Sentences In Quiet Research Articles

Investigating the Minimal Clinically Important Difference for AzBio and CNC Speech Recognition Scores.

To assess the minimal clinically important difference (MCID) values for cochlear implant-related speech recognition scores, which have not been previously reported. Retrospective cohort. Tertiary referral center. Eight hundred sixty-three adult patients who underwent cochlear implantation between 2009 and 2022. MCID values for consonant-nucleus-consonant (CNC) word scores and AzBio sentences in quiet and noise scores using distribution-based methods (half-standard deviation, standard error of measurement, Cohen's d, and minimum detectable change). In this cohort, the mean preoperative CNC word score was 13.9% (SD, 15.6). The mean preoperative AzBio sentences in quiet score was 19.1% (SD, 22.1), and the mean preoperative AzBio sentences in noise score was 13.0% (SD, 12.0). The average MCID values of several distribution-based methods for CNC, AzBio in quiet, and AzBio in noise were 7.4%, 9.0%, and 4.9%, respectively. Anchor-based approaches with the Speech, Spatial, and Qualities of hearing patient-reported measure did not have strong classification accuracy across CNC or AzBio in quiet and noise scores (ROC areas under-the-curve ≤0.69), highlighting weak associations between improvements in speech recognition scores and subjective hearing-related abilities. Our estimation of MCID values for CNC and AzBio in quiet and noise allows for enhanced patient counseling and clinical interpretation of past, current, and future research studies assessing cochlear implant outcomes.

When to Start Computer-Based Auditory Training After Cochlear Implantation: Effects on Quality of Life and Speech Recognition.

Computer-based auditory training (CBAT) has been shown to improve outcomes in adult cochlear implant (CI) users. This study evaluates in new CI users whether starting CBAT within 3 months of activation or later impacts CI outcomes. Prospective natural experiment. Tertiary academic medical center. Sixty-five new adult CI users. CBAT use over the first-year postactivation. Speech recognition scores and CIQOL-35 Profile score improvements between CI recipients who started CBAT resources early (<3 mo) and late (3-12 mo) postactivation. A total of 43 CI recipients started using CBAT within 3 months postactivation (early) and 22 after 3 months (late). Patients who used CBAT within 3 months postactivation showed significantly greater improvement in consonant-nucleus-consonant words (CNCw) (48.3 ± 24.2% vs 27.8 ± 24.9%; d = 0.84), AzBio Sentences in quiet (55.1 ± 28.0% vs 35.7 ± 36.5%; d = 0.62), and CIQOL-35 listening domain scores (18.2 ± 16.3 vs 6.9 ± 12.9, d = 0.73 [0.023, 1.43]), at 3 months postactivation, compared to those who had not yet initiated CBAT. However, by 12 months postactivation, after which all CI recipients had started CBAT, there were no differences observed between patients who started CBAT early or late in speech recognition scores (CNCw: d = 0.26 [-0.35, 0.88]; AzBio: d = 0.37 [-0.23, 0.97]) or in any CIQOL global or domain score (d-range = 0.014-0.47). Auditory training with self-directed computer software (CBAT) may yield speech recognition and quality-of-life benefits for new adult CI recipients. While early users showed greater improvement in outcomes at 3 months postactivation than users who started later, both groups achieved similar benefits by 12 months postactivation.

Auditory distraction during reading: Investigating the effects of background sounds on parafoveal processing.

