Effectiveness of Computer-Based Auditory Training for Adult Cochlear Implant Users: A Randomized Crossover Study

Effects of training length on adaptation to noise-vocoded speech

Listeners show rapid perceptual learning of acoustically degraded speech, though the amount of exposure required to maximize speech adaptation is unspecified. The current work used a single-session design to examine the length of auditory training on perceptual learning for normal hearing listeners exposed to eight-channel noise-vocoded speech. Participants completed short, medium, or long training using a two-alternative forced choice sentence identification task with feedback. To assess learning and generalization, a 40-trial pre-test and post-test transcription task was administered using trained and novel sentences. Training results showed all groups performed near ceiling with no reliable differences. For test data, we evaluated changes in transcription accuracy using separate linear mixed models for trained or novel sentences. In both models, we observed a significant improvement in transcription at post-test relative to pre-test. Critically, the three training groups did not differ in the magnitude of improvement following training. Subsequent Bayes factors analysis evaluating the test by group interaction provided strong evidence in support of the null hypothesis. For these stimuli and procedure, results suggest increased training does not necessarily maximize learning outcomes; both passive and trained experience likely supported adaptation. Findings may contribute to rehabilitation recommendations for listeners adapting to degraded speech signals.

Hearing Rehabilitation With a Chat-Based Mobile Auditory Training Program in Experienced Hearing Aid Users: Prospective Randomized Controlled Study

Background

Hearing rehabilitation with auditory training (AT) is necessary to improve speech perception ability in patients with hearing loss. However, face-to-face AT has not been widely implemented due to its high cost and personnel requirements. Therefore, there is a need for the development of a patient-friendly, mobile-based AT program.

Objective

In this study, we evaluated the effectiveness of hearing rehabilitation with our chat-based mobile AT (CMAT) program for speech perception performance among experienced hearing aid (HA) users.

Methods

A total of 42 adult patients with hearing loss who had worn bilateral HAs for more than 3 months were enrolled and randomly allocated to the AT or control group. In the AT group, CMAT was performed for 30 minutes a day for 2 months, while no intervention was provided in the control group. During the study, 2 patients from the AT group and 1 patient from the control group dropped out. At 0-, 1- and 2-month visits, results of hearing tests and speech perception tests, compliance, and questionnaires were prospectively collected and compared in the 2 groups.

Results

The AT group (n=19) showed better improvement in word and sentence perception tests compared to the control group (n=20; P=.04 and P=.03, respectively), while no significant difference was observed in phoneme and consonant perception tests (both P>.05). All participants were able to use CMAT without any difficulties, and 85% (17/20) of the AT group completed required training sessions. There were no changes in time or completion rate between the first and the second month of AT. No significant difference was observed between the 2 groups in questionnaire surveys.

Conclusions

After using the CMAT program, word and sentence perception performance was significantly improved in experienced HA users. In addition, CMAT showed high compliance and adherence over the 2-month study period. Further investigations are needed to validate long-term efficacy in a larger population.

TRIAL REGISTRATION

Clinical Research Information Service (CRiS) KCT0006509; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22110&search_page=L.

Effectiveness of Computerized Auditory Training on Speech Perception in Children With Hearing Loss: A Systematic Review

PURPOSE

The purpose of this study was to investigate the effectiveness of using computerized auditory training in the auditory perception of speech in children who use electronic devices through a systematic review of the literature.

METHOD

This is a systematic review based on the elaboration of the following guiding question: In hearing-impaired children who use electronic devices, how effective is the use of computerized auditory training in the auditory perception of speech? The Cochrane Library, Embase, LILACS, PubMed, Web of Science, and Scopus databases and gray literature (Google Scholar and ProQuest) were consulted.

RESULTS

Nine hundred and eighteen records were identified, with additional two studies in the citation search, totaling 920 studies. After excluding the 184 duplicate references, using the Rayyan platform, the titles and abstracts were screened (n = 736), with 20 studies selected and considered for full reading. Six of the 20 studies were included in the systematic review of the literature.

CONCLUSIONS

Positive and beneficial results regarding computerized auditory training are evidenced, which describe and discuss the proof of the effectiveness of the positive effects on the auditory perception of speech in children using hearing aids and cochlear implants with regard to auditory detection skills, discrimination, recognition, and auditory memory. The positive results are inspiring for the continuity and expansion of studies that further investigate the use of computerized auditory training with contemporary technologies and have an impact on the improvement of access to specialized intervention.

Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies

PURPOSE

Military risk factors such as blast exposure, noise exposure, head trauma, and neurotoxin exposure place Service members and Veterans at risk for deficits associated with auditory processing dysfunction. However, there is no clinical guidance specific to the treatment of auditory processing deficits in this unique population. We provide an overview of available treatments and their limited supporting evidence for use in adults, emphasizing the need for multidisciplinary case management and interdisciplinary research to support evidence-based solutions.

METHOD

We explored relevant literature to inform the treatment of auditory processing dysfunction in adults, with emphasis on findings involving active or former military personnel. We were able to identify a limited number of studies, pertaining primarily to the treatment of auditory processing deficits through the use of assistive technologies and training strategies. We assessed the current state of the science for knowledge gaps that warrant additional study.

CONCLUSIONS

Auditory processing deficits often co-occur with other military injuries and may pose significant risk in military operational and occupational settings. Research is needed to advance clinical diagnostic and rehabilitative capabilities, guide treatment planning, support effective multidisciplinary management, and inform fitness-for-duty standards. We emphasize the need for an inclusive approach to the assessment and treatment of auditory processing concerns in Service members and Veterans and for evidence-based solutions to address complex military risk factors and injuries.

Many tasks, same outcome: Role of training task on learning and maintenance of noise-vocoded speech

Listeners who use cochlear implants show variability in speech recognition. Research suggests that structured auditory training can improve speech recognition outcomes in cochlear implant users, and a central goal in the rehabilitation literature is to identify factors that maximize training. Here, we examined factors that may influence perceptual learning for noise-vocoded speech in normal hearing listeners as a foundational step towards clinical recommendations. Three groups of listeners were exposed to anomalous noise-vocoded sentences and completed one of three training tasks: transcription with feedback, transcription without feedback, or talker identification. Listeners completed a word transcription test at three time points: immediately before training, immediately after training, and one week following training. Accuracy at test was indexed by keyword accuracy at the sentence-initial and sentence-final position for high and low predictability noise-vocoded sentences. Following training, listeners showed improved transcription for both sentence-initial and sentence-final items, and for both low and high predictability sentences. The training groups showed robust and equivalent learning of noise-vocoded sentences immediately after training. Critically, gains were largely maintained equivalently among training groups one week later. These results converge with evidence pointing towards the utility of non-traditional training tasks to maximize perceptual learning of noise-vocoded speech.

Poor Performer: A Distinct Entity in Cochlear Implant Users?

INTRODUCTION

Several factors are known to influence speech perception in cochlear implant (CI) users. To date, the underlying mechanisms have not yet been fully clarified. Although many CI users achieve a high level of speech perception, a small percentage of patients does not or only slightly benefit from the CI (poor performer, PP). In a previous study, PP showed significantly poorer results on nonauditory-based cognitive and linguistic tests than CI users with a very high level of speech understanding (star performer, SP). We now investigate if PP also differs from the CI user with an average performance (average performer, AP) in cognitive and linguistic performance.

METHODS

Seventeen adult postlingually deafened CI users with speech perception scores in quiet of 55 (9.32) % (AP) on the German Freiburg monosyllabic speech test at 65 dB underwent neurocognitive (attention, working memory, short- and long-term memory, verbal fluency, inhibition) and linguistic testing (word retrieval, lexical decision, phonological input lexicon). The results were compared to the performance of 15 PP (speech perception score of 15 [11.80] %) and 19 SP (speech perception score of 80 [4.85] %). For statistical analysis, U-Test and discrimination analysis have been done.

RESULTS

Significant differences between PP and AP were observed on linguistic tests, in Rapid Automatized Naming (RAN: p = 0.0026), lexical decision (LexDec: p = 0.026), phonological input lexicon (LEMO: p = 0.0085), and understanding of incomplete words (TRT: p = 0.0024). AP also had significantly better neurocognitive results than PP in the domains of attention (M3: p = 0.009) and working memory (OSPAN: p = 0.041; RST: p = 0.015) but not in delayed recall (delayed recall: p = 0.22), verbal fluency (verbal fluency: p = 0.084), and inhibition (Flanker: p = 0.35). In contrast, no differences were found hereby between AP and SP. Based on the TRT and the RAN, AP and PP could be separated in 100%.

DISCUSSION

The results indicate that PP constitute a distinct entity of CI users that differs even in nonauditory abilities from CI users with an average speech perception, especially with regard to rapid word retrieval either due to reduced phonological abilities or limited storage. Further studies should investigate if improved word retrieval by increased phonological and semantic training results in better speech perception in these CI users.