Aaron Moberly - Academia.edu (original) (raw)

Papers by Aaron Moberly

Research paper thumbnail of Early Bimodal Stimulation Benefits Language Acquisition for Children With Cochlear Implants

Otology & Neurotology, 2016

Research paper thumbnail of Developing a synchronous otolaryngology telemedicine Clinic: Prospective study to assess fidelity and diagnostic concordance

Laryngoscope, Oct 27, 2017

Research paper thumbnail of Bottom-Up Signal Quality Impacts the Role of Top-Down Cognitive-Linguistic Processing During Speech Recognition by Adults with Cochlear Implants

Otology & Neurotology, Dec 1, 2021

Research paper thumbnail of Emerging Relations among Cognitive Constructs and Cochlear Implant Outcomes: A Systematic Review and Meta‐Analysis

Otolaryngology-Head and Neck Surgery, Jun 27, 2023

ObjectiveHearing loss has a detrimental impact on cognitive function. However, there is a lack of... more ObjectiveHearing loss has a detrimental impact on cognitive function. However, there is a lack of consensus on the impact of cochlear implants on cognition. This review systematically evaluates whether cochlear implants in adult patients lead to cognitive improvements and investigates the relations of cognition with speech recognition outcomes.Data SourcesA literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Studies evaluating cognition and cochlear implant outcomes in postlingual, adult patients from January 1996 to December 2021 were included. Of 2510 total references, 52 studies were included in qualitative analysis and 11 in meta‐analyses.Review MethodsProportions were extracted from studies of (1) the significant impacts of cochlear implantation on 6 cognitive domains and (2) associations between cognition and speech recognition outcomes. Meta‐analyses were performed using random effects models on mean differences between pre‐ and postoperative performance on 4 cognitive assessments.ResultsOnly half of the outcomes reported suggested cochlear implantation had a significant impact on cognition (50.8%), with the highest proportion in assessments of memory & learning and inhibition‐concentration. Meta‐analyses revealed significant improvements in global cognition and inhibition‐concentration. Finally, 40.4% of associations between cognition and speech recognition outcomes were significant.ConclusionFindings relating to cochlear implantation and cognition vary depending on the cognitive domain assessed and the study goal. Nonetheless, assessments of memory & learning, global cognition, and inhibition‐concentration may represent tools to assess cognitive benefit after implantation and help explain variability in speech recognition outcomes. Enhanced selectivity in assessments of cognition is needed for clinical applicability.

Research paper thumbnail of Verbal Learning and Memory Following Cochlear Implantation

Over the last 50 years, results of free-recall experiments using categorized word lists have prov... more Over the last 50 years, results of free-recall experiments using categorized word lists have provided detailed information about how subjects encode, store, and retrieve words from memory and how they control their attentional resources and develop organizational strategies to optimize verbal learning and memory. The basic experimental methodology is now well understood and has been used to develop several clinical instruments that are routinely used by neuropsychologists to assess verbal learning and memory disorders in a range of clinical populations. This chapter summarizes three new studies that used the California Verbal Learning Test (CVLT) with deaf children and adults who received cochlear implants. In addition to the “primary measures” of immediate free and cued recall, the CVLT also provides several “process measures,” such as repetition learning, primacy and recency effects, proactive (PI) and retroactive interference (RI), semantic, serial and subjective clustering, short- and long-delayed free and cued recall, response intrusions, and recognition memory. The study of verbal learning and memory represents a new approach to understanding variability in speech recognition and spoken-language outcomes following implantation and provides new knowledge about the elementary cognitive processes that form the core building blocks of word recognition, lexical access, and spoken-language understanding.