Previous research suggests that unexpected (deviant) sounds negatively affect reading performance by inhibiting saccadic planning, which models of reading agree takes place simultaneous to parafoveal processing. This study examined the effect of deviant sounds on foveal and parafoveal processing. Participants read single sentences in quiet, standard (repeated sounds), or deviant sound conditions (a new sound within a repeated sound sequence). Sounds were presented with a variable delay coincident with the onset of fixations on target words during a period when saccadic programming and parafoveal processing occurred. We used the moving window paradigm to manipulate the amount of information readers could extract from the parafovea (the entire sentence or a 13-character window of text). Global, sentence-level analyses showed typical disruption to reading by the window, and under quiet conditions similar effects were observed at the target and post-target word in the local analyses. Standard and deviant sounds also produced clear distraction effects of differing magnitudes at the target and post-target words, though at both regions, these effects were qualified by interactions. Effects at the target word suggested that with sounds, readers engaged in less effective parafoveal processing than under quiet. Similar patterns of effects due to standard and deviant sounds, each with a different time course, occurred at the post-target word. We conclude that distraction via auditory deviation causes disruption to parafoveal processing during reading, with such effects being modulated by the degree to which a sound's characteristics are more or less unique.

Morphosyntactic agreement in English: does it help the listener in noise?

English morphosyntactic agreement, such as determiner–noun agreement in These cabs broke down and noun–verb agreement in The cabs break down, has a few interesting properties that enable us to investigate whether agreement has a psycholinguistic function, that is, whether it helps the listener process linguistic information expressed by a speaker. The present project relies on these properties in a perception experiment, examines the two aforementioned types of English agreement, and aims at analyzing whether and how native English listeners benefit from agreement. The two types of agreement were contrasted with cases without any overtly agreeing elements (e.g. The cabs broke down). Native speakers of English with normal hearing heard short English sentences in quiet and in more or less intense white noise and were requested to indicate whether the second word of the sentence (e.g. These cabs broke down) was a singular or plural noun. Accuracy was entered as the response variable in the binomial logistic regression model. Results showed that overt determiner–noun agreement clearly increased response accuracy, while noun–verb agreement had at best marginal effects. The findings are interpreted against the background of functional aspects of linguistic structures in English, in the context of unfavorable listening conditions in particular.

AI model for predicting adult cochlear implant candidacy using routine behavioral audiometry

ObjectiveTo describe an AI model to facilitate adult cochlear implant candidacy prediction based on basic demographical data and standard behavioral audiometry. MethodsA machine-learning approach using retrospective demographic and audiometric data to predict candidacy CNC word scores and AzBio sentence in quiet scores was performed at a tertiary academic center. Data for the model were derived from adults completing cochlear implant candidacy testing between January 2011 and March 2023. Comparison of the prediction model to other published prediction tools and benchmarks was performed. ResultsThe final dataset included 770 adults, encompassing 1045 AzBio entries, and 1373 CNC entries. Isophoneme scores and word recognition scores exhibited strongest importance to both the CNC and AzBio prediction models, followed by standard pure tone average and low-frequency pure tone average. The mean absolute difference between the predicted and actual score was 15 percentage points for AzBio sentences in quiet and 13 percentage points for CNC word scores, approximating anticipated test-retest constraints inherent to the variables incorporated into the model. Our final combined model achieved an accuracy of 87 % (sensitivity: 90 %; precision: 80 %). ConclusionWe present an adaptive AI model that predicts adult cochlear implant candidacy based on routine behavioral audiometric and basic demographical data. Implementation efforts include a public-facing online prediction tool and accompanying smartphone program, an embedded notification flag in the electronic medical record to alert providers of potential candidates, and a program to retrospectively engage past patients who may be eligible for cochlear implantation based on audiogram results.

Perceptual weighting of acoustic cues to contrastive prosody for sentences in quiet and in noise

Prosody is used to mark important information in speech, yet despite this important role in everyday communication it is not a customary part of speech recognition testing in routine audiometry. Listeners might fail to perceive meaningful emphasis on a specific word signaled by prosodic cues despite repeating the words correctly. This study introduces a new paradigm for assessing perception of prosodic cues that are used to signify new/corrective information in a sentence. Stimuli consisted of spoken sentences where one word (in various sentence positions) was emphasized through acoustic modifications across the entire utterance, in a manner that corrected wrong information. Participants used a visual analog scale to mark the timing and degree of emphasis aligned with the target words. Perceptual data in this study are linked with acoustic measures of voice pitch contour, intensity, and duration to characterize how contrastive stress cues are recovered by listeners with and without cochlear implants, who are especially at risk for poorer pitch perception. Follow-up conditions used stimuli where acoustic cues (F0, duration, intensity) were manipulated independently to explore perceptual cue weighting, and the perseverance of these cues through background noise.

