Improved Singing Accuracy in Children With Bilateral Hearing Devices With More Musical Activities and Better Verbal Fluency.

objectivesThe singing pitch accuracy of children with hearing loss (HL) is typically poor, which may discourage them from singing. Improving this skill is important because it can further impact their cognitive and language development and overall well-being. In children with normal hearing (NH), improving singing pitch accuracy is associated with more musical activities and better language skills. We hypothesized that the singing pitch accuracy of children with HL (1) would be poorer than that of children with NH, (2) would improve more during the music intervention period than during the period without music intervention, (3) would be higher in children who participate in more informal musical activities and (4) would be higher in children who have better semantic verbal fluency performance.

designThe participants were 18 children with HL (age range: 3 to 6 years 10 months; 7 with bilateral cochlear implants, 7 with bilateral hearing aids, 4 with bimodal devices) and 20 children with NH (age range: 2 years 10 months to 6 years 10 months). Children with HL participated in remote or in-person music intervention for 10 weeks. A crossover study design was used, with waiting periods before and after the intervention. Three rounds of measurements were made for each child with HL, before and after each period (at T1, T2, and T3). Children with NH did not participate in the music intervention, and their singing pitch accuracy was measured at a single time point. Children sang the song "Twinkle Twinkle Little Star." A measure of mean note deviation assessed the accuracy of each individually sung note, while a measure of mean interval deviation assessed the accuracy of the relative pitch between two consecutively sung notes (e.g., C4 - F4 = 4th), both averaged across the sung sequence. The average of the "mean note" and "mean interval deviation" was used as a dependent variable in a Linear Mixed Model (LMM). For the semantic verbal fluency task, children listed as many animals as they could in one minute, and the number of correct animal words was calculated. Informal music participation was calculated from a parent-completed questionnaire. The mean of the frequency of these activities/number of correct animal words across T1, T2, and T3 was used in LMM.

resultsThe singing pitch accuracy of the children with bilateral HL group at baseline (T1) was similar to that of children with NH, and there were no significant effects of intervention versus waiting period on mean note/interval deviation. The LMM showed that (i) the more children with HL participated in informal music activities, the better their singing pitch accuracy (main effect, p = 0.009), and (ii) the better they were at the semantic verbal fluency task, the better their singing pitch accuracy (main effect, p = 0.014).

conclusionsAlthough a 10-week music intervention did not improve singing pitch accuracy in this study of children with HL, these novel results showed that participation in informal music activities, along with language skills, is an important contributing factor to how accurately children with HL can sing in tune.