Speech Recognition as a Function of Age and Listening Experience in Adult Cochlear Implant Users

Murr, Alexander T.; Canfarotta, Michael W; O’Connell, Brendan P.; Buss, Emily; King, English R.; Bucker, Andrea L.; Dillon, Sarah; Rooth, Meredith A; Dedmon, Matthew M.; Brown, Kevin D.; Dillon, Margaret T.

doi:10.1002/lary.29663

Cited by 13 publications

(18 citation statements)

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“…Our results align with previous evidence (14,21,25,(29)(30)(31) showing positive results in DHH adults with postlingual CI treatment. The outcome of treatment success measure (IOI-HA)…”

Section: Discussionsupporting

confidence: 93%

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A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

Bustos-Rubilar

Kyle

Luna

et al. 2023

Preprint

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Background: Post-lingual deafness represents a critical challenge for adults' well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the Ley Ricarte Soto (LRS) health policy. However, wide variability exists in the use of this device. To date, no study has been published on policy evaluation in Chile or other Latin American countries. Objectives: This study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020. Design: We performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) for social inclusion and occupation status for labour market inclusion. Results: Our study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes (P=0.078 and P= 0.011, respectively). Regarding social determinants of health, finding suggested participants with high social health insurance and a shorter commute time to the clinic (p=0.070 and p=0.086, respectively) had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation (p=0.069 and p=0.021, respectively) had better post-CI occupation status, and findings suggested an impact of high education levels. Conclusions: In evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them near each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these parameters could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities

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“…Our results align with previous evidence (14,21,25,(29)(30)(31) showing positive results in DHH adults with postlingual CI treatment. The outcome of treatment success measure (IOI-HA)…”

Section: Discussionsupporting

confidence: 93%

“…Unilateral/ Bilateral CI Two level variable: 1) Bilateral, 2) Unilateral. Two CI and the binaural stimulation have (+) effects (21).…”

Section: Dhh-a Surveymentioning

confidence: 99%

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

Bustos-Rubilar

Kyle

Luna

et al. 2023

Preprint

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“…This suggests that older adults may need a longer listening experience to reach peak performance on measures of binaural hearing. There have been previous reports suggesting that older adult CI users with bilateral moderate‐to‐profound sensorineural hearing loss need more listening experience before reaching asymptotic performance, 24–26 though other reports show similar acclimatization compared to younger CI users 27 . Cognitive function and temporal processing abilities have been shown to decline with increasing age 28,29 .…”

Section: Discussionmentioning

confidence: 95%

“…There have been previous reports suggesting that older adult CI users with bilateral moderate-to-profound sensorineural hearing loss need more listening experience before reaching asymptotic performance, [24][25][26] though other reports show similar acclimatization compared to younger CI users. 27 Cognitive function and temporal processing abilities have been shown to decline with increasing age. 28,29 It is possible that this complex task requires more central processing, necessitating the longer acclimatization period in older participants.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Binaural Hearing Improvements for Cochlear Implant Users with Asymmetric Hearing Loss

et al. 2022

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Objective To assess long‐term binaural hearing abilities for cochlear implant (CI) users with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). Methods A prospective, longitudinal, repeated measures study was completed at a tertiary referral center evaluating adults with UHL or AHL undergoing cochlear implantation. Binaural hearing abilities were assessed with masked speech recognition tasks using AzBio sentences in a 10‐talker masker. Performance was evaluated as the ability to benefit from spatial release from masking (SRM). SRM was calculated as the difference in scores when the masker was presented toward the CI‐ear (SRMci) or the contralateral ear (SRMcontra) relative to the co‐located condition (0°). Assessments were completed pre‐operatively and at annual intervals out to 5 years post‐activation. Results Twenty UHL and 19 AHL participants were included in the study. Linear Mixed Models showed significant main effects of interval and group for SRMcontra. There was a significant interaction between interval and group, with UHL participants reaching asymptotic performance early and AHL participants demonstrating continued growth in binaural abilities to 5 years post‐activation. The improvement in SRM showed a significant positive correlation with contralateral unaided hearing thresholds (p = 0.050) as well as age at implantation (p = 0.031). Conclusions CI recipients with UHL and AHL showed improved SRM with long‐term device use. The time course of improvement varied by cohort, with the UHL cohort reaching asymptotic performance early and the AHL cohort continuing to improve beyond 1 year. Differences between cohorts could be driven by differences in age at implantation as well as contralateral unaided hearing thresholds. Level of Evidence 3 Laryngoscope, 133:1480–1485, 2023

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“…Studying the speech perception abilities of older adults with CIs may allow researchers to determine the relative contributions of these cognitive factors to the ability to recognize rapid speech. Several studies have documented improved speech perception with the use of CIs in older adults (e.g., Dillon et al, 2013 ; Forli et al, 2019 ; Canfarotta et al, 2020 ; Murr et al, 2021 ). Despite the clear benefits of CIs for understanding normal-rate speech in quiet, less is known about the performance of older adults using a CI in more demanding listening situations.…”

Section: Introductionmentioning

confidence: 99%

The recognition of time-compressed speech as a function of age in listeners with cochlear implants or normal hearing

Tinnemore

Montero²,

Gordon‐Salant³

et al. 2022

Front. Aging Neurosci.

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Speech recognition is diminished when a listener has an auditory temporal processing deficit. Such deficits occur in listeners over 65 years old with normal hearing (NH) and with age-related hearing loss, but their source is still unclear. These deficits may be especially apparent when speech occurs at a rapid rate and when a listener is mostly reliant on temporal information to recognize speech, such as when listening with a cochlear implant (CI) or to vocoded speech (a CI simulation). Assessment of the auditory temporal processing abilities of adults with CIs across a wide range of ages should better reveal central or cognitive sources of age-related deficits with rapid speech because CI stimulation bypasses much of the cochlear encoding that is affected by age-related peripheral hearing loss. This study used time-compressed speech at four different degrees of time compression (0, 20, 40, and 60%) to challenge the auditory temporal processing abilities of younger, middle-aged, and older listeners with CIs or with NH. Listeners with NH were presented vocoded speech at four degrees of spectral resolution (unprocessed, 16, 8, and 4 channels). Results showed an interaction between age and degree of time compression. The reduction in speech recognition associated with faster rates of speech was greater for older adults than younger adults. The performance of the middle-aged listeners was more similar to that of the older listeners than to that of the younger listeners, especially at higher degrees of time compression. A measure of cognitive processing speed did not predict the effects of time compression. These results suggest that central auditory changes related to the aging process are at least partially responsible for the auditory temporal processing deficits seen in older listeners, rather than solely peripheral age-related changes.

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Speech Recognition as a Function of Age and Listening Experience in Adult Cochlear Implant Users

Cited by 13 publications

References 58 publications

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

Long‐Term Binaural Hearing Improvements for Cochlear Implant Users with Asymmetric Hearing Loss

The recognition of time-compressed speech as a function of age in listeners with cochlear implants or normal hearing

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