Predicting Early Cochlear Implant Performance: Can Cognitive Testing Help?

There is significant variability in speech recognition outcomes in adults who receive cochlear implants (CIs). Little is known regarding cognitive influences on very early CI performance, during which significant neural plasticity occurs. Prospective study of 15 postlingually deafened adult CI candidates tested preoperatively with a battery of cognitive assessments. The mini-mental state exam (MMSE), forward digit span, Stroop measure of inhibition-concentration, and test of word reading efficiency were utilized to assess cognition. consonant-nucleus-consonant words, AZBio sentences in quiet, and AZBio sentences in noise (+10 dB SNR) were utilized to assess speech recognition at 1- and 3-months of CI use. Performance in all speech measures at 1-month was moderately correlated with preoperative MMSE, but these correlations were not strongly correlated after correcting for multiple comparisons. There were large correlations of forward digit span with 1-month AzBio quiet (P ≤ 0.001, rho = 0.762) and AzBio noise (P ≤ 0.001, rho = 0.860), both of which were strong after correction. At 3 months, forward digit span was strongly predictive of AzBio noise (P ≤ 0.001, rho = 0.786), which was strongly correlated after correction. Changes in speech recognition scores were not correlated with preoperative cognitive test scores. Working memory capacity significantly predicted early CI sentence recognition performance in our small cohort, while other cognitive functions assessed did not. These results differ from prior studies predicting longer-term outcomes. Findings and further studies may lead to better preoperative counseling and help identify patients who require closer evaluation to ensure optimal CI performance.

Intelligibility of British and American English in different listening conditions

Communication specialists frequently hear complaints from patients that unfamiliar accents are more difficult to understand, particularly in background noise. Previous work (Schilaty et al., 2021) has indeed shown that when presenting American listeners with both American and British accents, intelligibility in noise is poorer for the unfamiliar accent across age and hearing status. However, Schilaty et al. (2021) examined relatively easy sentence materials (Basic English Lexicon [BEL] sentences; Calandruccio &amp; Smiljanic, 2012) in only one type of noise. The current study expands on previous work by comparing the intelligibility of American and British accents for a more difficult sentence set (Harvard sentences; Rothauser et al., 1969) in young adult American listeners across two noise types (speech-shaped noise and 12-talker babble). Stimuli consisted of 180 Harvard sentences produced by two male talkers: one with an American (Northwestern) dialect and one with a Southern British dialect. Young adult listeners with normal hearing transcribed the sentences in quiet, in speech-shaped noise at −3 dB SNR, and in 12-talker babble at −3 dB SNR. Listeners also completed a dialect familiarity questionnaire. The results will shed additional light on the interactions between talker and listener dialect, dialect familiarity, and background noise type.

Coordinated Same- or Next-Day Radiosurgery and Cochlear Implantation for Vestibular Schwannoma.

To describe the experience and results from coordinated and closely scheduled radiosurgery and cochlear implantation (CI) in a vestibular schwannoma (VS) cohort. Patients with VS who underwent radiosurgery followed by CI on the same or next day. Interventions included sequential radiosurgery and CI. Tumor control defined by tumor growth on posttreatment surveillance and audiometric outcomes including consonant-nucleus-consonant words and AzBio sentences in quiet. In total, six patients were identified that met the inclusion criteria, with an age range of 38 to 69 years and tumor sizes ranging from 2.0 to 16.3 mm. All patients successfully underwent radiosurgery and CI on the same or immediately successive day. Postoperatively, all patients obtained open-set speech recognition. Consonant-nucleus-consonant word scores ranged from 40 to 88% correct, and AzBio scores ranged from 44 to 94% correct. During posttreatment magnetic resonance imaging surveillance, which ranged from 12 to 68 months, all tumors were noted to be adequately visualized, and no tumor progression was noted. Coordinated radiosurgery and CI can be safely performed in patients with VS on the same or next day, serving to decrease burden on patients and increase access to this vital rehabilitative strategy.

