IU Indianapolis ScholarWorks :: Browsing by Subject "Cochlear implants"

Browsing by Subject "Cochlear implants"

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An analysis of hearing aid fittings in adults using cochlear implants and contralateral hearing aids
(Wiley, 2010-12) Harris, Michael S.; Hay-McCutcheon, Marcia; Otolaryngology -- Head and Neck Surgery, School of Medicine
OBJECTIVES/HYPOTHESIS: The objective of this study was to assess the appropriateness of hearing aid fittings within a sample of adult cochlear implant recipients who use a hearing aid in the contralateral ear (i.e., bimodal stimulation). METHODS: The hearing aid gain was measured using real ear testing for 14 postlingually deaf English-speaking adults who use a cochlear implant in the contralateral ear. Unaided and aided audiometric testing assessed the degree of functional gain derived from hearing aid use. RESULTS: On average, the target to actual output level difference was within 10 dB only at frequencies of 750 Hz and 1,000 Hz. Only 1 of the 14 study participants had a hearing aid for which the majority of the tested frequencies were within 10 dB of the target gain. In addition, a greater amount of functional gain (i.e., the increase in unaided behavioral thresholds after amplification) was provided for lower frequencies than higher frequencies. CONCLUSIONS: Hearing aid settings in our sample were suboptimal and may be regarded as a contributing factor to the variability in bimodal benefit. Refining hearing aid fitting strategies tailored to the needs of the concurrent cochlear implant and hearing aid user is recommended.
Contribution of Verbal Learning & Memory and Spectro-Temporal Discrimination to Speech Recognition in Cochlear Implant Users
(Wiley, 2023) Harris, Michael S.; Hamel, Benjamin L.; Wichert, Kristin; Kozlowski, Kristin; Mleziva, Sarah; Ray, Christin; Pisoni, David B.; Kronenberger, William G.; Moberly, Aaron C.; Psychiatry, School of Medicine
Objectives: Existing cochlear implant (CI) outcomes research demonstrates a high degree of variability in device effectiveness among experienced CI users. Increasing evidence suggests that verbal learning and memory (VL&M) may have an influence on speech recognition with CIs. This study examined the relations in CI users between visual measures of VL&M and speech recognition in a series of models that also incorporated spectro-temporal discrimination. Predictions were that (1) speech recognition would be associated with VL&M abilities and (2) VL&M would contribute to speech recognition outcomes above and beyond spectro-temporal discrimination in multivariable models of speech recognition. Methods: This cross-sectional study included 30 adult postlingually deaf experienced CI users who completed a nonauditory visual version of the California Verbal Learning Test-Second Edition (v-CVLT-II) to assess VL&M, and the Spectral-Temporally Modulated Ripple Test (SMRT), an auditory measure of spectro-temporal processing. Participants also completed a battery of word and sentence recognition tasks. Results: CI users showed significant correlations between some v-CVLT-II measures (short-delay free- and cued-recall, retroactive interference, and "subjective" organizational recall strategies) and speech recognition measures. Performance on the SMRT was correlated with all speech recognition measures. Hierarchical multivariable linear regression analyses showed that SMRT performance accounted for a significant degree of speech recognition outcome variance. Moreover, for all speech recognition measures, VL&M scores contributed independently in addition to SMRT. Conclusion: Measures of spectro-temporal discrimination and VL&M were associated with speech recognition in CI users. After accounting for spectro-temporal discrimination, VL&M contributed independently to performance on measures of speech recognition for words and sentences produced by single and multiple talkers.
