Predicting Speech Recognition in Adults Receiving Cochlear Implants

项目摘要/摘要： 获得性听力损失正变得越来越普遍，特别是随着老龄化人口的增长。 对许多人来说，听力损失严重到需要植入人工耳蜗。虽然很多成年人 人工耳蜗(CI)通过他们的设备很好地理解语音，巨大的无法解释的可变性 存在于语音识别结果以及语音识别改进的轨迹中(即， 知觉学习)植入后。不幸的是，由于这种无法解释的变异性，临床医生 无法预测一个人在使用CI时的表现如何，无法解释为什么某人的语言能力很差 对CI的认可，或设计适当的康复策略来帮助贫困个人 性能。目前，这种结果的可变性只有一半可以用传统的临床方法来解释。 最近的研究表明，CI用户在语音识别方面的个体差异反映了 更基本的感觉(“自下而上”)和认知-语言(“自上而下”)因素的可变性。这些因素 应该解释CI结果的额外变异性，以及一个综合的模型 需要传统的临床措施以及自下而上和自上而下的因素。总的目标是 拟议的项目是为了填补关于CI中无法解释的可变性来源的知识空白 语音识别结果和知觉学习。目标1将决定在多大程度上 自下而上感觉功能的操作测量和自上而下的认知-语言过程预测CI 语音识别结果。目标2将调查附加目标自下而上的程度 感觉过程，特别是它们与自上而下因素的相互作用，解释了句子识别。目标 3将研究语音识别中的知觉学习在前两个过程中的轨迹 使用CI的年限。本研究项目的发现将具有重要的理论和临床意义。 通过全面描述自下而上和自上而下的贡献和相互作用的影响 与语音识别的可变性相关的因素，以及帮助临床医生更好地预测 术前和术后了解知觉学习的结果和时间进程 发生在植入后。

Project Summary/Abstract: Acquired hearing loss is becoming increasingly common, especially with the growth of the aging population. For many individuals, hearing loss is severe enough to warrant cochlear implantation. While many adults with cochlear implants (CIs) understand speech well through their devices, enormous unexplained variability exists in speech recognition outcomes, as well as in the trajectory of speech recognition improvement (i.e., perceptual learning) after implantation. Unfortunately, because of this unexplained variability, clinicians are unable to predict how an individual will perform with a CI, to explain why someone has poor speech recognition with a CI, or to design appropriate rehabilitation strategies to help an individual with poor performance. Currently, only half of this outcome variability can be explained by traditional clinical measures. Recent studies have suggested that individual differences in speech recognition among CI users reflect variability in more basic sensory (“bottom-up”) and cognitive-linguistic (“top-down”) factors. These factors should explain additional variability in CI outcomes, and a comprehensive integrative model incorporating traditional clinical measures along with bottom-up and top-down factors is needed. The overall objective of the proposed project is to fill the gap in knowledge regarding the sources of unexplained variability in CI speech recognition outcomes and perceptual learning. Aim 1 will determine the degree to which pre- operative measures of bottom-up sensory functions and top-down cognitive-linguistic processes predict CI speech recognition outcomes. Aim 2 will investigate the degree to which additional objective bottom-up sensory processes, and especially their interactions with top-down factors, explain sentence recognition. Aim 3 will investigate the trajectories of perceptual learning in speech recognition that occur during the first two years of CI use. The findings from this research project will have important theoretical and clinical implications by comprehensively delineating the contributions and interactions of bottom-up and top-down factors as they relate to variability in recognition of speech, as well as helping clinicians to better predict pre-operatively and understand post-operatively the outcomes and time course of perceptual learning that occurs after implantation.