Research paper thumbnail of Quality of Life Outcomes Reported by Patients and Significant Others Following Cochlear Implantation

American Journal of Audiology, Sep 3, 2020

Purpose This study tested the hypotheses that both patients receiving cochlear implants (CIs) and... more Purpose This study tested the hypotheses that both patients receiving cochlear implants (CIs) and their significant others (SOs) would demonstrate improvements in perceived hearing handicap over time following cochlear implantation and that the SOs would demonstrate delayed patterns of perceived improvement compared to the patients who directly experienced the changes in hearing function provided by the CI. Method A study sample of 19 pairs of postlingually deafened adult candidates with CIs and their SOs answered questions about the patients' hearing handicap. Patient- and SO-reported scores were obtained preoperatively and at 1, 3, and 6 months after CI activation. The study hypotheses were tested using linear mixed-effects models. Results Patients and SOs independently reported improvements on self-reported hearing handicap measures at 1, 3, and 6 months post CI activation compared to preoperatively. Correlations between patient- and SO-reported scores were significant at all intervals; however, the asynchrony between pairs at 1 month postactivation was greater in magnitude compared to the other intervals. Conclusions Findings support the hypotheses of the study. Results should inform future clinical practice and research to guide the expectations of patients and their SOs as they adjust to hearing with a CI and experience various benefits and challenges over time.

Research paper thumbnail of Automated video summarization and label assignment for otoscopy videos using deep learning and natural language processing

Tympanic membrane (TM) diseases are among the most frequent pathologies, affecting the majority o... more Tympanic membrane (TM) diseases are among the most frequent pathologies, affecting the majority of the pediatric population. Video otoscopy is an effective tool for diagnosing TM diseases. However, access to Ear, Nose, and Throat (ENT) physicians is limited in many sparsely-populated regions worldwide. Moreover, high inter- and intra-reader variability impair accurate diagnosis. This study proposes a digital otoscopy video summarization and automated diagnostic label assignment model that benefits from the synergy of deep learning and natural language processing (NLP). Our main motivation is to obtain the key visual features of TM diseases from their short descriptive reports. Our video database consisted of 173 otoscopy records from three different TM diseases. To generate composite images, we utilized our previously developed semantic segmentation-based stitching framework, SelectStitch. An ENT expert reviewed these composite images and wrote short reports describing the TM's visual landmarks and the disease for each ear. Based on NLP and a bag-of-words (BoW) model, we determined the five most frequent words characterizing each TM diagnostic category. A neighborhood components analysis was used to predict the diagnostic label of the test instance. The proposed model provided an overall F1-score of 90.2%. This is the first study to utilize textual information in computerized ear diagnostics to the best of our knowledge. Our model has the potential to become a telemedicine application that can automatically make a diagnosis of the TM by analyzing its visual descriptions provided by a healthcare provider from a mobile device.

Research paper thumbnail of Partial Resection in Microsurgical Management of Vestibular Schwannomas

JAMA otolaryngology-- head & neck surgery, Sep 1, 2017

Observation, stereotactic radiosurgery, and microsurgical resection comprise the conventional arm... more Observation, stereotactic radiosurgery, and microsurgical resection comprise the conventional armamentarium in the management of vestibular schwannomas (VSs).1 The potential to “cure,” as opposed to control tumor growth, is unique to microsurgical resection. Progress in neuroimaging, permitting more accurate surveillance and refinement of stereotactic radiosurgery, along with a priority shift toward minimizing morbidity, has made partial tumor resection (PTR) attractive as an alternative to gross total resection (GTR). For most patients with VSs, we strive to achieve a GTR. In our practice, judicious use of PTR, in particular near total resection (NTR), is reserved for imminent compromise of facial nerve functional integrity or in cases where a safe GTR is deemed unlikely for reasons related to patient stability or very large tumor size. Below we discuss some of the considerations that inform this position.

