Designing the BEARS (Both Ears) virtual reality training suite for improving spatial hearing abilities in teenage bilateral cochlear implantees

Lorenzo Picinali1, Kevin Sum1, Jordi Albanell Flores1, Bhavisha Parmar3, Sandra Driver2, Chris Rocca2, Marina Salorio-Corbetto3, Dan Jiang2, Deborah Vickers3

1 Audio Experience Design, Dyson School of Design Engineering, Imperial College London, United Kingdom; 2 St Thomas’ Hearing Implant Centre, St Thomas’ Hospital, Westminster Bridge Road, London, United Kingdom; 3 Sound Laboratory, Cambridge Hearing Group, Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom

Background: teenagers with bilateral cochlear implants (CI) often suffer from poor spatial hearing abilities, which arise from their difficulties to fuse sounds from the two ears. This deficit jeopardises speech and language development, education and social well-being, and is worsened by the lack of protocols for fitting bilateral cochlear implants and of resources for spatial-hearing training. A large body of research demonstrates that sound localisation can improve with training, underpinned by plasticity-driven changes in the auditory pathways. Maximal benefit for generalising training to non-trained auditory skills is best achieved by using a multi-modal (audio-visual) implementation and multi-domain training tasks (localisation, spatial speech-in-noise and spatial music). The goal of this work was to develop, using an action research protocol, a package of VR games (BEARS, Both EARS) to train spatial hearing in teenagers with bilateral CI.

Method: formalised cycles were used for patient participants to experience a prototype of the BEARS games and provide feedback, which was then transformed in system requirements for further developments.

Results: the main areas which were modified based on participatory feedback were the variety of immersive scenarios to cover a range of ages and interests, the organisation of levels to ensure small improvements were measured and rewarded, and specific provision for participants with balance issues, who had difficulties when using head-mounted displays. The effectiveness of the finalised BEARS suite will be evaluated in a large-scale clinical trial.

Conclusions: interventions such as the BEARS allow patients to take control of their own management thus reducing the reliance upon outpatient-based rehabilitation programmes.  Specifically for teenagers, a VR implementation is more engaging than traditional rehabilitation methods, and the participatory design approach has ensured that the BEARS games are relevant and engaging.

Picinali et al
A cochlear implants teenage user trying one of the BEARS games at one of the participatory design sessions we organised during the past two years.