Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users
IntroductionSpeech understanding in cochlear implant (CI) users is influenced by various factors, particularly cognitive and linguistic abilities. While previous studies have explored both bottom-up and top-down processes in speech comprehension, this study focuses specifically on the role of cognit...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Audiology and Otology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fauot.2025.1625799/full |
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| author | Nadine Buczak Nadine Buczak Eugen Kludt Eugen Kludt Thomas Lenarz Thomas Lenarz Andreas Büchner Andreas Büchner |
| author_facet | Nadine Buczak Nadine Buczak Eugen Kludt Eugen Kludt Thomas Lenarz Thomas Lenarz Andreas Büchner Andreas Büchner |
| author_sort | Nadine Buczak |
| collection | DOAJ |
| description | IntroductionSpeech understanding in cochlear implant (CI) users is influenced by various factors, particularly cognitive and linguistic abilities. While previous studies have explored both bottom-up and top-down processes in speech comprehension, this study focuses specifically on the role of cognitive and linguistic factors in shaping speech recognition outcomes in post-lingually deafened adults.MethodsFifty-eight post-lingually deafened adults, with at least 12 months of CI experience, participated in this study using a previously established dataset. Participants were categorized into Poor Performers (n = 25; ≤ 35% word recognition at 65 dB SPL) and Good Performers (n = 33; ≥65% word recognition at 65 dB SPL). Participants with single-sided deafness were excluded to avoid confounding effects. Cognitive and linguistic variables, including vocabulary size (Wortschatztest, WST), processing speed (Symbol Digit Modality Test, SDMT), and executive control (Stroop Test), were assessed. Descriptive statistics were calculated to explore group differences, and Cohen's d was used to assess effect sizes. Statistical tests included univariate linear regression for individual predictors and multiple linear regression for the overall model.ResultsThe results indicated that larger vocabulary size, faster processing speed, and higher educational level were significantly associated with better speech performance. Additionally, younger age at testing correlated with improved outcomes, while early onset hearing loss (before age 7) was linked to poorer performance.DiscussionThese findings emphasize the critical influence of cognitive and linguistic abilities, early auditory experiences, and educational background on CI outcomes. Together, these factors significantly predict speech understanding, highlighting the need to consider them in rehabilitation planning and comprehensive assessments to guide targeted interventions. |
| format | Article |
| id | doaj-art-b094098364bc449eb5352f2eba9a8b9c |
| institution | DOAJ |
| issn | 2813-6055 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Audiology and Otology |
| spelling | doaj-art-b094098364bc449eb5352f2eba9a8b9c2025-08-20T02:57:35ZengFrontiers Media S.A.Frontiers in Audiology and Otology2813-60552025-08-01310.3389/fauot.2025.16257991625799Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant usersNadine Buczak0Nadine Buczak1Eugen Kludt2Eugen Kludt3Thomas Lenarz4Thomas Lenarz5Andreas Büchner6Andreas Büchner7Department of Otolaryngology, Hannover Medical School, Hannover, GermanyCluster of Excellence “Hearing4All”, Hannover, GermanyDepartment of Otolaryngology, Hannover Medical School, Hannover, GermanyCluster of Excellence “Hearing4All”, Hannover, GermanyDepartment of Otolaryngology, Hannover Medical School, Hannover, GermanyCluster of Excellence “Hearing4All”, Hannover, GermanyDepartment of Otolaryngology, Hannover Medical School, Hannover, GermanyCluster of Excellence “Hearing4All”, Hannover, GermanyIntroductionSpeech understanding in cochlear implant (CI) users is influenced by various factors, particularly cognitive and linguistic abilities. While previous studies have explored both bottom-up and top-down processes in speech comprehension, this study focuses specifically on the role of cognitive and linguistic factors in shaping speech recognition outcomes in post-lingually deafened adults.MethodsFifty-eight post-lingually deafened adults, with at least 12 months of CI experience, participated in this study using a previously established dataset. Participants were categorized into Poor Performers (n = 25; ≤ 35% word recognition at 65 dB SPL) and Good Performers (n = 33; ≥65% word recognition at 65 dB SPL). Participants with single-sided deafness were excluded to avoid confounding effects. Cognitive and linguistic variables, including vocabulary size (Wortschatztest, WST), processing speed (Symbol Digit Modality Test, SDMT), and executive control (Stroop Test), were assessed. Descriptive statistics were calculated to explore group differences, and Cohen's d was used to assess effect sizes. Statistical tests included univariate linear regression for individual predictors and multiple linear regression for the overall model.ResultsThe results indicated that larger vocabulary size, faster processing speed, and higher educational level were significantly associated with better speech performance. Additionally, younger age at testing correlated with improved outcomes, while early onset hearing loss (before age 7) was linked to poorer performance.DiscussionThese findings emphasize the critical influence of cognitive and linguistic abilities, early auditory experiences, and educational background on CI outcomes. Together, these factors significantly predict speech understanding, highlighting the need to consider them in rehabilitation planning and comprehensive assessments to guide targeted interventions.https://www.frontiersin.org/articles/10.3389/fauot.2025.1625799/fullcochlear implantsspeech performancePoor Performerlinguistic skillsneurocognitive functions |
| spellingShingle | Nadine Buczak Nadine Buczak Eugen Kludt Eugen Kludt Thomas Lenarz Thomas Lenarz Andreas Büchner Andreas Büchner Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users Frontiers in Audiology and Otology cochlear implants speech performance Poor Performer linguistic skills neurocognitive functions |
| title | Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users |
| title_full | Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users |
| title_fullStr | Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users |
| title_full_unstemmed | Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users |
| title_short | Beyond auditory sensitivity: cognitive and linguistic influences on clinical performance in post-lingual adult cochlear implant users |
| title_sort | beyond auditory sensitivity cognitive and linguistic influences on clinical performance in post lingual adult cochlear implant users |
| topic | cochlear implants speech performance Poor Performer linguistic skills neurocognitive functions |
| url | https://www.frontiersin.org/articles/10.3389/fauot.2025.1625799/full |
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