Title: Maximizing Cochlear Implant Benefits with Short-Term AR Intervention
Names and Affiliations of Authors:
1. Claire Bernstein- Gallaudet University
2. Diane Brewer- George Washington University
3. Matthew Bakke- Gallaudet University
Speaker: Claire Bernstein
Date: November 6, 2013; 12-1 PM
Room: LeFrak Hall Room 2208
Abstract:
Purpose: The purpose of this study is to evaluate the efficacy of aural rehabilitation (AR) intervention to improve outcomes for adult cochlear implant users. By taking advantage of neuroplasticity, auditory training may offer an avenue for enhancing the benefits afforded by the cochlear implant device. The proposed research will examine whether short-term auditory training, can significantly improve the speech recognition abilities of post-lingually deafened adult cochlear implant users. A second goal is to assess the additional benefit of communication strategies training in concert with informational counseling. The hypothesis is that AR intervention will improve psychosocial outcomes including self-perceived communication function, hearing handicap, quality of life and self-confidence.
Method:A total of 30 adult cochlear implant users will be randomly assigned to either the AR intervention protocol or a control group. The AR Protocol is an intensive 6 week training program that combines Informational Counseling, Communication Strategies Training, and Auditory Training for 1 and ½ hours each week. The informational counseling and communication strategies training are both structured yet sufficiently flexible to respond to specific communication needs of each client. The auditory training component is primarily top-down/synthetic training (with speech tracking and sentence identification tasks) with some bottom-up/analytic training (vowel and consonant contrasts) that is adaptive to each client’s level of function. The Control group protocol consists of cognitive exercises.
Multiple outcome measures (pre-intervention, one week, two months and 6 months post-intervention) are used to quantify the effectiveness of the short-term AR protocol. Speech recognition is assessed using the CasperSent sentence intelligibility test. Quality of Life/Self-Assessment measures include the Hearing Handicap Inventory for Adults or Elderly (HHIE/HHIA) (Newman et al, 1990, Ventry and Weinstein, 1982); the Client Oriented Scale of Improvement (COSI) (Dillon et al., 1997); the Nijmegen Cochlear Implant Questionnaire (NCIQ) (Hinderink et al., 2000); Visual Analog Scale, and the Glasgow Benefit Inventory (GBI) (Robinson et al., 1996). These combined self-assessment measures will provide insight into the impact of AR training on communication performance and psychosocial function – personal adjustment, participation or withdrawal from activities, and quality of life.
Results: Data for the first twelve participants will be presented. Participants in the AR intervention group showed improvement in both speech recognition and psychosocial benefit, including areas of personal adjustment and decreased hearing handicap. No improvement in speech recognition was seen for participants in the control group but there were some reports of greater self-confidence. These preliminary results suggest that short-term AR intervention can help maximize outcomes for post-lingually deafened adult cochlear implant users.