Computer-based Auditory Training by New Adult Cochlear Implant Recipients Is Associated With Durable Improvements in Cochlear Implant Quality of Life.

The process of adapting to communicate with a cochlear implant (CI) is complex. The use of auditory training after cochlear implantation may help to facilitate improvements in postoperative speech recognition and quality-of-life outcomes in new adult CI recipients. However, the effectiveness of auditory training remains uncertain and long-term effects have not been examined in a large sample of new adult CI users. As such, the objective of this study was to examine the influence of common forms of auditory training on speech recognition and CI-related quality-of-life (CI-related QOL) outcomes at 1 year after cochlear implantation. We hypothesized that patients who reported use of computer-based auditory training (CBAT) would show improved speech and CIQOL-35 Profile scores at 1 year after activation of their implant, compared with their peers. This study was designed as a prospective study and was undertaken at a tertiary academic CI center. Participants included 114 adults undergoing cochlear implantation for bilateral hearing loss. Patients serially self-reported use of the following types of post-CI auditory training over their first-year postactivation: (1) face-to-face training (e.g., speech-language pathologist), (2) passive home-based training (e.g., listening to audiobooks), and (3) CBAT (e.g., self-directed software). Outcomes measures for this study included change in Consonant-Nucleus-Consonant phoneme (CNCp), CNC word (CNCw), AzBio sentences in quiet, and CIQOL-35 Profile global and domain scores from pre-CI to 12-mo post-CI. Of 114 patients, 94 (82.5%) used one or more auditory training resources. Of these, 19.3% used face-to-face training, 67.5% passive home-based training, and 46.5% CBAT. Of 114 patients, 73 had complete CIQOL data. At 12 mo, only CBAT use was associated with significantly greater improvements in global and all domain-specific CIQOL scores ( d -range = 0.72-0.87), compared with those not using CBAT. Controlling for demographics and use of multiple training resources, CBAT remained the strongest positive predictor of CIQOL improvement, with significant associations with global score (ß = 12.019[4.127,19.9]) and all domain scores at 12-mo post-CI: communication (ß = 11.937[2.456,21.318), emotional (ß = 12.293[1.827,22.759), entertainment (ß = 17.014[5.434,28.774), environment (ß = 13.771[1.814,25.727]), listening effort (ß = 12.523[2.798,22.248]), and social (ß = 18.114[7.403,28.826]). No significant benefits were noted with use of CBAT or any other form of auditory training and speech recognition scores at 12-mo post-CI ( d -range = -0.12-0.22). Auditory training with CBAT was associated with improved CI-related QOL outcomes at 12-mo post-CI. Given its availability and low cost, this study provides evidence to support using CBAT to improve real-world functional abilities in new adult CI recipients.

Variability in Receptive Language Development Following Bilateral Cochlear Implantation.

The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.

Improved Cochlear Implant Performance Estimation Using Tonotopic-Based Electrocochleography

