Gated Word Recognition by Postlingually Deafened Adults With Cochlear Implants: Influence of Semantic Context

Effects of spectral degradation on gated word recognition

Although much is known about how normal-hearing listeners process spoken words under ideal listening conditions, little is known about how a degraded signal, such as speech transmitted via cochlear implants, affects the word recognition process. In this study, gated word recognition performance was measured with the goal of describing the time course of word identification by using a noise-band vocoder simulation. The results of this study demonstrate that spectral degradations can impact the temporal aspects of speech processing. These results also provide insights into the potential advantages of enhancing spectral resolution in the processing of spoken words.

Exploring neurocognitive factors and brain activation in adult cochlear implant recipients associated with speech perception outcomes-A scoping review

Background

Cochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable among adult CI recipients. Top-down neurocognitive factors have been hypothesized to contribute to this variation that is currently only partly explained by biological and audiological factors. Studies investigating this, use varying methods and observe varying outcomes, and their relevance has yet to be evaluated in a review. Gathering and structuring this evidence in this scoping review provides a clear overview of where this research line currently stands, with the aim of guiding future research.

Objective

To understand to which extent different neurocognitive factors influence speech perception in adult CI users with a postlingual onset of hearing loss, by systematically reviewing the literature.

Methods

A systematic scoping review was performed according to the PRISMA guidelines. Studies investigating the influence of one or more neurocognitive factors on speech perception post-implantation were included. Word and sentence perception in quiet and noise were included as speech perception outcome metrics and six key neurocognitive domains, as defined by the DSM-5, were covered during the literature search (Protocol in open science registries: 10.17605/OSF.IO/Z3G7W of searches in June 2020, April 2022).

Results

From 5,668 retrieved articles, 54 articles were included and grouped into three categories using different measures to relate to speech perception outcomes: (1) Nineteen studies investigating brain activation, (2) Thirty-one investigating performance on cognitive tests, and (3) Eighteen investigating linguistic skills.

Conclusion

The use of cognitive functions, recruiting the frontal cortex, the use of visual cues, recruiting the occipital cortex, and the temporal cortex still available for language processing, are beneficial for adult CI users. Cognitive assessments indicate that performance on non-verbal intelligence tasks positively correlated with speech perception outcomes. Performance on auditory or visual working memory, learning, memory and vocabulary tasks were unrelated to speech perception outcomes and performance on the Stroop task not to word perception in quiet. However, there are still many uncertainties regarding the explanation of inconsistent results between papers and more comprehensive studies are needed e.g., including different assessment times, or combining neuroimaging and behavioral measures.

Systematic review registration

https://doi.org/10.17605/OSF.IO/Z3G7W.

Children With Cochlear Implants Use Semantic Prediction to Facilitate Spoken Word Recognition

Purpose Children with cochlear implants (CIs) are more likely to struggle with spoken language than their age-matched peers with normal hearing (NH), and new language processing literature suggests that these challenges may be linked to delays in spoken word recognition. The purpose of this study was to investigate whether children with CIs use language knowledge via semantic prediction to facilitate recognition of upcoming words and help compensate for uncertainties in the acoustic signal. Method Five- to 10-year-old children with CIs heard sentences with an informative verb (draws) or a neutral verb (gets) preceding a target word (picture). The target referent was presented on a screen, along with a phonologically similar competitor (pickle). Children's eye gaze was recorded to quantify efficiency of access of the target word and suppression of phonological competition. Performance was compared to both an age-matched group and vocabulary-matched group of children with NH. Results Children with CIs, like their peers with NH, demonstrated use of informative verbs to look more quickly to the target word and look less to the phonological competitor. However, children with CIs demonstrated less efficient use of semantic cues relative to their peers with NH, even when matched for vocabulary ability. Conclusions Children with CIs use semantic prediction to facilitate spoken word recognition but do so to a lesser extent than children with NH. Children with CIs experience challenges in predictive spoken language processing above and beyond limitations from delayed vocabulary development. Children with CIs with better vocabulary ability demonstrate more efficient use of lexical-semantic cues. Clinical interventions focusing on building knowledge of words and their associations may support efficiency of spoken language processing for children with CIs. Supplemental Material https://doi.org/10.23641/asha.14417627.

