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Word Recognition Variability With Cochlear Implants: "Perceptual Attention" Versus "Auditory Sensitivity".

Aaron C Moberly1, Joanna H Lowenstein, Susan Nittrouer

  • 11Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA; and 2Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA.

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Summary

Cochlear implant (CI) users show significant variability in word recognition, influenced by attention and sensitivity to spectral cues. Improving spectral cue representation and auditory training can enhance spoken language understanding.

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Area of Science:

  • Audiology
  • Neuroscience
  • Speech and Hearing Sciences

Background:

  • Cochlear implantation (CI) outcomes for spoken language understanding in postlingually deafened adults are highly variable.
  • Understanding speech via CIs is challenging due to degraded acoustic representations.
  • Variability in word recognition may be linked to perceptual attention and auditory sensitivity to speech cues.

Purpose of the Study:

  • To investigate the relationship between perceptual attention, auditory sensitivity, and word recognition variability in adult CI users.
  • To compare CI users with normal-hearing (NH) controls regarding their processing of acoustic speech cues.

Main Methods:

  • Thirty postlingually deafened adults with CIs and 20 NH controls were assessed.
  • Word recognition in quiet was measured.
  • Perceptual attention (cue-weighting) and auditory sensitivity were evaluated for duration and spectral cues in phonemic contrasts ('cop'-'cob', 'sa'-'sha').

Main Results:

  • Word recognition varied widely among CI users (20-96%) and was generally poorer than in NH participants.
  • CI users and NH controls had similar attention and sensitivity to duration cues.
  • CI users demonstrated poorer attention and sensitivity to spectral cues, which predicted word recognition variability.

Conclusions:

  • Perceptual attention and auditory sensitivity to spectral cues are crucial for word recognition in CI users.
  • Enhancing spectral cue representation in CIs and implementing auditory training for attention to these cues are recommended.