Hearing pictures, seeing sounds
                                                                                  04 Jun 94
 

                                Ear and eye implants for the deaf and blind are still not living up
                                to their promise. Rosie Mestel asks whether researchers would
                                do better to exploit the potential of the unimpaired senses

                                Peter Meijer is demonstrating his device - a machine that transforms
                                pictures into patterns of sound. 'This is a bright line, running upward,
                                from left to right,' he says, and the machine chirps out a sound that
                                starts with a low note and smoothly slides up to a high one, then
                                repeats itself again and again. Next, Meijer plays a tune representing
                                a square (a discordant chunk, chunk). Then he plays a sound
                                representing a circle slowly moving towards the listener: a series of
                                slowly changing blips and blares.

                                All the sounds seem strange and alien, like warning signals for some
                                unspecified disaster. But Meijer, a physicist-engineer at the Philips
                                Research Laboratories in the Netherlands, hopes that one day they
                                might become familiar, and that people who are blind might one day
                                'see' by interpreting sounds.

                                By tapping into a sense that remains intact, Meijer's machine and
                                others like it could give blind and deaf people glimpses and whispers of
                                a sensory realm denied them at the moment. For blind people, there
                                are devices like Meijer's, and others that turn pictures into patterns of
                                vibrations on the skin. For deaf people, there are machines that turn
                                sound into vibrations or sounds into pictures.

                                At the very best, these aids might let blind people recognise cars,
                                houses, trees - even specific faces - as they go about their
                                day-to-day business. And deaf people might understand speech from
                                vibrations on the skin. At the very least people who are deaf may
                                learn better speaking and lip-reading skills, and blind people may gain
                                access to the world of computer graphics.

                                Sensory aids such as Meijer's differ from the cochlear implants
                                available for deaf people, or the various implants being developed for
                                blind people, both of which seek to repair the damaged sense directly.
                                Cochlear implants, for instance, detect sound and crudely sort it into
                                several frequency bands. Then they stimulate cells in the auditory
                                nerve via a set of electrodes embedded in the inner ear, providing
                                rudimentary hearing for those who lack the sensory cells that normally
                                do this job.

                                Meanwhile, scientists at the National Institutes of Health in Bethesda,
                                Maryland, have plans to produce implants for blind people. One
                                approach uses special spectacles that convert patterns of light into
                                electrical stimuli which travel to electrodes sitting in the brain's visual
                                centre, stimulating nerve cells in precise patterns.

                                Restoring a damaged sense to full working order seems attractive. But
                                today's cochlear implants do not restore normal hearing, and the
                                language comprehension of people implanted with them is variable. Of
                                85 adults who became deaf after learning to speak, and had cochlear
                                implants fitted at Los Angeles' House Ear Clinic, only 35 per cent can
                                understand enough speech from sound alone to hold a simple
                                telephone conversation - and only one or two can chat on the phone
                                for long periods. The statistics are worse for children born deaf. And
                                the surgery is both invasive and expensive (between $14 000 to $29
                                000 per implant). The implant debate is charged with emotion among
                                the deaf community, many of whom consider poor hearing a poor
                                option - one that would cut off deaf children from the rich, visual
                                world of sign language. Meanwhile, implants for blind people are still in
                                the early stages of development.

                                Good vibrations

                                So the time is ripe for people who have alternative ideas. Paul
                                Bach-y-Rita, a neurophysiologist at the University of Wisconsin in
                                Madison, has developed another means of improving existing senses.
                                While Meijer's machine converts images into sounds, Bach-y-Rita's
                                device converts images into a pattern of vibrations on the skin. The
                                work dates back to 1969, when a paper in Nature described his first
                                prototype. In that setup, blind volunteers wore a camera on the head.
                                The camera was attached to a computer that encoded video images
                                into a 20-pixel by 20-pixel grid. This information was then fed to a
                                400-point grid of plastic spikes (like teeth on a comb) that was placed
                                in contact with the back of the volunteer. If the pixel was bright,
                                then the elements would vibrate; if it was dark, then they would not.
                                Thus, the device would 'vibrate' the shape of the image onto the skin,
                                and with practice some volunteers could distinguish facial images like
                                those of Twiggy the model and Khrushchev the Soviet statesman.
                                'They could recognise faces and say, for instance: 'Oh, that's Mary
                                and she's wearing her hair down today,'' says Bach-y-Rita.