Research paper thumbnail of Considerations for Integrating Cognitive Testing Into Adult Cochlear Implant Evaluations—Foundations for the Future

JAMA otolaryngology-- head & neck surgery, May 1, 2021

Research paper thumbnail of Audiometric findings in children with unilateral enlarged vestibular aqueduct

International Journal of Pediatric Otorhinolaryngology, May 1, 2019

Research paper thumbnail of Visual Reliance During Speech Recognition in Cochlear Implant Users and Candidates

Journal of The American Academy of Audiology, 2020

Research paper thumbnail of Relations Between Self-reported Executive Functioning and Speech Perception Skills in Adult Cochlear Implant Users

Otology & Neurotology, Feb 1, 2018

Research paper thumbnail of Explaining Speech Recognition and Quality of Life Outcomes in Adult Cochlear Implant Users: Complementary Contributions of Demographic, Sensory, and Cognitive Factors

Otology & Neurotology, May 14, 2020

Hypotheses: Adult cochlear implant (CI) outcomes depend on demographic, sensory, and cognitive fa... more Hypotheses: Adult cochlear implant (CI) outcomes depend on demographic, sensory, and cognitive factors. However, these factors have not been examined together comprehensively for relations to different outcome types, such as speech recognition versus quality of life (QOL). Three hypotheses were tested: 1) speech recognition will be explained most strongly by sensory factors, whereas QOL will be explained more strongly by cognitive factors. 2) Different speech recognition outcome domains (sentences versus words) and different QOL domains (physical versus social versus psychological functioning) will be explained differentially by demographic, sensory, and cognitive factors. 3) Including cognitive factors as predictors will provide more power to explain outcomes than demographic and sensory predictors alone. Background: A better understanding of the contributors to CI outcomes is needed to prognosticate outcomes before surgery, explain outcomes after surgery, and tailor rehabilitation efforts. Methods: Forty-one adult postlingual experienced CI users were assessed for sentence and word recognition, as well as hearing-related QOL, along with a broad collection of predictors. Partial least squares regression was used to identify factors that were most predictive of outcome measures. Results: Supporting our hypotheses, speech recognition abilities were most strongly dependent on sensory skills, while QOL outcomes required a combination of cognitive, sensory, and demographic predictors. The inclusion of cognitive measures increased the ability to explain outcomes, mainly for QOL. Conclusions: Explaining variability in adult CI outcomes requires a broad assessment approach. Identifying the most important predictors depends on the particular outcome domain and even the particular measure of interest.

Research paper thumbnail of Intraoperative Electrocochleography: A Window Into Endolymphatic Hydrops in a Patient With an Endolymphatic Sac Tumor

Otology & Neurotology, Apr 1, 2017

Intraoperative electrocochleography (ECochG) provides valuable information regarding inner ear fu... more Intraoperative electrocochleography (ECochG) provides valuable information regarding inner ear function during surgical procedures. Here, we report findings from ECochG collected at three time intervals during the management of a patient with symptoms of inner ear hydrops. A 38-year-old man with an endolymphatic sac tumor who demonstrated classic Ménière's symptoms. Endolymphatic shunt, tumor biopsy, and definitive resection of an endolymphatic sac tumor. Intraoperative ECochG measurements at three time intervals, using frequency-specific tone bursts and clicks. Across time intervals, the amplitude of ECochG summation potential (SP) responses decreased for tone bursts of all frequencies. On the other hand, the SP response to the click stimulus, and the ratio of the SP to action potential (AP), basically remained unchanged across time points. Results suggest that the absolute amplitude of the SP response to frequency-specific tone bursts may be more sensitive to inner ear hydrops than the traditionally used SP/AP ratio as a response to click stimuli.

Research paper thumbnail of Digital Otoscopy Videos Versus Composite Images: A Reader Study to Compare the Accuracy of ENT Physicians

Laryngoscope, Nov 10, 2020

Research paper thumbnail of Acoustic Cue Weighting by Adults with Cochlear Implants: A Mismatch Negativity Study

Ear and Hearing, Jul 1, 2016

Research paper thumbnail of Discussing Age-Related Hearing Loss and Cognitive Decline With Patients

JAMA otolaryngology-- head & neck surgery, Sep 1, 2019

Research paper thumbnail of Does Cochlear Implantation Improve Cognitive Function?

