High-Variability Sentence Recognition in Long-Term Cochlear Implant Users: Associations With Rapid Phonological Coding and Executive Functioning.
Gretchen N L Smith, David B Pisoni, William G Kronenberger
PMID 30601227WHAT IT FOUND
Long-term cochlear implant users struggle more than normal hearing peers with sentences spoken by multiple talkers and dialects.
This difficulty is linked to how quickly they can repeat non-words, not to their executive function. Clinicians should test these high-variability skills to better understand real-world listening challenges.
Key findings
01Cochlear implant users scored significantly lower than normal hearing peers on high-variability sentence recognition tests, even after accounting for their performance on standard single-talker sentence recognition.
02For cochlear implant users, the ability to repeat non-words was strongly correlated with sentence recognition scores, whereas this relationship was not significant for normal hearing peers.
03No statistically significant correlations were found between executive functioning measures and sentence recognition for either group after correcting for multiple comparisons.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is correlational, so it cannot prove that poor phonological coding causes poor sentence recognition. Executive function tests were administered approximately two years before the sentence recognition tests, which may have weakened any potential associations. The sample size was limited, and the strict statistical correction used may have hidden small but real relationships between executive function and listening performance. The high-variability tests used were still relatively simple sentences and may not reflect the complexity of everyday conversation.
The easy way to misread this
Do not conclude that executive functioning is unimportant for cochlear implant users. The study found no significant links, but the authors note that the statistical correction was very conservative and the time gap between tests may have obscured real effects. The lack of significance here does not rule out a role for cognitive effort in listening.