Executive functioning and spoken language skills in young children with hearing aids and cochlear implants: Longitudinal findings
(Frontiers Media, 2022-09-23) Jamsek, Izabela A.; Kronenberger, William G.; Pisoni, David B.; Holt, Rachael Frush; Psychiatry, School of Medicine
Deaf or hard-of-hearing (DHH) children who use auditory-oral communication display considerable variability in spoken language and executive functioning outcomes. Furthermore, language and executive functioning skills are strongly associated with each other in DHH children, which may be relevant for explaining this variability in outcomes. However, longitudinal investigations of language and executive functioning during the important preschool period of development in DHH children are rare. This study examined the predictive, reciprocal associations between executive functioning and spoken language over a 1-year period in samples of 53 DHH and 59 typically hearing (TH) children between ages 3-8 years at baseline. Participants were assessed on measures of receptive spoken language (vocabulary, sentence comprehension, and following spoken directions) and caregiver-completed executive functioning child behavior checklists during two in-person home visits separated by 1 year. In the sample of DHH children, better executive functioning at baseline (Time 1) was associated with better performance on the higher-order language measures (sentence comprehension and following spoken directions) 1 year later (Time 2). In contrast, none of the Time 1 language measures were associated with better executive functioning in Time 2 in the DHH sample. TH children showed no significant language-executive functioning correlations over the 1-year study period. In regression analyses controlling for Time 1 language scores, Time 1 executive functioning predicted Time 2 language outcomes in the combined DHH and TH samples, and for vocabulary, that association was stronger in the DHH than in the TH sample. In contrast, after controlling for Time 1 executive functioning, none of the regression analyses predicting Time 2 executive functioning from Time 1 language were statistically significant. These results are the first findings to demonstrate that everyday parent-rated executive functioning behaviors predict basic (vocabulary) and higher-order (comprehension, following directions) spoken language development 1 year later in young (3-8 year old) DHH children, even after accounting for initial baseline language skills.
List Equivalency of PRESTO for the Evaluation of Speech Recognition
(American Academy of Audiology, 2015-06) Faulkner, Kathleen F.; Tamati, Terrin N.; Gilbert, Jaimie L.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
BACKGROUND: There is a pressing clinical need for the development of ecologically valid and robust assessment measures of speech recognition. Perceptually Robust English Sentence Test Open-set (PRESTO) is a new high-variability sentence recognition test that is sensitive to individual differences and was designed for use with several different clinical populations. PRESTO differs from other sentence recognition tests because the target sentences differ in talker, gender, and regional dialect. Increasing interest in using PRESTO as a clinical test of spoken word recognition dictates the need to establish equivalence across test lists. PURPOSE: The purpose of this study was to establish list equivalency of PRESTO for clinical use. RESEARCH DESIGN: PRESTO sentence lists were presented to three groups of normal-hearing listeners in noise (multitalker babble [MTB] at 0 dB signal-to-noise ratio) or under eight-channel cochlear implant simulation (CI-Sim). STUDY SAMPLE: Ninety-one young native speakers of English who were undergraduate students from the Indiana University community participated in this study. DATA COLLECTION AND ANALYSIS: Participants completed a sentence recognition task using different PRESTO sentence lists. They listened to sentences presented over headphones and typed in the words they heard on a computer. Keyword scoring was completed offline. Equivalency for sentence lists was determined based on the list intelligibility (mean keyword accuracy for each list compared with all other lists) and listener consistency (the relation between mean keyword accuracy on each list for each listener). RESULTS: Based on measures of list equivalency and listener consistency, ten PRESTO lists were found to be equivalent in the MTB condition, nine lists were equivalent in the CI-Sim condition, and six PRESTO lists were equivalent in both conditions. CONCLUSIONS: PRESTO is a valuable addition to the clinical toolbox for assessing sentence recognition across different populations. Because the test condition influenced the overall intelligibility of lists, researchers and clinicians should take the presentation conditions into consideration when selecting the best PRESTO lists for their research or clinical protocols.
The Perception of Regional Dialects and Foreign Accents by Cochlear Implant Users
(American Speech-Language-Hearing Association, 2021-02-17) Tamati, Terrin N.; Pisoni, David B.; Moberly, Aaron C.; Otolaryngology -- Head and Neck Surgery, School of Medicine
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 (not intelligible at all) to 7 (very intelligible). Individual performance was compared to demographic factors and sentence recognition scores. Results: Both CI and NH groups demonstrated difficulty with regional dialect categorization, but NH listeners significantly outperformed the CI users. In the intelligibility rating task, both CI and NH listeners rated foreign-accented sentences as less intelligible than native sentences; however, CI users perceived smaller differences in intelligibility between native and foreign-accented sentences. Sensitivity to accent differences was related to sentence recognition accuracy in CI users. Conclusions: Prelingually deaf, long-term CI users are sensitive to accent variability in speech, but less so than NH peers. Additionally, individual differences in CI users' sensitivity to indexical variability was related to sentence recognition abilities, suggesting a common source of difficulty in the perception and encoding of fine acoustic–phonetic details in speech.