Cochlear implantation produces remarkable results in postlingual deafness, although auditory outcomes vary. Electrocochleography (ECochG) has emerged as a valuable tool for assessing the cochlear-neural substrate and evaluating patient prognosis. To assess whether ECochG-total response (ECochG-TR) recorded at the best-frequency electrode (BF-ECochG-TR) correlates more strongly with speech perception performance than ECochG-TR measured at the round window (RW-ECochG-TR). This single-center cross-sectional study recruited 142 patients from July 1, 2021, to April 30, 2022, with 1-year follow-up. Exclusions included perilymph suctioning, crimped sound delivery tubes, non-native English speakers, inner ear malformations, nonpatent external auditory canals, or cochlear implantation revision surgery. Cochlear implantation. Speech perception testing, including the consonant-nucleus-consonant (CNC) words test, AzBio sentences in quiet, and AzBio sentences in noise plus 10-dB signal to noise ratio (with low scores indicating poor performance and high scores indicating excellent performance on all tests), at 6 months postoperatively; and RW-ECochG-TR and BF-ECochG-TR (measured for 250, 500, 1000, and 2000 Hz). A total of 109 of the 142 eligible postlingual adults (mean [SD] age, 68.7 [15.8] years; 67 [61.5%] male) were included in the study. Both BF-ECochG-TR and RW-ECochG-TR were correlated with 6-month CNC scores (BF-ECochG-TR: r = 0.74; 95% CI, 0.62-0.82; RW-ECochG-TR: r = 0.67; 95% CI, 0.54-0.76). A multivariate model incorporating age, duration of hearing loss, and angular insertion depth did not outperform BF-ECochG-TR or RW-ECochG-TR alone. The BF-ECochG-TR correlation with CNC scores was significantly stronger than the RW-ECochG-TR correlation (r difference = -0.18; 95% CI, -0.31 to -0.01; z = -2.02). More moderate correlations existed between 6-month AzBio scores in noise, Montreal Cognitive Assessment (MoCA) scores (r = 0.46; 95% CI, 0.29-0.60), and BF-ECochG-TR (r = 0.42; 95% CI, 0.22-0.58). MoCA and the interaction between BF-ECochG-TR and MoCA accounted for a substantial proportion of variability in AzBio scores in noise at 6 months (R2 = 0.50; 95% CI, 0.36-0.61). In this case series, BF-ECochG-TR was identified as having a stronger correlation with cochlear implantation performance than RW-ECochG-TR, although both measures highlight the critical role of the cochlear-neural substrate on outcomes. Demographic, audiologic, and surgical factors demonstrated weak correlations with cochlear implantation performance, and performance in noise was found to require a robust cochlear-neural substrate (BF-ECochG-TR) as well as sufficient cognitive capacity (MoCA). Future cochlear implantation studies should consider these variables when assessing performance and related interventions.

Cochlear Implant Outcomes between Patients with Sporadic and Neurofibromatosis Type 2-Associated Vestibular Schwannoma.

Compare cochlear implant (CI) performance between patients with ipsilateral sporadic vestibular schwannoma (VS) and NF2-related schwannomatosis (NF2). Compare CI performance according to VS management modality. Historical cohort. Tertiary academic center. Forty-nine patients (52 ears) undergoing cochlear implantation in the setting of ipsilateral sporadic (n = 21) or NF2-associated VS (n = 28). CI ipsilateral to VS. Auditory thresholds, consonant-nucleus-consonant (CNC) word scores, and AzBio sentences in quiet scores. Among all patients, median post-CI pure tone average was 28 dB HL (interquartile range [IQR], 21-38), CNC word score was 39% (IQR, 6-62), and AzBio sentences in quiet score was 60% (IQR, 11-83) at a median of 12.5 months postimplantation. Despite the NF2 cohort having larger tumors, when comparing patients with sporadic versus NF2-associated VS, there were no statistically significant differences in CNC word (49% [30-70] vs. 31% [0-52]) or AzBio sentences in quiet (66% [28-80] vs. 57% [5-83]) scores. Regardless of NF2 status, all patients managed with observation, and radiosurgery achieved open-set speech. In patients who underwent microsurgery, 6 (46%) of 13 with NF2 achieved open-set speech recognition compared with 4 (67%) of 6 with sporadic disease. Select patients with VS achieve successful hearing rehabilitation with a CI. In this cohort, tumor management strategy significantly influenced CI performance, whereas differences in NF2 status exhibited less effect. Specifically, all patients managed with observation or radiosurgery achieved open-set speech perception, whereas approximately half of people with NF2-related VS and two-thirds of people with sporadic VS achieved this outcome after tumor microsurgery. When disease permits, observation and radiosurgery should be considered in patients who may later pursue a CI.

