Speech perception in CI recipients: What`s the input of top-down mechanisms?

Introduction Despite significant improvements there is a high variability in speech understanding with cochlear implants (CI). In addition to bottom-up processes "top-down" mechanisms play an important role in decoding the speech signal. Therefore, the aim of the study was to rule out whether differences in cognitive and linguistic abilities may explain speech outcome.

Method 15 postlingually deaf adult CI recipients with a maximum speech perception of 30 %  and 19 CI with at least 70 %  in the Freiburger monosyllabic test underwent a visually presented cognitive and linguistic test battery assessing attention, memory, inhibition, working memory, lexical access, phonological input lexicon and automatic naming.

Results Speech outcome is determined mainly by linguistic and less by cognitive skills (canonical r=0.68, p=0.0075). In 91.7 %  speech outcome could be predicted by rapid naming speed. Furthermore, CI users with poor speech perception scored significantly lower in lexical access (p=0.017*) and in phonological input lexicon (p=0.0039**). CI users with good speech outcome showed better cognitive skills, most prominent in attentional tasks (p=0.003**).

Discussion Phonologically based deficits in fast automatic speech processing seem to be crucial for speech outcome in CI users and should be trained postoperatively. Preoperative testing may allow a better prediction of speech outcome.

Poster-PDF A-1060.pdf

Publication History

Article published online:
13 May 2021