Bilateral cochlear implantation versus unilateral cochlear implantation in deaf children: Effects of sentence context and listening conditions on recognition of spoken words in sentences

OBJECTIVES

Previous studies have investigated the efficacy of bilateral cochlear implants (CIs) in deaf children. The current study focused on the use of sentence-context information in different listening conditions to better explain the benefits of bilateral cochlear implantation. We compared the word recognition abilities of children with bilateral CIs and children with unilateral CIs in relation to sentence context and listening conditions. Additionally, we investigated whether sentence context- and listening condition-dependent word recognition scores can differentiate children with bilateral CIs from children with unilateral CIs.

METHODS

Twenty children with bilateral CIs and 20 children with unilateral CIs participated in this study. All children were presented with semantically controlled sentences (high vs. low predictability) in quiet and noisy conditions and were asked to repeat the final words of each sentence.

RESULTS

Children with bilateral CIs had significantly higher word recognition scores than children with unilateral CIs on words embedded in both high- and low-predictability sentences in noisy conditions. The two groups recognized more words in high-predictability sentences than in low-predictability sentences in noisy conditions. The scores on the high-predictability sentences in noisy conditions significantly differentiated children with bilateral CIs from children with unilateral CIs.

CONCLUSION

Bilateral cochlear implantation is more advantageous than unilateral cochlear implantation at the auditory-linguistic processing level in complex listening conditions.

Semantic influences on the perception of degraded speech by individuals with cochlear implants

This study investigated whether speech intelligibility in cochlear implant (CI) users is affected by semantic context. Three groups participated in two experiments: Two groups of listeners with normal hearing (NH) listened to either full spectrum speech or vocoded speech, and one CI group listened to full spectrum speech. Experiment 1 measured participants' sentence recognition as a function of target-to-masker ratio (four-talker babble masker), and experiment 2 measured perception of interrupted speech as a function of duty cycles (long/short uninterrupted speech). Listeners were presented with both semantic congruent/incongruent targets. Results from the two experiments suggested that NH listeners benefitted more from the semantic cues as the listening conditions became more challenging (lower signal-to-noise ratios and interrupted speech with longer silent intervals). However, the CI group received minimal benefit from context, and therefore performed poorly in such conditions. On the contrary, in the conditions that were less challenging, CI users benefitted greatly from the semantic context, and NH listeners did not rely on such cues. The results also confirmed that such differential use of semantic cues appears to originate from the spectro-temporal degradations experienced by CI users, which could be a contributing factor for their poor performance in suboptimal environments.

Time-Gated Word Recognition in Children: Effects of Auditory Access, Age, and Semantic Context

Purpose We employed a time-gated word recognition task to investigate how children who are hard of hearing (CHH) and children with normal hearing (CNH) combine cognitive-linguistic abilities and acoustic-phonetic cues to recognize words in sentence-final position. Method The current study included 40 CHH and 30 CNH in 1st or 3rd grade. Participants completed vocabulary and working memory tests and a time-gated word recognition task consisting of 14 high- and 14 low-predictability sentences. A time-to-event model was used to evaluate the effect of the independent variables (age, hearing status, predictability) on word recognition. Mediation models were used to examine the associations between the independent variables (vocabulary size and working memory), aided audibility, and word recognition. Results Gated words were identified significantly earlier for high-predictability than low-predictability sentences. First-grade CHH and CNH showed no significant difference in performance. Third-grade CHH needed more information than CNH to identify final words. Aided audibility was associated with word recognition. This association was fully mediated by vocabulary size but not working memory. Conclusions Both CHH and CNH benefited from the addition of semantic context. Interventions that focus on consistent aided audibility and vocabulary may enhance children's ability to fill in gaps in incoming messages.