Impact of Patient Frailty on Speech Recognition and Quality of Life Outcomes in Adult Cochlear Implant Users.

The process of cochlear implantation (CI) and subsequent post-cochlear implant care is extensive and can be difficult to navigate for patients considered medically frail. This study investigates potential impact of patient frailty on speech recognition and quality of life outcomes after CI. Retrospective review of a prospectively maintained database. Tertiary cochlear implant center. Three hundred seventy adults undergoing CI for traditional bilateral hearing loss indication. None. Comparison of pre-CI to 12-month post-CI change in consonant-nucleus-consonant phoneme/words, AzBio sentences in quiet/+10SNR, and Cochlear Implant Quality of Life (CIQOL)-35 Profile domain and global scores based on degree of patient frailty as assessed using the five-factor modified frailty index and Charlson Comorbidity Index. The average age at implantation was 65.4 years (±SD, 15.7; 19-94 years). Overall, there were minimal to absent and nonsignificant differences in speech recognition outcomes (consonant-nucleus-consonant phoneme/words, and AzBio sentences +10SNR) based on pre-CI patient frailty. The exception was less improvement in AzBio quiet sentence score in patients noted to be severely frail based on Charlson Comorbidity Index (57.1% vs. 35.2%, d = 0.7 [0.3, 1]). Similar findings were observed for CIQOL-35 Profile domain and global scores where no associations were found other than decreased improvement in the social domain in patients noted to be severely frail (21.7 vs. -0.3, d = 1 [0.4, 1.7]). Although some differences in outcomes were noted based on cochlear implant user frailty, these were small and isolated to only a few outcome measures. Therefore, assuming the patient is medically safe for surgery, preoperative frailty should not dissuade clinicians from recommending CI.

Evaluation of the American English Matrix Test with Cochlear Implant Recipients

Objective Currently, the variety of speech recognition tests used to evaluate cochlear implant (CI) recipients makes it difficult to compare results, especially across languages. The Matrix Test limits contextual cues and is available in multiple languages, including American English. The current study investigated test format and noise type for the American English Matrix Test (AMT) and compared results to AzBio sentence scores in adult CI recipients. Design Fifteen experienced CI recipients were administered the AMT in fixed- and adaptive-level formats and AzBio sentences in a fixed-level format. Testing in noise used the AMT-specific noise and 4-talker babble. Results Ceiling effects were present for all AMT fixed-level conditions and AzBio sentences in quiet. Group mean AzBio scores were poorer than AMT scores. Noise type affected performance regardless of format; 4-talker babble was more challenging. Conclusions The limited number of word choices in each category likely aided listeners performance for the AMT compared to AzBio sentences. The use of the AMT in the designed adaptive-level format would allow effective evaluation and comparison of CI performance internationally. A test battery with the AMT may also benefit from including AzBio sentences in 4-talker babble to reflect performance during listening challenges.

Effect of cochlear implantation on speech recognition under different listening modes in children

