Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2018 Oct;39(9):e794-e802.
doi: 10.1097/MAO.0000000000001964.

What to Do When Cochlear Implant Users Plateau in Performance: a Pilot Study of Clinician-guided Aural Rehabilitation

Aaron C Moberly  1 , Kara Vasil  1 , Jodi Baxter  2 , Christin Ray  2
Affiliations
Clinical Trial

What to Do When Cochlear Implant Users Plateau in Performance: a Pilot Study of Clinician-guided Aural Rehabilitation

Aaron C Moberly et al. Otol Neurotol. 2018 Oct.

Abstract

Hypothesis: For experienced adult cochlear implant (CI) users who have reached a plateau in performance, a clinician-guided aural rehabilitation (CGAR) approach can improve speech recognition and hearing-related quality of life (QOL).

Background: A substantial number of CI users do not reach optimal performance in terms of speech recognition ability and/or personal communication goals. Although self-guided computerized auditory training programs have grown in popularity, compliance and efficacy for these programs are poor. We propose that CGAR can improve speech recognition and hearing-related QOL in experienced CI users.

Methods: Twelve adult CI users were enrolled in an 8-week CGAR program guided by a speech-language pathologist and audiologist. Nine patients completed the program along with pre-AR and immediate post-AR testing of speech recognition (AzBio sentences in quiet and in multitalker babble, Consonant-Nucleus-Consonant words in quiet), QOL (Nijmegen Cochlear Implant Questionnaire, Hearing Handicap Inventory for Adults/Elderly, and Speech, Spatial and Qualities of Hearing Scale), and neurocognitive functioning (working memory capacity, information-processing speed, inhibitory control, speed of lexical/phonological access, and nonverbal reasoning). Pilot data for these nine patients are presented.

Results: From pre-CGAR to post-CGAR, group mean improvements in word recognition were found. Improvements were also demonstrated on some composite and subscale measures of QOL. Patients who demonstrated improvements in word recognition were those who performed most poorly at baseline.

Conclusions: CGAR represents a potentially efficacious approach to improving speech recognition and QOL for experienced CI users. Limitations and considerations in implementing and studying aural rehabilitation approaches are discussed.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors receive grant funding support from Cochlear Americas for a related investigator-initiated study of clinician-guided aural rehabilitation in newly implanted adult cochlear implant patients.

Figures

Figure 1.
Figure 1.
Pre- and post-aural rehabilitation (AR) mean scores for 9 individual subjects (S1 through S9) on (a) AzBio sentences (percent words correct) in quiet; and (b) AzBio sentences (percent words correct) in multi-talker babble. 95% critical differences for individual scores are shown as error bars.
Figure 2.
Figure 2.
Pre- and post-aural rehabilitation (AR) mean scores for 9 individual subjects (S1 through S9) on CNC words (percent words correct) in quiet. 95% critical differences for individual scores are shown as error bars.
Figure 3.
Figure 3.
Difference scores from pre- to post-aural rehabilitation (AR) for 9 individual subjects (S1 through S9) on (a) the Nijmegen Cochlear Implant Questionnaire (NCIQ, note that positive difference scores represent better quality of life); (b) the Hearing Handicap Inventory for Adults/Elderly (HHIA/HHIE, note that negative difference scores represent better quality of life); and (c) the Speech, Spatial and Qualities of Hearing scale (SSQ, note that positive difference scores represent better quality of life). Group mean difference scores are shown as dotted lines.
See this image and copyright information in PMC

References

    1. Firszt JB, Holden LK, Skinner MW, et al. Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear Hear 2004;25(4):375–387. - PubMed
    1. Gifford RH, Shallop JK, Peterson AM. Speech recognition materials and ceiling effects: considerations for cochlear implant programs. Audiol Neurotol 2008;13:193–205. - PubMed
    1. Hast A, Schlücker L, Digeser F, Liebscher T, Hoppe U. Speech perception of elderly cochlear implant users under different noise conditions. Otol Neurotol 2015;36(10):1638–43. - PubMed
    1. Holden LK, Finley CC, Firszt JB, et al. Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear 2013;34(3):342–360. - PMC - PubMed
    1. Lenarz M, Sönmez H, Joseph G, Büchner A, Lenarz T. Long-term performance of cochlear implants in postlingually deafened adults. Otolaryng Head Neck 2012;147(1)112–8. - PubMed

Publication types