 6-26 years) Mandarin-speaking CI users. Lexical tone recognition was measured for four tonal patterns: tone 1 (flat F0), tone 2 (rising F0), tone 3 (falling-rising F0), and tone 4 (falling F0). MCI was measured using nine five-note melodic patterns that contained changes in pitch contour, as well as different semitone spacing between notes.
Results:
Lexical tone recognition was generally good (overall mean = 81% correct), and there was no significant difference between subject groups. MCI performance was generally poor (mean = 23% correct). MCI performance was significantly better for postlingual (mean = 32% correct) than for prelingual CI participants (mean = 18% correct). After correcting for outliers, there was no significant correlation between lexical tone recognition and MCI performance for prelingual or postlingual CI participants. Age at deafness was significantly correlated with MCI performance only for postlingual participants. CI experience was significantly correlated with MCI performance for both prelingual and postlingual participants. Duration of deafness was significantly correlated with tone recognition only for prelingual participants.
Conclusions:
Despite the prevalence of pitch cues in Mandarin, the present CI participants had great difficulty perceiving melodic pitch. The availability of amplitude and duration cues in lexical tones most likely compensated for the poor pitch perception observed with these CI listeners. Previous acoustic hearing experience seemed to benefit postlingual CI users' melodic pitch perception. Longer CI experience was associated with better MCI performance for both subject groups, suggesting that CI users' music perception may improve as they gain experience with their device.
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