Individual Differences in the Recognition of Spectrally Degraded Speech: Associations With Neurocognitive Functions in Adult Cochlear Implant Users and With Noise-Vocoded Simulations.

When listening to speech under adverse conditions, listeners compensate using neurocognitive resources. A clinically relevant form of adverse listening is listening through a cochlear implant (CI), which provides a spectrally degraded signal. CI listening is often simulated through noise-vocoding.

Bilateral Cochlear Implants and Bimodal Hearing: A Comparison of Quality of Life.

Background:  Despite significant advances in the field of cochlear implants (CIs), there is no widely accepted criterion for when to counsel on bilateral CIs in adults. This is partly due to conflicting findings on the advantages of bilateral CIs versus bimodal hearing (i.e.

Barriers to Cochlear Implant Uptake in Adults: A Scoping Review.

Introduction: Cochlear implants (CIs) provide access to sound and help mitigate the negative effects of hearing loss. As a field, we are successfully implanting more adults with greater amounts of residual hearing than ever before. Despite this, utilization remains low, which is thought to arise from barriers that are both intrinsic and extrinsic.

Current practices and opinions on auditory training in adult cochlear implant recipients.

Objective: To examine current practices and opinions of cochlear implant (CI) providers with respect to post-implantation auditory training.

Methods: A survey was submitted to the American Cochlear Implant Alliance membership that reviewed current practice and opinions with respect to post-implantation auditory training for adult CI recipients.

Main Outcome Measures: Review of respondent practice, center volume, role on CI team, and current usage and opinions surrounding auditory training, including resources used and schedule of use.

Predicting Early Cochlear Implant Performance: Can Cognitive Testing Help?

Introduction: There is significant variability in speech recognition outcomes in adults who receive cochlear implants (CIs). Little is known regarding cognitive influences on very early CI performance, during which significant neural plasticity occurs.

Methods: Prospective study of 15 postlingually deafened adult CI candidates tested preoperatively with a battery of cognitive assessments.

The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users.

Hypothesis: As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic.

Background: The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users' real-world functioning is not well understood.

Lexical effects on talker discrimination in adult cochlear implant usersa).

The lexical and phonological content of an utterance impacts the processing of talker-specific details in normal-hearing (NH) listeners. Adult cochlear implant (CI) users demonstrate difficulties in talker discrimination, particularly for same-gender talker pairs, which may alter the reliance on lexical information in talker discrimination. The current study examined the effect of lexical content on talker discrimination in 24 adult CI users.

Audiovisual Processing Skills Before Cochlear Implantation Predict Postoperative Speech Recognition in Adults.

Objectives: Adults with hearing loss (HL) demonstrate greater benefits of adding visual cues to auditory cues (i.e., "visual enhancement" [VE]) during recognition of speech presented in a combined audiovisual (AV) fashion when compared with normal-hearing peers.

Evaluating Listening Effort in Unilateral, Bimodal, and Bilateral Cochlear Implant Users.

Objective: Evaluate listening effort (LE) in unilateral, bilateral, and bimodal cochlear implant (CI) users. Establish an easy-to-implement task of LE that could be useful for clinical decision making.

Study Design: Prospective cohort study.

Effect of Cochlear Implantation on Social Life.

Objective: Explore the effects of hearing loss on social life and identify residual social life deficits that remain after cochlear implantation.

Study Design: Retrospective review of prospectively obtained data.

Setting: Tertiary care adult neurotology center.

Assessment of High-Variability Speech Recognition in Adult Cochlear Implant Users using PRESTO.

Background:  Speech recognition in adult cochlear implant (CI) users is typically assessed using sentence materials with low talker variability. Little is known about the effects of talker variability on speech recognition in adult CI users, the factors underlying individual differences in speech recognition with high talker variability, or how sentence materials with high talker variability could be utilized clinically.

Purpose:  To examine the effects of talker variability on sentence recognition in adult CI users, using sentences from the Perceptually Robust English Sentence Test Open-Set (PRESTO), and to examine the relation between working memory capacity and high-variability speech recognition.

Development of a Sentence Verification Task to Measure Speech Comprehension and Listening Effort in Cochlear Implant Users.

Purpose: Tests measuring speech comprehension and listening effort for cochlear implant (CI) users may reflect important aspects of real-world speech communication. In this study, we describe the development of a multiple-talker, English-language sentence verification task (SVT) for use in adult CI users to measure speech comprehension and listening effort. We also examine whether talker differences affect speech comprehension and listening effort.

The relation between speaking-style categorization and speech recognition in adult cochlear implant users.

The current study examined the relation between speaking-style categorization and speech recognition in post-lingually deafened adult cochlear implant users and normal-hearing listeners tested under 4- and 8-channel acoustic noise-vocoder cochlear implant simulations. Across all listeners, better speaking-style categorization of careful read and casual conversation speech was associated with more accurate recognition of speech across those same two speaking styles. Findings suggest that some cochlear implant users and normal-hearing listeners under cochlear implant simulation may benefit from stronger encoding of indexical information in speech, enabling both better categorization and recognition of speech produced in different speaking styles.

Noise-Vocoded Sentence Recognition and the Use of Context in Older and Younger Adult Listeners.