Objective:To investigate speech recognition among children with a unilateral cochlear implant（CI）, bilateral CI, and bimodal hearing and identify the benefits of binaural hearing. Methods:A total of 67 children with severe sensorineural hearing loss who received bilateral CI, bimodal hearing, and unilateral CI from 2012 to 2021 were recruited, including 23 cases with unilateral CI, 25 cases of bimodal hearing, and 19 cases of bilateral CI. The aided hearing threshold at 250-4000 Hz and speech recognition performance of two-syllable words and short sentences in quiet and noisy environments were tested, respectively. Results:There was no significant difference in the hearing threshold results of the bilateral CI group, the bimodal hearing group, and the unilateral CI group by ANOVA（P>0.05）. According to the paired t-test within the group, the speech recognition of disyllabic words and short sentences in quiet and noisy environments were significantly different among the three groups（P<0.05）. There was no significant difference in the speech recognition rates of disyllabic words and short sentences among the three groups in a quiet environment（P>0.05）, but there was a statistically significant difference in a noisy environment（P<0.05）. Additional multiple linear regression analysis showed no significant difference in the recognition rates of disyllabic words and short sentences between the bimodal group and the bilateral CI group in quiet and noisy environments（β=-0.567, P>0.05; β=-0.643, P>0.05）. There was a statistically significant difference in speech recognition of disyllabic words and short sentences between the bimodal group and the unilateral CI group in the noise environment（β=-0.124, P<0.05）, but the difference was not statistically significant in a quiet environment（β=-0.671, P>0.05）; there was a statistically significant difference in the recognition rate of disyllabic words and short sentences between the bilateral CI group and the unilateral CI group in the noise environment（β=-0.226, P<0.05）, but the difference was not statistically significant in a quiet environment（β=-0.341, P>0.05）. Conclusion:Clinicians and guardians are encouraged to provide the most comprehensive audiological evaluation for children with hearing loss. Bilateral CI and bimodal hearing have demonstrated enormous advantages over unilateral CI regarding speech recognition in noise. Bimodal hearing deems a strong recommendation if the contralateral ear has sufficient speech recognition capability. Bilateral CI should be warranted if hearing aids deemed to be ineffective.

Noise-induced change of tone dispersion in Cantonese speech

Noise effect on speaking non-tonal languages is reported on acoustic correlates including increased intensity, enlarged vowel space and raised fundamental frequency. Adverse influence may also be present in realization of tones, which however remains under-explored. Tone-space size and the according tone dispersion offer key indicators to the nature of a tonal system. The present study investigates whether and how Cantonese tones are modified in speaking under noise. Adult native speakers of Cantonese read tri-syllabic words embedded in carrier sentences in quiet and under multi-talker babbles. The speech materials cover six tones (T55, T25, T33, T21, T23, T22) and are balanced between high-low and low-high tone combinations to avoid biased articulatory effects. Results confirm Lombard speech effect in Cantonese speaking. Moreover, under the noise condition, tone spaces of all six tones are enlarged and tones are more dispersed, especially in realization of T55 and T21 that mark the upper and lower ranges of the tonal space. Changes in tone production by female speakers are more significant than those in male speech. This study provides new evidence of phonetic accommodation under noise and in particular noise effects on sizes of tone space, which is not found in the production of monosyllabic words in Cantonese. Our speakers may have used labored speech production to compensate for signal degradation under babble noise, leading to higher dispersion of tones than clear speech in quiet.

Association of Cognitive Impairment Screening Scores With Improvements in Speech Recognition and Quality of Life After Cochlear Implantation