                                Since then, Bach-y-Rita and his colleagues have fine-tuned their
                                device. Now they can break the video image into more than a
                                thousand pixels and they have switched from using vibrations to
                                painless jolts of electricity, and adding different amounts of
                                stimulation to correspond to different intensities of light. They have
                                also used their device with young schoolchildren. 'This has been real
                                fun to do,' he says. Suppose a child asks to see a candle flame.
                                'These kids have never 'seen' a lighted candle before because you
                                can't touch it,' Bach-y-Rita says. 'All of them are surprised by how
                                small the flame is, because they feel the heat well above the candle.
                                And they're surprised that there's a space between the candle and
                                the flame itself.' There is a wealth of detail about the world we live in
                                that blind people never experience, he says, but with pictures on the
                                skin, they might.

                                With this in mind, Bach-y-Rita's colleague Kamal Sesalem is busy
                                scaling down the bulky hardware (a video camera which connects to a
                                computer that runs a pixel conversion program) to something that
                                teachers could carry from school to school. It might be particularly
                                useful for teaching blind children about science, which is very visual,
                                says Sesalem. For instance, it might enable kids to see samples down
                                microscopes. 'We would like to see blind children deal with scientific
                                information as well as anyone else in school,' he says.

                                But Bach-y-Rita admits there are limitations. Blind volunteers did learn
                                to recognise faces. 'But it was not an immediate, snap recognition like
                                with the visual system,' he says. 'Interpreting a face took a minute or
                                two - and this was in an environment where we cut out all the
                                clutter. It wasn't one face standing out in a crowd of faces. It was
                                one face on a white background.'

                                Now Bach-y-Rita is planning to fit babies with the device, in the hope
                                that younger, nimbler brains might do much more with tactile images
                                than his blind, adult college students. He and psychologist Eliana
                                Sampaio at the University of Paris have funding from the French
                                government to strap on cameras to babies' heads and test just that.
                                'If you're ever going to have people develop useful artificial vision or
                                tactile substitution vision I think it's most likely it will work if you start
                                with very, very young blind children,' he says. The babies could gain a
                                lot as well, since their lack of sight can cause developmental delays
                                that last well into childhood.

                                The sound of light

                                Meijer's system, while similar to Bach-y-Rita's, is harder to visualise. It
                                consists of a video camera that takes a picture which is converted
                                into a digitised image made up of 64 by 64 pixels. But then the image
                                is converted into sounds by a computer, following two simple rules.
                                First, pixels of light situated 'high' in the picture are converted into
                                high tones; those that are low are converted into low tones.
                                Secondly, the brighter the pixel, the louder the sound. So a bright dot
                                near the top of the pixel grid would be high-pitched and loud.

                                If you were to 'hear' a picture with Meijer's device, you wouldn't hear
                                the whole image instantly: rather, you would hear a column at a time,
                                from left to right. A bright, diagonal line stretching upward to the right
                                produces a loud 'ooiieep' sound and another stretching downward to
                                the right makes the opposite sound - 'eeiioop'. After one entire scan,
                                which takes about a second, the scan begins again. If the image
                                changes, so will the next pattern of sound.

