The Important Role of Contextual Information in Speech Perception in Cochlear Implant Users and Its Consequences in Speech Tests.
J. Gertjan Dingemanse, André Goedegebure
PMID 30991904WHAT IT FOUND
Cochlear implant users relied more on sentence context than normal-hearing listeners.
Scoring words from sentences was sensitive, but high scores hit ceiling; adding noise kept scores responsive.
Key findings
01Cochlear implant users showed higher context use than normal-hearing listeners for both words and sentences.
02Scoring words from sentences was most sensitive for reliably detecting changes in sensory information when isolated phoneme scores were below 0.75, but above 0.75 it reached a ceiling and became insensitive.
03After basic word recognition was accounted for, greater use of sentence context was related to better verbal working memory.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Test-retest reliability was not measured; it was derived from a model, and sentence list variability in CI users was not known. Only CI users with at least 60% phoneme scores and who could perform the noise test at 50% correct were included, so results do not apply to people with much poorer implant performance. The CI and normal-hearing groups were not age matched, and the mean ages differed. The study tested context within words and sentences only; it did not test real-life context from topics, lipreading, or other visual cues. Some context measures were model-based, not direct patient outcomes.
The easy way to misread this
Do not conclude that sentence tests are better for all cochlear implant users. Word scoring of sentences was sensitive only when isolated phoneme scores were below 0.75; above that it reached ceiling and became insensitive.