SLPNarrative ReviewEar and hearing2017

Multisensory Integration in Cochlear Implant Recipients.

Ryan A Stevenson, Sterling W Sheffield, Iliza M Butera and 2 others

PMID 28399064

WHAT IT FOUND

Cochlear implant users often understand speech better when they can see and hear it, especially words and phonemes.

Gains vary with age at implantation, experience, and task; emotion and pitch benefits are less reliable.

Key findings

01Adult cochlear implant users showed consistent improvement in phoneme perception under audiovisual conditions, reported as 15- to 20-percentage points compared with unimodal perception in quiet.

02Children with cochlear implants can require up to one year of implant experience before word and sentence audiovisual benefits appear, and gains can continue increasing for at least five years.

03For pitch, emphasis, and emotion, the reviewed studies did not show the audiovisual benefit seen in normal-hearing listeners.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

This is a review of published studies, not a new trial, so it cannot establish that any clinical procedure works. The included studies used different ages, implant histories, hearing-loss onset, residual hearing, communication backgrounds, stimuli, and outcome measures. Many studies were small or preliminary, and some lacked visual-only or normal-hearing comparison conditions needed to interpret audiovisual gain. Neural evidence is limited by implant artifacts and small samples. The review does not combine the study results into an overall estimate, so it cannot rank the strength of evidence for specific clinical recommendations.

Declared interests

The article states that no conflicts of interest or sources of funding are declared for any of the other authors.

The easy way to misread this

Do not conclude that adding visual cues always improves cochlear implant speech performance. The review found benefits mainly for phoneme, word, and sentence tasks, not for pitch or emotion, and a training study found audiovisual training did not improve auditory-only performance.

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