Laryngoscope, Jun 14, 2019

Research paper thumbnail of How Does Quality of Life Relate to Auditory Abilities? A Subitem Analysis of the Nijmegen Cochlear Implant Questionnaire

Journal of The American Academy of Audiology, Apr 1, 2020

Research paper thumbnail of What to Do When Cochlear Implant Users Plateau in Performance: a Pilot Study of Clinician-guided Aural Rehabilitation

Otology & Neurotology, Oct 1, 2018

Hypothesis: For experienced adult cochlear implant (CI) users who have reached a plateau in perfo... more Hypothesis: For experienced adult cochlear implant (CI) users who have reached a plateau in performance, a clinician-guided aural rehabilitation (AR) approach can improve speech recognition and hearing-related quality of life (QOL). Background: A substantial number of CI users do not reach optimal performance in terms of speech recognition ability and/or personal communication goals. Although self-guided computerized auditory training programs have grown in popularity, compliance and efficacy for these programs are poor. We propose that clinician-guided AR can improve speech recognition and hearing-related QOL in experienced CI users. Methods: Twelve adult CI users were enrolled in an 8-week AR program guided by a speechlanguage pathologist and audiologist. Nine patients completed the program along with pre-AR and immediate post-AR testing of speech recognition (AzBio sentences in quiet and in multi-talker babble, Consonant-Nucleus-Consonant words), QOL (Nijmegen Cochlear Implant Questionnaire, Hearing Handicap Inventory for Adults/Elderly, and Speech, Spatial and Qualities of Hearing Scale), and neurocognitive functioning (working memory capacity, information-processing speed, inhibitory control, speed of lexical/phonological access, and nonverbal reasoning). Pilot data for these 9 patients are presented. Results: From pre-AR to post-AR, group mean improvements in word recognition were found. Improvements were also demonstrated on some composite and subscale measures of QOL. Patients who demonstrated improvements in word recognition were those who performed most poorly at baseline. Clinician-guided AR represents a potentially efficacious approach to improving speech recognition and QOL for experienced CI users. Limitations and considerations in implementing and studying AR approaches are discussed.

Research paper thumbnail of Early Bimodal Stimulation Benefits Language Acquisition for Children With Cochlear Implants

Otology & Neurotology, 2016

Research paper thumbnail of Developing a synchronous otolaryngology telemedicine Clinic: Prospective study to assess fidelity and diagnostic concordance

Laryngoscope, Oct 27, 2017

Research paper thumbnail of Bottom-Up Signal Quality Impacts the Role of Top-Down Cognitive-Linguistic Processing During Speech Recognition by Adults with Cochlear Implants

Otology & Neurotology, Dec 1, 2021

Research paper thumbnail of Emerging Relations among Cognitive Constructs and Cochlear Implant Outcomes: A Systematic Review and Meta‐Analysis

Otolaryngology-Head and Neck Surgery, Jun 27, 2023

ObjectiveHearing loss has a detrimental impact on cognitive function. However, there is a lack of... more ObjectiveHearing loss has a detrimental impact on cognitive function. However, there is a lack of consensus on the impact of cochlear implants on cognition. This review systematically evaluates whether cochlear implants in adult patients lead to cognitive improvements and investigates the relations of cognition with speech recognition outcomes.Data SourcesA literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Studies evaluating cognition and cochlear implant outcomes in postlingual, adult patients from January 1996 to December 2021 were included. Of 2510 total references, 52 studies were included in qualitative analysis and 11 in meta‐analyses.Review MethodsProportions were extracted from studies of (1) the significant impacts of cochlear implantation on 6 cognitive domains and (2) associations between cognition and speech recognition outcomes. Meta‐analyses were performed using random effects models on mean differences between pre‐ and postoperative performance on 4 cognitive assessments.ResultsOnly half of the outcomes reported suggested cochlear implantation had a significant impact on cognition (50.8%), with the highest proportion in assessments of memory & learning and inhibition‐concentration. Meta‐analyses revealed significant improvements in global cognition and inhibition‐concentration. Finally, 40.4% of associations between cognition and speech recognition outcomes were significant.ConclusionFindings relating to cochlear implantation and cognition vary depending on the cognitive domain assessed and the study goal. Nonetheless, assessments of memory & learning, global cognition, and inhibition‐concentration may represent tools to assess cognitive benefit after implantation and help explain variability in speech recognition outcomes. Enhanced selectivity in assessments of cognition is needed for clinical applicability.