                                Meijer's machine is simply a prototype for now. But if one day he can
                                persuade a company to develop his idea and make it portable, Meijer
                                imagines a blind person with a portable camera, scanning things as
                                she or he walks down the street. The images would be converted into
                                repeated one-second blasts of noise that would change as objects
                                grew nearer or receded from sight. 'Blind people have their cane,
                                which is a very useful thing,' says Meijer. 'But they don't have the
                                ability to detect buildings from a distance, or to recognise buildings
                                they have encountered before. I hope that a system like this would
                                help with orientation in particular.'

                                It is easy enough, with Meijer's machine, to 'hear' a straight line. But
                                as the images become more complex, so too do the signals. Nobody
                                trying out the machine for the first time could immediately 'hear' a
                                face or a tree and know it was a face or tree - especially if the
                                images were cluttered with other faces, trees, buildings and more. But
                                how good might someone become, given time and training? Could any
                                of us ever learn to see via blasts of sound, or weird jiggles of the
                                skin?

                                Nobody knows the answer yet. But we do know that our brains are
                                fabulously plastic, especially early on: each one is moulded by the
                                events of our lives. Blind people, for instance, use areas of their brain
                                normally reserved for vision when touching or hearing. Mike Merzenich,
                                a researcher in brain plasticity at the University of California at San
                                Francisco, found that monkeys trained to do manual tasks in return
                                for food quickly harness more of their brains for analysing touch
                                sensations from their fingers. In one mind-boggling experiment at the
                                Massachusetts Institute of Technology, a ferret's optic nerve was
                                surgically rerouted to the auditory portion of its brain with the result
                                that the animal could still see.

                                Merzenich believes that people could gain valuable information from
                                Meijer and Bach-y-Rita's systems, but he doubts if it would ever be
                                much like vision. Nor does he think that people will ever come to grips
                                with sounds by sensing them through touch - especially when it
                                comes to learning a language. 'It's not clear that the machinery in the
                                touch system in the higher reaches of the nervous system is up to
                                the job (of language),' he says.

                                Others are more hopeful. Geoffrey Plant, who teaches deaf people and
                                works at MIT, points to the incredible feats of people who are both
                                blind and deaf, some of whom can understand speech simply by
                                feeling the mouth and throat of the speaker. To develop this ability,
                                scientists are building devices that turn sounds into vibrations.

                                Today, about 400 deaf people worldwide are using Tactaid 7, a device
                                that sorts sound into seven frequency channels which are linked to
                                seven vibrators along the wearer's arm. With it, people who could
                                once hear can learn to understand much of speech with lip-reading.
                                Also, children who went deaf before they could speak learn to
                                enunciate better and can more easily distinguish between words like
                                'cat' and 'bat'. Tactaid 7 was designed by the Audiological Engineering
                                Corporation in Massachusetts, where Plant also works.

                                Tactile hearing

                                How does the device compare with a cochlear implant? One study at
                                the University of Miami's Mailman Center for Child Development found
                                that children who went deaf before learning language do as well with
                                Tactaid 7 combined with a hearing aid as they do with implants. But a
                                group led by Richard Miyamoto at Indiana University found that while
                                Tactaid 7 was clearly helpful, the performance of children using it
                                reached a plateau. Meanwhile, the speech skills of children with
                                cochlear implants continue to improve.

                                The Miami group, consisting of Rebecca Eilers, Kim Oller and Ozcan
                                Ozdamar, thinks that higher precision tactile devices are the answer.
                                They have built a 16-channel tactile aid which emphasise more
                                detailed sound signals. The aid digitises sounds which are then
                                manipulated by computer to produce more subtle vibrations. These
                                emphasise the cues people use to recognise speech. Ozdamar, who is
                                a biomedical engineer, is trying to make it portable so it can be used
                                all the time.

                                Meanwhile, Plant and David Franklin, president of Audiological
                                Engineering, are moving towards simpler aids - with the help of Gustaf
                                Soderlund, a 53-year-old Swedish man deaf since the age of eight.
                                Soderlund's father was very attentive of his son and would let him
                                climb on his lap and feel the gentle vibrations of his body while he
                                spoke. 'To meet him is a rather startling experience,' says Franklin.
                                'What he does is he loosely throws his hand on your shoulder and he
                                feels vibrations and lip-reads. Yet when I try it I can't feel a thing.'

