Feb 2019 Healthy Hearing

Singing is fun for any child, but for children with cochlear implants, it may help refine their hearing, particularly in noisy environments, according to a new study.


Singing can strengthen the connections between hearing and speech. The study, published in the journal Music Perception, analysed “speech-in-noise” skills in children with cochlear implants. Over about a year, the study team tested two groups of children with cochlear implants, ages 4 to 13, to see how well they did at understanding speech in noisy situations. The team, from Finland, also studied a control group of children with normal hearing.

The children were sorted into groups according to their everyday habits of singing, as reported in a parental questionnaire. The researchers tracked reports of "informal" singing, such as singing to nursery rhymes to songs from movies, YouTube or the radio.  Then, during testing, the children were asked to point to pictures representing the words and sentences they heard through a loudspeaker over steady background noise. The children with normal hearing showed better speech perception than those with cochlear implants, though all groups did better on the second round of testing. Of those with cochlear implants, the children who sang, even without formal musical training, performed better and showed better attention skills than those who didn’t sing. They were also better able to catch the rhythm of songs, suggesting they were better at understanding speech patterns.

The challenges of background noise

The study team previously found that children with cochlear implants who sing regularly also were sung to by their parents early in life. Parents frequently sing face-to-face with children, which could help because children can see the mouth and lip movements. Children with cochlear implants benefit from the visual cues of lip reading, so singing to them may provide similar benefits, according to the study.

Cochlear implant wearers have trouble picking out speech in noisier environments because the implants can’t provide the audio range necessary to hear simultaneous sounds, said lead study author Ritva Torppa, PhD, of the Department of Psychology and Logopedics at the University of Helsinki in Finland. That makes things difficult for younger implant users, she said, because background noise is typical at day care, school and at home. “Thus, in everyday life, poor perception of speech in noise leads to difficulties in hearing conversations between others, or even in hearing speech targeted for children,” such as instructions from teachers. “This harms language and other learning.” Children can’t fully understand speech in noise until ages 11 to 15, according to the study, and the lost education and interaction can damage self-esteem as well as their relationships with others.  In addition, said Torppa, background noise can make it difficult to hear the sounds of approaching vehicles, leading to potentially dangerous situations.

Understanding the links between music and speech

According to the study, playing or singing music can help people improve their vocal pitch and intensity as well as their speech rhythms. Singing can strengthen the connections between hearing and speech. And since songs have a small number of words with a lot of repetition, listeners have more time to process what they’re hearing. What seemed to help most, said Torppa, was “clear and regular rhythm, slow tempo, singing by oneself and face-to-face with parents, and lots of repetition of songs.” The children needed to enjoy singing to get the most out of it, she said.  

Torppa said the link between music and understanding speech in noise has been examined before in those with normal hearing, and musicians have shown better perception than non-musicians. However, the effect of music on speech in noise hasn’t been studied before in children with cochlear implants, she said. A small study on adults with hearing loss showed it helped with brainstem response for processing sound.

Music matters, for all kids

The study didn’t include a detailed log of time spent singing, and though it shows a link, it wasn't designed to show that singing directly causes better perception of speech in noise.  Torrpa said the results do point out how important singing and music are for kids with hearing issues. Day cares and schools should use music every day as part of children’s learning, and parents should sing to them at home, according to the study. “This is important in many ways for all children, but especially for children with cochlear implants – and even for other children with difficulties in hearing,” Torppa said.

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