Contribution of bimodal hearing to lexical tone normalization in Mandarin-speaking cochlear implant users.

Native Mandarin normal-hearing (NH) listeners can easily perceive lexical tones even under conditions of great voice pitch variations across speakers by using the pitch contrast between context and target stimuli. It is however unclear whether cochlear implant (CI) users with limited access to pitch cues can make similar use of context pitch cues for tone normalization. In this study, native Mandarin NH listeners and pre-lingually deafened unilaterally implanted CI users were asked to recognize a series of Mandarin tones varying from Tone 1 (high-flat) to Tone 2 (mid-rising) with or without a preceding sentence context. Most of the CI subjects used a hearing aid (HA) in the non-implanted ear (i.e., bimodal users) and were tested both with CI alone and CI + HA. In the test without context, typical S-shaped tone recognition functions were observed for most CI subjects and the function slopes and perceptual boundaries were similar with either CI alone or CI + HA. Compared to NH subjects, CI subjects were less sensitive to the pitch changes in target tones. In the test with context, NH subjects had more (resp. fewer) Tone-2 responses in a context with high (resp. low) fundamental frequencies, known as the contrastive context effect. For CI subjects, a similar contrastive context effect was found statistically significant for tone recognition with CI + HA but not with CI alone. The results suggest that the pitch cues from CIs may not be sufficient to consistently support the pitch contrast processing for tone normalization. The additional pitch cues from aided residual acoustic hearing can however provide CI users with a similar tone normalization capability as NH listeners.