New VR Technology Shows Promise in Training Hearing for Cochlear Implant Children

A trial is underway to find out if Virtual Reality games can help young people with bilateral (both ears) cochlear implants adapt to busy and noisy environments.

Researchers are exploring if VR software can improve children’s perception of where sounds are coming from and their ability to separate speech from background noise. Both are important skills we all use in a multitude of everyday tasks, such as safely crossing the road, or easily conversing in a busy room.

The BEARS study is led by Guys and St Thomas’ NHS Foundation Trust (GSTT) and the University of Cambridge, working with the University of Southampton and three other universities – Imperial, Nottingham and UCL (who run the clinical trial). It is funded by the National Institute for Health and Care Research (NIHR).

“Sound from a cochlear implant isn’t the same as most people hear. Patients have to work on their listening skills to adapt and make sense of what they are hearing after implants are fitted,” says Professor Helen Cullington , audiologist at the University of Southampton Auditory Implant Service . “Having hearing in two ears helps your brain to find where a sound is coming from. For children who have two cochlear implants, locating and separating sound can be a real challenge and take time to master.”

The trial team has recruited over 160 children at 11 sites across the UK. The volunteers, aged between eight and 16, are randomised to either try out the BEARS software package for three months, or continue on their usual clinical care pathway. The team provides the children with VR headsets and specially designed software to immerse them in a 3D sound and vision experience.

The BEARS games range from a target practice challenge, a music making activity and a game set in a busy, noisy pizza restaurant. All have been co-designed with young people who are deaf or hard of hearing, working alongside scientists, researchers, speech and language therapists, surgeons, audio engineers and audiological societies. The games all aim to help with recognising the direction of sound and understanding speech in noisy environments.

Cochlear implants are provided to children and adults with severe to profound deafness. A tiny microphone close to the ear picks up sounds which are coded by a processor and turned into digital signals. These signals are transmitted to the implant inside the ear, which in turn stimulate nerve fibres in the cochlea – part of the inner ear. From here, the hearing nerve carries the signals to the brain where they are recognised as sounds.

Kaitlyn is a 20-year-old actor and theatre student from London who was born profoundly deaf. She’s had cochlear implants to help with her hearing since she was three but the implants aren’t a complete fix: “It can be challenging growing up being deaf. Lots of everyday situations can be a struggle, from playing sport to crossing the road.

“Even when you’ve had positive experiences at school with lots of support and D/deaf friends, conversations can be difficult and exhausting. You can’t work out where voices are coming from and by the time you’ve found who’s speaking you’ve missed the first half of what they said.

“With cochlear implants, you’re constantly hearing new sounds that you either haven’t noticed before or just haven’t been tuned into. It can be quite scary hearing a new sound and thinking ‘should I be worried or is that okay?’ Finding ways to improve your ability to identify sounds is so important.”

Kaitlyn’s involvement began at 18 years old when she saw a flyer about the BEARS project while attending an appointment at Guy’s and St Thomas’ NHS Foundation Trust. Intrigued by the potential of VR, she eagerly volunteered. She explains: “My brother played VR games at home so I thought it sounded exciting and wanted to give it a go.

“I played the games at home every week for three months and afterwards I noticed my sound location skills had improved – even after this short period of time. I fed back on the games so they could be developed further to make them as user friendly for children and young people as possible.”

Jameel Muzaffar, NIHR National Specialty Lead for Ear, Nose and Throat Surgery & Audiology says: “By offering a tailored, interactive, and patient-centred approach, the BEARS VR-based training games have the potential to transform spatial hearing skills, improve understanding of speech in noisy conditions and enhance quality of life for young cochlear implant users.”