Recognizing spoken words in semantically-anomalous sentences: Effects of executive control in early-implanted deaf children with cochlear implants
(Taylor & Francis, 2021) Pisoni, David B.; Kronenberger, William G.; Otolaryngology -- Head and Neck Surgery, School of Medicine
To investigate differences in speech, language, and neurocognitive functioning in normal hearing (NH) children and deaf children with cochlear implants (CIs) using anomalous sentences. Anomalous sentences block the use of downstream predictive coding during speech recognition, allowing for investigation of rapid phonological coding and executive functioning. Methods: Extreme groups were extracted from samples of children with CIs and NH peers (ages 9 to 17) based on the 7 highest and 7 lowest scores on the Harvard-Anomalous sentence test (Harvard-A). The four groups were compared on measures of speech, language, and neurocognitive functioning. Results: The 7 highest-scoring CI users and the 7 lowest-scoring NH peers did not differ in Harvard-A scores but did differ significantly on measures of neurocognitive functioning. Compared to low-performing NH peers, high performing children with CIs had significantly lower nonword repetition scores but higher nonverbal IQ scores, greater verbal WM capacity, and excellent EF skills related to inhibition, shifting attention/mental flexibility and working memory updating. Discussion: High performing deaf children with CIs are able to compensate for their sensory deficits and weaknesses in automatic phonological coding of speech by engaging in a slow effortful mode of information processing involving inhibition, working memory and executive functioning.
Relations of Social Maturity, Executive Function, and Self-Efficacy Among Deaf University Students
(Taylor & Francis, 2018) Marschark, Marc; Walton, Dawn; Crowe, Kathryn; Borgna, Georgianna; Kronenberger, William G.; Psychiatry, School of Medicine
This study explored possible associations of social maturity, executive function (EF), self-efficacy, and communication variables among deaf university students, both cochlear implant (CI) users and nonusers. Previous studies have demonstrated differences between deaf and hearing children and young adults in EF and EF-related social and cognitive functioning. EF differences also have been demonstrated between hearing children and deaf children who use CIs. Long-term influences of cochlear implantation in the social domain largely have not been explored, but were examined in the present study in terms of social maturity, as it might be related to EF and communication variables. Replicating and extending recent findings, social maturity was found to be related to somewhat different aspects of EF in CI users, deaf nonusers, and hearing students, but unrelated to hearing status, CI use, or deaf students' use of sign language versus spoken language. Self-efficacy proved a predictor of self-reported socially mature and immature behaviours for all groups. Individuals' beliefs about their parents' views of such behaviours was a potent predictor of behaviours for deaf CI users and those deaf students who reported sign language as their best form of communication.
Remote Assessment of Verbal Memory in Youth With Cochlear Implants During the COVID-19 Pandemic
(American Speech-Language-Hearing Association, 2021) Kronenberger, William G.; Montgomery, Caitlin J.; Henning, Shirley C.; Ditmars, Allison; Johnson, Courtney A.; Herbert, Carolyn J.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
Purpose: Youth with cochlear implants (CIs) are at risk for delays in verbal short-term memory (STM)/working memory (WM), which adversely affect language, neurocognitive, and behavioral outcomes. Assessment of verbal STM/WM is critical for identifying and addressing these delays, but standard assessment procedures require face-to-face (FTF) administration. The purpose of this study was to determine the feasibility and validity of remote testing methods (teleassessment) of verbal STM/WM in youth with CIs as a method of addressing COVID-19–related restrictions on FTF test administration. Method: Tests of verbal STM/WM for nonwords, digit spans, letter–number sequences, sentences, and stories were individually administered by speech-language pathologists over a teleassessment platform to 28 youth (aged 9–22 years) with CIs and 36 same-aged normal-hearing peers. Examiners, parents, and participants completed quality and satisfaction ratings with the teleassessment procedure. Teleassessment scores were compared to results of tests obtained at FTF visits an average of 1.6 years earlier. Results: Quality and satisfaction ratings for teleassessment were high and in almost all cases did not differ between the CI and normal-hearing samples. Youth with CIs scored lower than normal-hearing peers on measures of verbal STM/WM, and scores for digit span and letter–number sequencing did not differbetween teleassessment and FTF methods. Correlations across teleassessment and FTF visits were strong for digit span, letter–number sequencing, and sentence memory, but were more modest for nonword repetition. Conclusion: With some caveats, teleassessment of verbal STM/WM was feasible and valid for youth with CIs.