Research paper thumbnail of Verbal Learning and Memory Following Cochlear Implantation

Over the last 50 years, results of free-recall experiments using categorized word lists have prov... more Over the last 50 years, results of free-recall experiments using categorized word lists have provided detailed information about how subjects encode, store, and retrieve words from memory and how they control their attentional resources and develop organizational strategies to optimize verbal learning and memory. The basic experimental methodology is now well understood and has been used to develop several clinical instruments that are routinely used by neuropsychologists to assess verbal learning and memory disorders in a range of clinical populations. This chapter summarizes three new studies that used the California Verbal Learning Test (CVLT) with deaf children and adults who received cochlear implants. In addition to the “primary measures” of immediate free and cued recall, the CVLT also provides several “process measures,” such as repetition learning, primacy and recency effects, proactive (PI) and retroactive interference (RI), semantic, serial and subjective clustering, short- and long-delayed free and cued recall, response intrusions, and recognition memory. The study of verbal learning and memory represents a new approach to understanding variability in speech recognition and spoken-language outcomes following implantation and provides new knowledge about the elementary cognitive processes that form the core building blocks of word recognition, lexical access, and spoken-language understanding.

Research paper thumbnail of Quality of Life Outcomes Reported by Patients and Significant Others Following Cochlear Implantation

American Journal of Audiology, Sep 3, 2020

Purpose This study tested the hypotheses that both patients receiving cochlear implants (CIs) and... more Purpose This study tested the hypotheses that both patients receiving cochlear implants (CIs) and their significant others (SOs) would demonstrate improvements in perceived hearing handicap over time following cochlear implantation and that the SOs would demonstrate delayed patterns of perceived improvement compared to the patients who directly experienced the changes in hearing function provided by the CI. Method A study sample of 19 pairs of postlingually deafened adult candidates with CIs and their SOs answered questions about the patients' hearing handicap. Patient- and SO-reported scores were obtained preoperatively and at 1, 3, and 6 months after CI activation. The study hypotheses were tested using linear mixed-effects models. Results Patients and SOs independently reported improvements on self-reported hearing handicap measures at 1, 3, and 6 months post CI activation compared to preoperatively. Correlations between patient- and SO-reported scores were significant at all intervals; however, the asynchrony between pairs at 1 month postactivation was greater in magnitude compared to the other intervals. Conclusions Findings support the hypotheses of the study. Results should inform future clinical practice and research to guide the expectations of patients and their SOs as they adjust to hearing with a CI and experience various benefits and challenges over time.

Research paper thumbnail of Automated video summarization and label assignment for otoscopy videos using deep learning and natural language processing

Tympanic membrane (TM) diseases are among the most frequent pathologies, affecting the majority o... more Tympanic membrane (TM) diseases are among the most frequent pathologies, affecting the majority of the pediatric population. Video otoscopy is an effective tool for diagnosing TM diseases. However, access to Ear, Nose, and Throat (ENT) physicians is limited in many sparsely-populated regions worldwide. Moreover, high inter- and intra-reader variability impair accurate diagnosis. This study proposes a digital otoscopy video summarization and automated diagnostic label assignment model that benefits from the synergy of deep learning and natural language processing (NLP). Our main motivation is to obtain the key visual features of TM diseases from their short descriptive reports. Our video database consisted of 173 otoscopy records from three different TM diseases. To generate composite images, we utilized our previously developed semantic segmentation-based stitching framework, SelectStitch. An ENT expert reviewed these composite images and wrote short reports describing the TM's visual landmarks and the disease for each ear. Based on NLP and a bag-of-words (BoW) model, we determined the five most frequent words characterizing each TM diagnostic category. A neighborhood components analysis was used to predict the diagnostic label of the test instance. The proposed model provided an overall F1-score of 90.2%. This is the first study to utilize textual information in computerized ear diagnostics to the best of our knowledge. Our model has the potential to become a telemedicine application that can automatically make a diagnosis of the TM by analyzing its visual descriptions provided by a healthcare provider from a mobile device.

