ORIGINAL RESEARCH article
Front. Audiol. Otol.
Sec. Clinical Research in Auditory Implants and Hearing Aids
Volume 3 - 2025 | doi: 10.3389/fauot.2025.1625799
Beyond Auditory Sensitivity: Cognitive and Linguistic Influences on Clinical Performance in Post-lingual Adult Cochlear Implant Users
Provisionally accepted
- 1Department of Otolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
- 2Cluster of Excellence “Hearing4All”, Hannover, Germany
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Introduction: Speech understanding in cochlear implant (CI) users is influenced by various factors, particularly cognitive and linguistic abilities. While previous studies have explored both bottom-up and top-down processes in speech comprehension, this study focuses specifically on the role of cognitive and linguistic factors in shaping speech recognition outcomes in postlingually deafened adults. Methods: Fifty-eight postlingually deafened adults, with at least 12 months of CI experience, participated in this study as part of the Dawson et al. (2025) dataset. Participants were categorized into Poor Performers (n = 25; ≤ 35% word recognition at 65 dB SPL) and Good Performers (n = 33; ≥ 65% word recognition at 65 dB SPL). Participants with single-sided deafness were excluded to avoid confounding effects. Cognitive and linguistic variables, including vocabulary size (Wortschatztest, WST), processing speed (Symbol Digit Modality Test, SDMT), and executive control (Stroop Test), were assessed. Descriptive statistics were calculated to explore group differences, and Cohen's d was used to assess effect sizes. Statistical tests included univariate linear regression for individual predictors and multiple linear regression for the overall model. Results: The results indicated that larger vocabulary size, faster processing speed, and higher educational level were significantly associated with better speech performance. Additionally, younger age at testing correlated with improved outcomes, while early onset hearing loss (before age 7) was linked to poorer performance. Discussion: These findings emphasize the critical influence of cognitive and linguistic abilities, early auditory experiences, and educational background on cochlear implant outcomes. Together, these factors significantly predict speech understanding, highlighting the need to consider them in rehabilitation planning and comprehensive assessments to guide targeted interventions.
Keywords: Cochlear Implants, Speech performance, poor performer, Linguistic skills, neurocognitive functions
Received: 09 May 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Buczak, Kludt, Lenarz and Büchner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Nadine Buczak, Department of Otolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
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