Three challenges for future research on cochlear implants
(Elsevier, 2018-01-02) Pisoni, David B.; Kronenberger, William G.; Harris, Michael S.; Moberly, Aaron C.; Otolaryngology -- Head and Neck Surgery, School of Medicine
Cochlear implants (CIs) often work very well for many children and adults with profound sensorineural (SNHL) hearing loss. Unfortunately, while many CI patients display substantial benefits in recognizing speech and understanding spoken language following cochlear implantation, a large number of patients achieve poor outcomes. Understanding and explaining the reasons for poor outcomes following implantation is a very challenging research problem that has received little attention despite the pressing clinical significance. In this paper, we discuss three challenges for future research on CIs. First, we consider the issue of individual differences and variability in outcomes following implantation. At the present time, we still do not have a complete and satisfactory account of the causal underlying factors that are responsible for the enormous individual differences and variability in outcomes. Second, we discuss issues related to the lack of preimplant predictors of outcomes. Very little prospective research has been carried out on the development of preimplant predictors that can be used to reliably identify CI candidates who may be at high risk for a poor outcome following implantation. Other than conventional demographics and hearing history, there are no prognostic tools available to predict speech recognition outcomes after implantation. Finally, we discuss the third challenge - what to do with a CI-user who has a poor outcome. We suggest that new research efforts need to be devoted to studying this neglected clinical population in greater depth to find out why they are doing poorly with their CI and what novel interventions and treatments can be developed to improve their speech recognition outcomes. Using these three challenges as objectives for future research on CIs, we suggest that the field needs to adopt a new narrative grounded in theory and methods from Cognitive Hearing Science and information processing theory. Without knowing which specific biological and neurocognitive factors are responsible for individual differences or understanding the underlying sensory and neurocognitive basis for variability in performance, it is impossible to select a specific approach to habilitation after a deaf adult or child receives a CI. Deaf adults and children who are performing poorly with their CIs are not a homogeneous group and may differ in many different ways from each other, reflecting the dysfunction of multiple brain systems associated with both congenital and acquired deafness. Hearing loss is not only an ear issue, it is also a brain issue too reflecting close links between perception and action and brain, body and world working together as a functionally integrated information processing system to support robust speech recognition and spoken language processing after implantation.
Verbal Working Memory Error Patterns and Speech-Language Outcomes in Youth With Cochlear Implants
(American Speech-Language-Hearing Association, 2021) Romano, Daniel R.; Kronenberger, William G.; Henning, Shirley C.; Montgomery, Caitlin J.; Ditmars, Allison M.; Johnson, Courtney A.; Bozell, Hannah D.; Yates, Adeline D.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
Purpose: Verbal working memory (VWM) delays are commonly found in prelingually deaf youth with cochlear implants (CIs), albeit with considerable interindividual variability. However, little is known about the neurocognitive information-processing mechanisms underlying these delays and how these mechanisms relate to spoken language outcomes. The goal of this study was to use error analysis of the letter-number sequencing (LNS) task to test the hypothesis that VWM delays in CI users are due, in part, to fragile, underspecified phonological representations in short-term memory. Method: Fifty-one CI users aged 7-22 years and 53 normal hearing (NH) peers completed a battery of speech, language, and neurocognitive tests. LNS raw scores and error profiles were compared between samples, and a hierarchical regression model was used to test for associations with measures of speech, language, and hearing. Results: Youth with CIs scored lower on the LNS test than NH peers and committed a significantly higher number of errors involving phonological confusions (recalling an incorrect letter/digit in place of a phonologically similar one). More phonological errors were associated with poorer performance on measures of nonword repetition and following spoken directions but not with hearing quality. Conclusions: Study findings support the hypothesis that poorer VWM in deaf children with CIs is due, in part, to fragile, underspecified phonological representations in short-term/working memory, which underlie spoken language delays. Programs aimed at strengthening phonological representations may improve VWM and spoken language outcomes in CI users.

Browsing by Subject "Cochlear implants"

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