Research paper thumbnail of Partial Resection in Microsurgical Management of Vestibular Schwannomas

JAMA otolaryngology-- head & neck surgery, Sep 1, 2017

Observation, stereotactic radiosurgery, and microsurgical resection comprise the conventional arm... more Observation, stereotactic radiosurgery, and microsurgical resection comprise the conventional armamentarium in the management of vestibular schwannomas (VSs).1 The potential to “cure,” as opposed to control tumor growth, is unique to microsurgical resection. Progress in neuroimaging, permitting more accurate surveillance and refinement of stereotactic radiosurgery, along with a priority shift toward minimizing morbidity, has made partial tumor resection (PTR) attractive as an alternative to gross total resection (GTR). For most patients with VSs, we strive to achieve a GTR. In our practice, judicious use of PTR, in particular near total resection (NTR), is reserved for imminent compromise of facial nerve functional integrity or in cases where a safe GTR is deemed unlikely for reasons related to patient stability or very large tumor size. Below we discuss some of the considerations that inform this position.

Research paper thumbnail of Considerations for Integrating Cognitive Testing Into Adult Cochlear Implant Evaluations—Foundations for the Future

JAMA otolaryngology-- head & neck surgery, May 1, 2021

Research paper thumbnail of Audiometric findings in children with unilateral enlarged vestibular aqueduct

International Journal of Pediatric Otorhinolaryngology, May 1, 2019

Research paper thumbnail of Visual Reliance During Speech Recognition in Cochlear Implant Users and Candidates

Journal of The American Academy of Audiology, 2020

Research paper thumbnail of Relations Between Self-reported Executive Functioning and Speech Perception Skills in Adult Cochlear Implant Users

Otology & Neurotology, Feb 1, 2018

Research paper thumbnail of Explaining Speech Recognition and Quality of Life Outcomes in Adult Cochlear Implant Users: Complementary Contributions of Demographic, Sensory, and Cognitive Factors

Otology & Neurotology, May 14, 2020

Hypotheses: Adult cochlear implant (CI) outcomes depend on demographic, sensory, and cognitive fa... more Hypotheses: Adult cochlear implant (CI) outcomes depend on demographic, sensory, and cognitive factors. However, these factors have not been examined together comprehensively for relations to different outcome types, such as speech recognition versus quality of life (QOL). Three hypotheses were tested: 1) speech recognition will be explained most strongly by sensory factors, whereas QOL will be explained more strongly by cognitive factors. 2) Different speech recognition outcome domains (sentences versus words) and different QOL domains (physical versus social versus psychological functioning) will be explained differentially by demographic, sensory, and cognitive factors. 3) Including cognitive factors as predictors will provide more power to explain outcomes than demographic and sensory predictors alone. Background: A better understanding of the contributors to CI outcomes is needed to prognosticate outcomes before surgery, explain outcomes after surgery, and tailor rehabilitation efforts. Methods: Forty-one adult postlingual experienced CI users were assessed for sentence and word recognition, as well as hearing-related QOL, along with a broad collection of predictors. Partial least squares regression was used to identify factors that were most predictive of outcome measures. Results: Supporting our hypotheses, speech recognition abilities were most strongly dependent on sensory skills, while QOL outcomes required a combination of cognitive, sensory, and demographic predictors. The inclusion of cognitive measures increased the ability to explain outcomes, mainly for QOL. Conclusions: Explaining variability in adult CI outcomes requires a broad assessment approach. Identifying the most important predictors depends on the particular outcome domain and even the particular measure of interest.

