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J Am Acad Audiol 2021; 32(03): 144-156
DOI: 10.1055/s-0041-1722987
Research Article

Maximizing Cochlear Implant Outcomes with Short-Term Aural Rehabilitation

Claire Marcus Bernstein   *
1   Department of Hearing, Speech, and Language Sciences, Gallaudet University, Washington, District of Columbia
,
Diane Majerus Brewer   *
2   Department of Speech and Hearing Sciences, George Washington University, Washington, District of Columbia
,
Matthew H. Bakke
1   Department of Hearing, Speech, and Language Sciences, Gallaudet University, Washington, District of Columbia
,
Anne D. Olson
3   Communication Sciences and Disorders, University of Kentucky College of Health Sciences, Lexington, Kentucky
,
Elizabeth Jackson Machmer
4   National Technical Institute for the Deaf, Center for Educational Research Partnerships, Rochester, New York
,
Jaclyn B. Spitzer
5   Columbia University Medical Center, Audiology and Speech Pathology in Otolaryngology, New York, New York
6   Montclair State University, Communication Sciences and Disorders, Bloomfield, New Jersey
,
Paula C. Schauer
7   Prince Georges County School System, Instructional Specialist Audiology, Landover, Maryland
,
Sarah A. Sydlowski
8   The Cleveland Clinic, Hearing Implant Program, Cleveland, Ohio
,
Harry Levitt
9   Advanced Hearing Concepts, Bodega Bay, California
› Author Affiliations
Funding This research was supported by Grant #H133E80006 from the United States Department of Education, National Institute on Disability and Rehabilitation Research (NIDRR). Funding for this research was also provided by Grant # 90RE5020 from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), which is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).
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Abstract

Background Increasing numbers of adults are receiving cochlear implants (CIs) and many achieve high levels of speech perception and improved quality of life. However, a proportion of implant recipients still struggle due to limited speech recognition and/or greater communication demands in their daily lives. For these individuals a program of aural rehabilitation (AR) has the potential to improve outcomes.

Purpose The study investigated the effects of a short-term AR intervention on speech recognition, functional communication, and psychosocial outcomes in post lingually deafened adult CI users.

Research Design The experimental design was a multisite clinical study with participants randomized to either an AR treatment or active control group. Each group completed 6 weekly 90-minute individual treatment sessions. Assessments were completed pretreatment, 1 week and 2 months post-treatment.

Study Sample Twenty-five post lingually deafened adult CI recipients participated. AR group: mean age 66.2 (48–80); nine females, four males; months postactivation 7.7 (3–16); mean years severe to profound deafness 18.4 (2–40). Active control group: mean age 62.8 (47–85); eight females, four males; months postactivation 7.0 (3–13); mean years severe to profound deafness 18.8 (1–55).

Intervention The AR protocol consisted of auditory training (words, sentences, speech tracking), and psychosocial counseling (informational and communication strategies). Active control group participants engaged in cognitive stimulation activities (e.g., crosswords, sudoku, etc.).

Data Collection and Analysis Repeated measures ANOVA or analysis of variance, MANOVA or multivariate analysis of variance, and planned contrasts were used to compare group performance on the following measures: CasperSent; Hearing Handicap Inventory; Nijmegen Cochlear Implant Questionnaire; Client Oriented Scale of Improvement; Glasgow Benefit Inventory.

Results The AR group showed statistically significant improvements on speech recognition performance, psychosocial function, and communication goals with no significant improvement seen in the control group. The two groups were statistically equivalent on all outcome measures at preassessment. The robust improvements for the AR group were maintained at 2 months post-treatment.

Conclusion Results of this clinical study provide evidence that a short-term AR intervention protocol can maximize outcomes for adult post lingually deafened CI users. The impact of this brief multidimensional AR intervention to extend CI benefit is compelling, and may serve as a template for best practices with adult CI users.

Keywords

cochlear implants - speech recognition - aural rehabilitation - auditory training - psychosocial outcomes

* Cofirst authors.




Publication History

Received: 30 July 2019

Accepted: 28 August 2020

Article published online:
22 April 2021

© 2021. American Academy of Audiology. This article is published by Thieme.

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