Blake S Wilson, a pioneer in speech processing, laid the cornerstone for the widespread use of cochlear implants today. He tells how he helped to turn what others called a ‘fool’s dream’ into a reality.
The big brother of CI systems
During the 1970s, Professor Blake Wilson, an electrical engineer, developed a small computer that analysed speech and showed the results as a series of light signals using an LED display. The system proved to be a useful help for deaf people who were lip-reading.
After the first CIs were developed in 1977, Blake, keen to learn more, won a professional development award in 1978, which enabled him to visit three of the four CI research centres in the USA.
That same year, he became a consultant for the CI programme at the University of California in San Francisco.
In the 1980s, Blake Wilson and his team of scientists developed a speechprocessing strategy that is still used in cochlear implants today. For him, this wasn’t the end of the story. Now, his aim is to work on new developments to improve outcomes for those who currently don’t get such good results with CIs, to tackle problems with background noise and to improve the perception of music even further.
From 1983, he led a research programme at the Research Triangle Institute in North Carolina, USA, with the primary aim of developing sound-processing strategies that would enable CI users not only to hear, but also to understand speech. And by the late 1980s Blake and his co-workers had produced the ground-breaking Continuous Interleaved Sampling (CIS) strategy, a coding system that enabled most CI users to understand speech and is still in use today.
The fascinating journey to this and other discoveries can be read in Blake’s essay in the special issue of Nature Medicine (volume 19, issue 10, page 1245), which celebrates the 2013 Lasker~DeBakey Award, given for achievements in medical science.
When you started your research, the first CIs were already out there, but they were crude by today’s standards. Was it a long road to your discovery of speech processing?
There were a lot of twists and turns along the way. We were a team of six or seven professionals and had a whole bunch of ideas. Over the years, we tested literally hundreds of them. And a few proved successful. During that time, I learned that you cannot become attached to one idea. You have to test lots. And although there were many false starts, we kept developing and testing new ideas. During that time, many experts in otology and hearing science said that CIs could not possibly work. The experts regarded the development of the CI as a fool’s dream at best, and at worst, an unethical experimentation on human beings.
How did it feel to be involved in a ‘fool’s dream’?
In the early days, we were on the frontier of what later proved to be many important discoveries. The field was wide open with lots of possibilities for huge improvements. But the level of hope wasn’t as high as it is now. Now we know that CIs work, the current challenge is to make them even better. Needless to say, this is a great problem to have!
So you see potential to improve CIs even further?
Today’s CIs provide a remarkable restoration of auditory function. Most users can talk on the telephone and have at least some degree of music appreciation. In my view, this performance is already a miracle. But not everyone gets such spectacular results. For them, new developments could improve the outcomes of their CIs.
Any ideas of where to start?
One possible reason for a poor hearing outcome is a deficit in the processing of auditory information in the brain. We didn’t appreciate the power of the brain in the early days. In retrospect, I now know that we had to exceed a threshold of quality and quantity of information with the implant and then the normal, intact brain could take over and do the rest. However, the parts of the brain involved with hearing can be compromised by years of auditory deprivation due to deafness or other causes. In those cases, a different approach may be needed to help the brain perform at its best. Possibly, a simpler representation of sound with the CI could help to give the compromised brain a foothold in processing. Also, smart training procedures may cause positive changes in brain function, which might help move the hearing parts toward normality. Another area for improvement is background noise, which remains a challenge for many CI users. In this case, perhaps a more detailed representation of sound provided by CI could be helpful. Also, the perception of music can be improved. We, and others worldwide, are working on it!
Perfect partner found in MED-EL
During the 1980s, a network of research collaborations developed around the world. The network included MED-EL’s Professor Erwin Hochmair and Dr Ingeborg Hochmair, who had been working on CIs since the mid 1970s.
As soon as Blake Wilson’s new Continuous Interleaved Sampling (CIS) coding strategy was published in the journal Nature, they started to design an implant system that could implement it. Since then, the collaboration between the three pioneers has become progressively closer in order to achieve increasingly better hearing outcomes for CI users. Today, Blake is the Chief CI Research Adviser for MED-EL, providing advice on the next best steps in CI research and development for the company. In addition, MED-EL supports his current research lab, the MED-EL Basic Research Laboratory in the Research Triangle Park, North Carolina, USA. Blake is also involved in multiple programmes and departments at Duke University, North Carolina, USA, and at the University of Warwick in the UK.