Many cochlear implant centers screen patients for cognitive impairment as part of the evaluation process, but the utility of these scores in predicting cochlear implant outcomes is unknown. To determine whether there is an association between cognitive impairment screening scores and cochlear implant outcomes. Retrospective case series of adult cochlear implant recipients who underwent preoperative cognitive impairment screening with the Montreal Cognitive Assessment (MoCA) from 2018 to 2020 with 1-year follow-up at a single tertiary cochlear implant center. Data analysis was performed on data from January 2018 through December 2021. Cochlear implantation. Preoperative MoCA scores and mean (SD) improvement (aided preoperative to 12-month postoperative) in Consonant-Nucleus-Consonant phonemes (CNCp) and words (CNCw), AzBio sentences in quiet (AzBio Quiet), and Cochlear Implant Quality of Life-35 (CIQOL-35) Profile domain and global scores. A total of 52 patients were included, 27 (52%) of whom were male and 46 (88%) were White; mean (SD) age at implantation was 68.2 (13.3) years. Twenty-three (44%) had MoCA scores suggesting mild and 1 (2%) had scores suggesting moderate cognitive impairment. None had been previously diagnosed with cognitive impairment. There were small to medium effects of the association between 12-month postoperative improvement in speech recognition measures and screening positive or not for cognitive impairment (CNCw mean [SD]: 48.4 [21.9] vs 38.5 [26.6] [d = -0.43 (95% CI, -1.02 to 0.16)]; AzBio Quiet mean [SD]: 47.5 [34.3] vs 44.7 [33.1] [d = -0.08 (95% CI, -0.64 to 0.47)]). Similarly, small to large effects of the associations between 12-month postoperative change in CIQOL-35 scores and screening positive or not for cognitive impairment were found (global: d = 0.32 [95% CI, -0.59 to 1.23]; communication: d = 0.62 [95% CI, -0.31 to 1.54]; emotional: d = 0.26 [95% CI, -0.66 to 1.16]; entertainment: d = -0.005 [95% CI, -0.91 to 0.9]; environmental: d = -0.92 [95% CI, -1.86 to 0.46]; listening effort: d = -0.79 [95% CI, -1.65 to 0.22]; social: d = -0.51 [95% CI, -1.43 to 0.42]). In this case series, screening scores were not associated with the degree of improvement of speech recognition or patient-reported outcome measures after cochlear implantation. Given the prevalence of screening positive for cognitive impairment before cochlear implantation, preoperative screening can be useful for early identification of potential cognitive decline. These findings support that screening scores may have a limited role in preoperative counseling of outcomes and should not be used to limit candidacy.

Effect of Background Noise on PTE Listening Test Scores for Korean and Native English Listeners

This study compares the effect that background noise has on the listening comprehension scores on the Pearson Test of English between first language (L1) English listeners and Korean, second language (L2) listeners of English. The extent to which L2 listeners are at a greater disadvantage when listening to more complex academic sentences in noise requires further investigation. A group of 16 Korean L2 listeners and a comparison group of 11 L1 English listeners were asked to repeat academic sentences in quiet, a small amount of noise and a greater amount of noise. L2 listeners obtained significantly poorer word recognition scores when listening in a larger amount of noise compared to when listening in the two other conditions. In addition, L2 listeners attained lower word recognition scores than native listeners across all three conditions.

Predictive Ability of First-Side Cochlear Implant Performance in Adult Sequential Bilateral Cochlear Implantation.

Predictors of second-side cochlear implant performance have not been well studied. We sought to assess whether speech recognition scores from first-side cochlear implant (CI1) could predict second-side cochlear implant (CI2) scores in sequential bilaterally implanted adults. Retrospective review using a prospectively collected database. Academic tertiary care hospital. Fifty-seven adults with postimplantation speech recognition testing performed at least 12 months after CI2. Sequential bilateral CI. CI2 performance at ≥12 months as measured using consonant-nucleus-consonant (CNC) words and AzBio sentences in quiet and +10 dB signal-to-noise ratio (S/N). CI1 performance scores at ≥12 months were independently associated with CI2 performance scores at ≥12 months for CNC words (β = 0.371 [0.136-0.606], p = 0.003), AzBio sentences in quiet (β = 0.614 [0.429-0.80], p < 0.0001), and AzBio +10 dB S/N (β = 0.712 [0.459-0.964], p < 0.0001). CI1 scores on AzBio in quiet at 0 to 6 months were also independently associated with CI2 AzBio in quiet scores at ≥12 months (β = 0.389 [0.004-0.774], p = 0.048). Hearing loss etiology and duration, age at implantation, interval between CI1 and CI2, duration of hearing aid use, and preimplantation speech recognition testing scores were not consistently associated with CI2 scores at ≥12 months. CI1 performance is an independent predictor of second-side performance as measured ≥12 months postimplantation. This may be a clinically useful metric when considering adult sequential bilateral implantation.