                                Many deaf people could benefit from Soderlund's method, but draping
                                one's arms around strangers is not always socially acceptable. Plant
                                and Franklin's solution is to build a hand-held device - a box small
                                enough to strap to the wrist which incorporates a microphone or a
                                radio tranceiver. This picks up sounds from transmitters worn by
                                people speaking and converts them into the frequencies that
                                Soderlund uses to understand speech. At the moment, the
                                researchers are running tests on Sonderlund to find out which
                                frequencies these are.

                                Visual cues might also help the deaf improve their speaking skills.
                                Lionel Tarassenko and Jake Reynolds at the University of Oxford have
                                developed a device that extracts certain information from speech -
                                the changes in resonances of the vocal tract as a sound is made -
                                and then displays it graphically on a computer screen. In future, deaf
                                students could study the patterns created when they speak. 'They
                                would try to adjust the way they pronounce a word or subword to
                                make it more like the pattern created by their teachers,' says
                                Tarassenko.

                                Best of both worlds?

                                None of these researchers are suggesting that deaf children use their
                                aids instead of learning sign language. Instead, they want the best of
                                both worlds for deaf children: sign and speech. But Moise Goldstein,
                                professor of biomedical engineering at Johns Hopkins University,
                                worries that parents who are desperate for their children to speak and
                                lip-read will latch onto tactile aids. As a result, they may neglect the
                                child's essential first language - signing. 'I started out in this field with
                                the hope of making the skin into an ear,' says Goldstein. 'But right
                                now what I'm trying to do is work with young engineers to see if we
                                can make it easier for the parents to learn sign language.'

                                The issue, then, is more than discovering what is feasible: it is
                                deciding what is helpful. Here, not surprisingly, opinions differ - for the
                                blind as well as the deaf. 'You can pull 100 blind people off the street
                                and ask them what ought to be done and you'll get 95 different
                                answers, probably,' says James Gashel, director of government affairs
                                with the National Federation of the Blind.

                                Gashel, for instance, doesn't think he needs devices to help him get
                                around town, especially noisy ones. 'Noises are distracting,' he says. 'I
                                could be listening for a pole or a bush and run into a person walking
                                down the street.' Meanwhile, Larry Scadden, director of a National
                                Science Foundation programme promoting education for disabled
                                students (and perhaps the only blind person with a PhD in visual
                                sciences) is more open to such devices - as long as they can be
                                turned off at will.

                                But more pressing by far, both men stress, is something more
                                workaday: finding a way to give blind people access to the world of
                                computer graphics. Many blind people were counselled into computing
                                careers, and the new trend toward graphics is leaving them high and
                                dry. Meijer and Bach-y-Rita hope their devices will help here too:
                                either by giving sound clues to the computer operator or by providing
                                a grid of tactile information. Other researchers around the world are
                                pursuing similar lines of research.

                                One day, perhaps, technology will deliver excellent sight to the blind
                                and perfect hearing to the deaf - either through devices such as
                                cochlear implants, or by less orthodox methods that harness other
                                sensations to do the job. But until then, there are a wealth of smaller,
                                more modest ways in which technology can help: teaching a blind
                                child what a candle flame looks like, or how to find the 'trash' icon on
                                her computer; showing a deaf child how to say 'cat', or coaxing his
                                parents to learn how to sign. 'You would not want to sit around just
                                waiting for the day somebody's going to develop a device to 'make
                                you see' - you've got to get on with your life,' says Gashel. 'Being
                                sighted may be nice but it's not the greatest thing in the world.

                                ROSIE MESTEL
                                From New Scientist magazine, vol 142 issue 1928, 04/06/1994, page
                                                            20
 
 

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