Phoneme Training for Adult Cochlear Implant Users: A Review of the Literature and Study Protocol

Abstract

Purpose: This study describes a protocol for a novel individualized phoneme training program for adult cochlear implant (CI) users, based on individual phoneme confusion errors. The protocol is underpinned by a literature review on phoneme training and a focus group with adult CI users. Method: After a literature search, five studies were included for review and evaluation of quality and level of evidence. A focus group with experienced adult CI users ( n = 7) was then conducted to gain insights into their experiences of auditory training post-implantation and recommendations for future training programs. The knowledge gained from the literature review and focus group was used as the foundation for a novel, individualized phoneme training program for adult CI users, for which the protocol is described in this study. Results: A review of the literature shows that phoneme training in adult CI users has variable outcomes for on-task and off-task measures. Overall, the concept of individualized training relates to adaptive difficulty within training tasks and not to tailoring training content to participants' individual needs, as indicated by clinical outcomes. The focus group revealed that participants want to be able to track their training progress, have training content tailored to their individual needs, and expressed a preference for shorter training sessions. Conclusions: Using learnings from a literature review and focus group, this study describes a protocol for a novel, individualized phoneme training program for adult CI users. Study findings from this phoneme training program will be disseminated when available. Supplemental Material: https://doi.org/10.23641/asha.24392863

Comparing Phoneme and Word Recognition Test Outcomes in Adult CI users: Data Analysis from the AuDieT Study

“…A participant who, for example, has difficulties distinguishing similar phonemes such as /i/ and /e/ might be characterized by a fitness score significantly higher than accuracy (since the phonemes being mistaken are similar) and a low error dispersion score (since the errors are consistently made between those phonemes). Conversely, a participant who experiences difficulties with recognizing phonemic cues would show a higher error dispersion score; those issues might be addressed with training exercises aimed at practicing their phoneme discrimination and recognition capabilities (Philpott, Philips, Tromp, et al, 2023).…”

“…As training interventions are complementary to fitting ones, it is worth mentioning how the concept of individualised auditory training has also been investigated: Magits et al (Magits et al, 2023) reported similar effectiveness for personalised and non-personalised training programs, and in their literature review, Philpott et al (Philpott, Philips, Tromp, et al, 2023) found variable effectiveness for both types of programs, although the personalisation of the training tended to refer to adaptive difficulty more than to a focus on the individual difficulties of each CI user. In this case, as well as investigating personalized fitting, we believed it worthwhile to evaluate whether personalized training based on the speech recognition issues of each CI user may be impactful.…”