Research paper thumbnail of Intraoperative Electrocochleography: A Window Into Endolymphatic Hydrops in a Patient With an Endolymphatic Sac Tumor

Otology & Neurotology, Apr 1, 2017

Intraoperative electrocochleography (ECochG) provides valuable information regarding inner ear fu... more Intraoperative electrocochleography (ECochG) provides valuable information regarding inner ear function during surgical procedures. Here, we report findings from ECochG collected at three time intervals during the management of a patient with symptoms of inner ear hydrops. A 38-year-old man with an endolymphatic sac tumor who demonstrated classic Ménière's symptoms. Endolymphatic shunt, tumor biopsy, and definitive resection of an endolymphatic sac tumor. Intraoperative ECochG measurements at three time intervals, using frequency-specific tone bursts and clicks. Across time intervals, the amplitude of ECochG summation potential (SP) responses decreased for tone bursts of all frequencies. On the other hand, the SP response to the click stimulus, and the ratio of the SP to action potential (AP), basically remained unchanged across time points. Results suggest that the absolute amplitude of the SP response to frequency-specific tone bursts may be more sensitive to inner ear hydrops than the traditionally used SP/AP ratio as a response to click stimuli.

Research paper thumbnail of Digital Otoscopy Videos Versus Composite Images: A Reader Study to Compare the Accuracy of ENT Physicians

Laryngoscope, Nov 10, 2020

Research paper thumbnail of Acoustic Cue Weighting by Adults with Cochlear Implants: A Mismatch Negativity Study

Ear and Hearing, Jul 1, 2016

Research paper thumbnail of Discussing Age-Related Hearing Loss and Cognitive Decline With Patients

JAMA otolaryngology-- head & neck surgery, Sep 1, 2019

Research paper thumbnail of Does Cochlear Implantation Improve Cognitive Function?

Laryngoscope, Jun 14, 2019

Research paper thumbnail of How Does Quality of Life Relate to Auditory Abilities? A Subitem Analysis of the Nijmegen Cochlear Implant Questionnaire

Journal of The American Academy of Audiology, Apr 1, 2020

Research paper thumbnail of What to Do When Cochlear Implant Users Plateau in Performance: a Pilot Study of Clinician-guided Aural Rehabilitation

Otology & Neurotology, Oct 1, 2018

Hypothesis: For experienced adult cochlear implant (CI) users who have reached a plateau in perfo... more Hypothesis: For experienced adult cochlear implant (CI) users who have reached a plateau in performance, a clinician-guided aural rehabilitation (AR) approach can improve speech recognition and hearing-related quality of life (QOL). Background: A substantial number of CI users do not reach optimal performance in terms of speech recognition ability and/or personal communication goals. Although self-guided computerized auditory training programs have grown in popularity, compliance and efficacy for these programs are poor. We propose that clinician-guided AR can improve speech recognition and hearing-related QOL in experienced CI users. Methods: Twelve adult CI users were enrolled in an 8-week AR program guided by a speechlanguage pathologist and audiologist. Nine patients completed the program along with pre-AR and immediate post-AR testing of speech recognition (AzBio sentences in quiet and in multi-talker babble, Consonant-Nucleus-Consonant words), QOL (Nijmegen Cochlear Implant Questionnaire, Hearing Handicap Inventory for Adults/Elderly, and Speech, Spatial and Qualities of Hearing Scale), and neurocognitive functioning (working memory capacity, information-processing speed, inhibitory control, speed of lexical/phonological access, and nonverbal reasoning). Pilot data for these 9 patients are presented. Results: From pre-AR to post-AR, group mean improvements in word recognition were found. Improvements were also demonstrated on some composite and subscale measures of QOL. Patients who demonstrated improvements in word recognition were those who performed most poorly at baseline. Clinician-guided AR represents a potentially efficacious approach to improving speech recognition and QOL for experienced CI users. Limitations and considerations in implementing and studying AR approaches are discussed.