Dataset Information

Evaluating Pediatric Cochlear Implant Users' Encoding, Storage, and Retrieval Strategies in Verbal Working Memory.

ABSTRACT: Purpose The current study adopts a systematic approach to the examination of working memory components in pediatric cochlear implant (CI) users by separately assessing contributions of encoding, storage, and retrieval. Method Forty-nine long-term CI users and 56 typically hearing controls completed forward and backward span tasks with 3 stimulus sets: visually presented digits, pictures of concrete nouns, and novel symbols. In addition, measures associated with each memory stage were collected: Rapid digit naming provided an estimate of phonological recoding speed, nonword repetition assessed the robustness of representations within phonological storage, and vocabulary knowledge (as measured by the Peabody Picture Vocabulary Test; Dunn & Dunn, 1997 ) estimated redintegration abilities during retrieval. Results Linear mixed modeling revealed that digit naming speed and vocabulary knowledge were consistently related to short-term and working memory span in both CI users and typically hearing controls. However, nonword repetition only contributed to the model for short-term memory. Conclusions Nonword repetition, an index of phonological storage, explained little of the individual variability inworking memory differences between CI users and typically hearing peers. On the other hand, individual differences in encoding and retrieval explained a significant amount of outcome variability in both short-term and working memory tasks. Differences between CI users and typically hearing peers in working memory therefore appear to reflect process components of encoding and retrieval and not simply differences in memory storage. Supplemental Material https://doi.org/10.23641/asha.7849394.

SUBMITTER: AuBuchon AM

PROVIDER: S-EPMC6802891 | biostudies-other | 2019 Apr

REPOSITORIES: biostudies-other

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Evaluating Pediatric Cochlear Implant Users' Encoding, Storage, and Retrieval Strategies in Verbal Working Memory.

AuBuchon Angela M AM Pisoni David B DB Kronenberger William G WG

Journal of speech, language, and hearing research : JSLHR 20190401 4

Purpose The current study adopts a systematic approach to the examination of working memory components in pediatric cochlear implant (CI) users by separately assessing contributions of encoding, storage, and retrieval. Method Forty-nine long-term CI users and 56 typically hearing controls completed forward and backward span tasks with 3 stimulus sets: visually presented digits, pictures of concrete nouns, and novel symbols. In addition, measures associated with each memory stage were collected: ...[more]

PMID: 30986139

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Project description:ObjectivesCochlear implants (CIs) are remarkable in allowing individuals with severe to profound hearing loss to perceive speech. Despite these gains in speech understanding, however, CI users often struggle to perceive elements such as vocal emotion and prosody, as CIs are unable to transmit the spectro-temporal detail needed to decode affective cues. This issue becomes particularly important for children with CIs, but little is known about their emotional development. In a previous study, pediatric CI users showed deficits in voice emotion recognition with child-directed stimuli featuring exaggerated prosody. However, the large intersubject variability and differential developmental trajectory known in this population incited us to question the extent to which exaggerated prosody would facilitate performance in this task. Thus, the authors revisited the question with both adult-directed and child-directed stimuli.DesignVocal emotion recognition was measured using both child-directed (CDS) and adult-directed (ADS) speech conditions. Pediatric CI users, aged 7-19 years old, with no cognitive or visual impairments and who communicated through oral communication with English as the primary language participated in the experiment (n = 27). Stimuli comprised 12 sentences selected from the HINT database. The sentences were spoken by male and female talkers in a CDS or ADS manner, in each of the five target emotions (happy, sad, neutral, scared, and angry). The chosen sentences were semantically emotion-neutral. Percent correct emotion recognition scores were analyzed for each participant in each condition (CDS vs. ADS). Children also completed cognitive tests of nonverbal IQ and receptive vocabulary, while parents completed questionnaires of CI and hearing history. It was predicted that the reduced prosodic variations found in the ADS condition would result in lower vocal emotion recognition scores compared with the CDS condition. Moreover, it was hypothesized that cognitive factors, perceptual sensitivity to complex pitch changes, and elements of each child's hearing history may serve as predictors of performance on vocal emotion recognition.ResultsConsistent with our hypothesis, pediatric CI users scored higher on CDS compared with ADS speech stimuli, suggesting that speaking with an exaggerated prosody-akin to "motherese"-may be a viable way to convey emotional content. Significant talker effects were also observed in that higher scores were found for the female talker for both conditions. Multiple regression analysis showed that nonverbal IQ was a significant predictor of CDS emotion recognition scores while Years using CI was a significant predictor of ADS scores. Confusion matrix analyses revealed a dependence of results on specific emotions; for the CDS condition's female talker, participants had high sensitivity (d' scores) to happy and low sensitivity to the neutral sentences while for the ADS condition, low sensitivity was found for the scared sentences.ConclusionsIn general, participants had higher vocal emotion recognition to the CDS condition which also had more variability in pitch and intensity and thus more exaggerated prosody, in comparison to the ADS condition. Results suggest that pediatric CI users struggle with vocal emotion perception in general, particularly to adult-directed speech. The authors believe these results have broad implications for understanding how CI users perceive emotions both from an auditory communication standpoint and a socio-developmental perspective.

Project description:Neuroprostheses designed to interface with the nervous system to replace injured or missing senses can significantly improve a patient's quality of life. The challenge remains to provide implants that operate optimally over several decades. Changes in the implant-tissue interface may precede performance problems. Tools to identify and characterize such changes using existing clinical measures would be highly valuable. Modern cochlear implant (CI) systems allow easy and regular measurements of electrode impedance (EI). This measure is routinely performed as a hardware integrity test, but it also allows a level of insight into the immune-mediated response to the implant, which is associated with performance outcomes. This study is a 5-year retrospective investigation of MED-EL CI users at the University of Southampton Auditory Implant Service including 176 adult ears (18-91) and 74 pediatric ears (1-17). The trend in EI in adults showed a decrease at apical electrodes. An increase was seen at the basal electrodes which are closest to the surgery site. The trend in the pediatric cohort was increasing EI over time for nearly all electrode positions, although this group showed greater variability and had a smaller sample size. We applied an outlier-labeling rule to statistically identify individuals that exhibit raised impedance. This highlighted 14 adult ears (8%) and 3 pediatric ears (5%) with impedance levels that deviated from the group distribution. The slow development of EI suggests intra-cochlear fibrosis and/or osteogenesis as the underlying mechanism. The usual clinical intervention for extreme impedance readings is to deactivate the relevant electrode. Our findings highlight some interesting clinical contradictions: some cases with raised (but not extreme) impedance had not prompted an electrode deactivation; and many cases of electrode deactivation had been informed by subjective patient reports. This emphasizes the need for improved objective evidence to inform electrode deactivations in borderline cases, for which our outlier-labeling approach is a promising candidate. A data extraction and analysis protocol that allows ongoing and automated statistical analysis of routinely collected data could benefit both the CI and wider neuroprosthetics communities. Our approach provides new tools to inform practice and to improve the function and longevity of neuroprosthetic devices.

Dataset Information

Evaluating Pediatric Cochlear Implant Users' Encoding, Storage, and Retrieval Strategies in Verbal Working Memory.

Publications

Evaluating Pediatric Cochlear Implant Users' Encoding, Storage, and Retrieval Strategies in Verbal Working Memory.

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