Purpose: When listening to speech under adverse conditions, older adults, even with "age-normal" hearing, face challenges that may lead to poorer speech recognition than their younger peers. Older listeners generally demonstrate poorer suprathreshold auditory processing along with aging-related declines in neurocognitive functioning that may impair their ability to compensate using "top-down" cognitive-linguistic functions. This study explored top-down processing in older and younger adult listeners, specifically the use of semantic context during noise-vocoded sentence recognition.

Preoperative Reading Efficiency as a Predictor of Adult Cochlear Implant Outcomes.

Hypotheses: 1) Scores of reading efficiency (the Test of Word Reading Efficiency, second edition) obtained in adults before cochlear implant surgery will be predictive of speech recognition outcomes 6 months after surgery; and 2) Cochlear implantation will lead to improvements in language processing as measured through reading efficiency from preimplantation to postimplantation.

Background: Adult cochlear implant (CI) users display remarkable variability in speech recognition outcomes. "Top-down" processing-the use of cognitive resources to make sense of degraded speech-contributes to speech recognition abilities in CI users.

Factors affecting talker discrimination ability in adult cochlear implant users.

Introduction: Real-world speech communication involves interacting with many talkers with diverse voices and accents. Many adults with cochlear implants (CIs) demonstrate poor talker discrimination, which may contribute to real-world communication difficulties. However, the factors contributing to talker discrimination ability, and how discrimination ability relates to speech recognition outcomes in adult CI users are still unknown.

Lexical Effects on the Perceived Clarity of Noise-Vocoded Speech in Younger and Older Listeners.

When listening to degraded speech, such as speech delivered by a cochlear implant (CI), listeners make use of top-down linguistic knowledge to facilitate speech recognition. Lexical knowledge supports speech recognition and enhances the perceived clarity of speech. Yet, the extent to which lexical knowledge can be used to effectively compensate for degraded input may depend on the degree of degradation and the listener's age.

Bottom-Up Signal Quality Impacts the Role of Top-Down Cognitive-Linguistic Processing During Speech Recognition by Adults with Cochlear Implants.

Hypotheses: Significant variability persists in speech recognition outcomes in adults with cochlear implants (CIs). Sensory ("bottom-up") and cognitive-linguistic ("top-down") processes help explain this variability. However, the interactions of these bottom-up and top-down factors remain unclear.

The effects of lexical content, acoustic and linguistic variability, and vocoding on voice cue perception.

Perceptual differences in voice cues, such as fundamental frequency (F0) and vocal tract length (VTL), can facilitate speech understanding in challenging conditions. Yet, we hypothesized that in the presence of spectrotemporal signal degradations, as imposed by cochlear implants (CIs) and vocoders, acoustic cues that overlap for voice perception and phonemic categorization could be mistaken for one another, leading to a strong interaction between linguistic and indexical (talker-specific) content. Fifteen normal-hearing participants performed an odd-one-out adaptive task measuring just-noticeable differences (JNDs) in F0 and VTL.

Talker Adaptation and Lexical Difficulty Impact Word Recognition in Adults with Cochlear Implants.

Introduction: Talker-specific adaptation facilitates speech recognition in normal-hearing listeners. This study examined talker adaptation in adult cochlear implant (CI) users. Three hypotheses were tested: (1) high-performing adult CI users show improved word recognition following exposure to a talker ("talker adaptation"), particularly for lexically hard words, (2) individual performance is determined by auditory sensitivity and neurocognitive skills, and (3) individual performance relates to real-world functioning.

How Does Cochlear Implantation Lead to Improvements on a Cognitive Screening Measure?

Purpose Cognitive screening tools to identify patients at risk for cognitive deficits are frequently used by clinicians who work with aging populations in hearing health care. Although some studies show improvements in performance on cognitive screening exams when hearing loss intervention is provided in the form of a hearing aid or cochlear implant (CI), it is worth examining whether these improvements are attributable to increased auditory access to test items. This study aimed to examine whether performance and pass rate on a cognitive screening measure, the Montréal Cognitive Assessment (MoCA), improve as a result of CI, whether improved performance on auditory-based test items drives changes in MoCA performance, and whether postoperative MoCA performance relates to post-CI speech perception ability.

The Perception of Regional Dialects and Foreign Accents by Cochlear Implant Users.

Purpose This preliminary research examined (a) the perception of two common sources of indexical variability in speech-regional dialects and foreign accents, and (b) the relation between indexical processing and sentence recognition among prelingually deaf, long-term cochlear implant (CI) users and normal-hearing (NH) peers. Method Forty-three prelingually deaf adolescent and adult CI users and 44 NH peers completed a regional dialect categorization task, which consisted of identifying the region of origin of an unfamiliar talker from six dialect regions of the United States. They also completed an intelligibility rating task, which consisted of rating the intelligibility of short sentences produced by native and nonnative (foreign-accented) speakers of American English on a scale from 1 () to 7 ().

Word and Nonword Reading Efficiency in Postlingually Deafened Adult Cochlear Implant Users.

Hypothesis: This study tested the hypotheses that 1) experienced adult cochlear implants (CI) users demonstrate poorer reading efficiency relative to normal-hearing controls, 2) reading efficiency reflects basic, underlying neurocognitive skills, and 3) reading efficiency relates to speech recognition outcomes in CI users.

Background: Weak phonological processing skills have been associated with poor speech recognition outcomes in postlingually deaf adult CI users. Phonological processing can be captured in nonauditory measures of reading efficiency, which may have wide use in patients with hearing loss.