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...

Full description

Saved in:
Bibliographic Details
Main Authors: Nadine Buczak, Eugen Kludt, Thomas Lenarz, Andreas Büchner
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Audiology and Otology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fauot.2025.1625799/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850035109114150912
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
work_keys_str_mv AT nadinebuczak beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT nadinebuczak beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT eugenkludt beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT eugenkludt beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT thomaslenarz beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT thomaslenarz beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT andreasbuchner beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers
AT andreasbuchner beyondauditorysensitivitycognitiveandlinguisticinfluencesonclinicalperformanceinpostlingualadultcochlearimplantusers