Beyond Technology: The Interaction of Perceptual Accuracy and Experiential Factors in Pediatric Music Engagement.

Background: Music engagement (the active making of music, e.g., music lessons and ensembles) is a common part of educational and community experiences. Music making typically involves listening to and production of rapidly changing combinations of pitch, timbre, and rhythm, which can be challenging for cochlear implant (CI) recipients, given that pitch and timbre are poorly conveyed through the CI. Pediatric CI users have variable patterns of music engagement, but some have achieved, sustained participation despite the degraded CI signal. What factors contribute to their persistence in these demanding listening situations? Our study examined a cohort of pediatric CI recipients from our center to better understand those perceptual and experiential factors most influential in relation to music engagement. Method: Regressions and correlations were run for measures of pitch and speech perception, hearing history, familial involvement in music, personal importance of music, and extent of music engagement (years in music lessons; general involvement in music). Results: Pitch ranking accuracy was a significant predictor of sustained participation in music lessons (p = 0.0019), and sustained involvement in music (p = 0.0038), as well as performance on CNC words (p = -0.0060) and phonemes (p = -0.0174). Extent of familial involvement in music at the time of testing was significantly predictive of the user's musical engagement (p = 0.0007). Personal importance of music was not predicted by or significantly correlated with, any of the variables investigated. Conclusion: Better pitch perception was associated with sustained involvement in music lessons as well as better speech perception. However, familial involvement in music was of greater impact for sustained music engagement. Judicious choice of musical instrument also influenced persistence. The positive impact of familial involvement indicates that perceptual limitations associated with CI processing do not present insurmountable barriers to music engagement. Because music engagement provides normalizing social involvement and challenging auditory practice, the impact of parental involvement has implications for counseling parents of CI users.