Publications by authors named "William G Kronenberger"

87 Publications

Remote Assessment of Verbal Memory in Youth With Cochlear Implants During the COVID-19 Pandemic.

Am J Speech Lang Pathol 2021 03 18;30(2):740-747. Epub 2021 Mar 18.

Department of Otolaryngology - Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.

Purpose Youth with cochlear implants (CIs) are at risk for delays in verbal short-term memory (STM)/working memory (WM), which adversely affect language, neurocognitive, and behavioral outcomes. Assessment of verbal STM/WM is critical for identifying and addressing these delays, but standard assessment procedures require face-to-face (FTF) administration. The purpose of this study was to determine the feasibility and validity of remote testing methods (teleassessment) of verbal STM/WM in youth with CIs as a method of addressing COVID-19-related restrictions on FTF test administration. Method Tests of verbal STM/WM for nonwords, digit spans, letter-number sequences, sentences, and stories were individually administered by speech-language pathologists over a teleassessment platform to 28 youth (aged 9-22 years) with CIs and 36 same-aged normal-hearing peers. Examiners, parents, and participants completed quality and satisfaction ratings with the teleassessment procedure. Teleassessment scores were compared to results of tests obtained at FTF visits an average of 1.6 years earlier. Results Quality and satisfaction ratings for teleassessment were high and in almost all cases did not differ between the CI and normal-hearing samples. Youth with CIs scored lower than normal-hearing peers on measures of verbal STM/WM, and scores for digit span and letter-number sequencing did not differbetween teleassessment and FTF methods. Correlations across teleassessment and FTF visits were strong for digit span, letter-number sequencing, and sentence memory, but were more modest for nonword repetition. Conclusion With some caveats, teleassessment of verbal STM/WM was feasible and valid for youth with CIs.
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http://dx.doi.org/10.1044/2021_AJSLP-20-00276DOI Listing
March 2021

Recognizing spoken words in semantically-anomalous sentences: Effects of executive control in early-implanted deaf children with cochlear implants.

Cochlear Implants Int 2021 Mar 5:1-14. Epub 2021 Mar 5.

DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine.

To investigate differences in speech, language, and neurocognitive functioning in normal hearing (NH) children and deaf children with cochlear implants (CIs) using anomalous sentences. Anomalous sentences block the use of downstream predictive coding during speech recognition, allowing for investigation of rapid phonological coding and executive functioning. Extreme groups were extracted from samples of children with CIs and NH peers (ages 9 to 17) based on the 7 highest and 7 lowest scores on the Harvard-Anomalous sentence test (Harvard-A). The four groups were compared on measures of speech, language, and neurocognitive functioning. The 7 highest-scoring CI users and the 7 lowest-scoring NH peers did not differ in Harvard-A scores but did differ significantly on measures of neurocognitive functioning. Compared to low-performing NH peers, highperforming children with CIs had significantly lower nonword repetition scores but higher nonverbal IQ scores, greater verbal WM capacity, and excellent EF skills related to inhibition, shifting attention/mental flexibility and working memory updating. High performing deaf children with CIs are able to compensate for their sensory deficits and weaknesses in automatic phonological coding of speech by engaging in a slow effortful mode of information processing involving inhibition, working memory and executive functioning.
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http://dx.doi.org/10.1080/14670100.2021.1884433DOI Listing
March 2021

Family-Level Executive Functioning and At-Risk Pediatric Hearing Loss Outcomes.

J Speech Lang Hear Res 2021 Jan 29;64(1):218-229. Epub 2020 Dec 29.

DeVault Otologic Research Laboratory, Department of Otolaryngology, Indiana University School of Medicine, Indianapolis.

Purpose Using a new measure of family-level executive functioning (EF; the Family Characteristics Scale [FCS]), we investigated associations between family-level EF, spoken language, and neurocognitive skills in children with hearing loss (HL), compared to children with normal hearing. Method Parents of children with HL ( = 61) or children with normal hearing ( = 65) completed the FCS-Parent, and clinicians evaluated families using the FCS-Examiner. Children completed an age-appropriate version of the Concepts and Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the Peabody Picture Vocabulary Test-Fourth Edition. Child EF was assessed via the parent report Behavior Rating Inventory of Executive Function. Results Two higher order components were derived from FCS subscales: Family Inhibition and Family Organization. For both samples, Family Inhibition was positively associated with child inhibition, child shifting, and child language comprehension skills. Family Organization was differentially associated with child inhibition, working memory, and planning/organization skills across the samples. Additionally, Family Inhibition was associated with child planning and organization skills for children with HL. Conclusions Results support the FCS as a measure of family-level EF. Family-level inhibition related to better child inhibition, flexibility/shifting, and language comprehension across both samples and to better planning and organization skills in children with HL. As children with HL experienced greater difficulties in EF, families demonstrated greater organization, possibly as a compensatory measure. Results suggest that inhibition and organization at a family level may be important targets for the development of novel interventions to promote EF and language outcomes for children with HL.
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http://dx.doi.org/10.1044/2020_JSLHR-20-00342DOI Listing
January 2021

Word and Nonword Reading Efficiency in Postlingually Deafened Adult Cochlear Implant Users.

Otol Neurotol 2021 Mar;42(3):e272-e278

Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Hypothesis: This study tested the hypotheses that 1) experienced adult cochlear implants (CI) users demonstrate poorer reading efficiency relative to normal-hearing controls, 2) reading efficiency reflects basic, underlying neurocognitive skills, and 3) reading efficiency relates to speech recognition outcomes in CI users.

Background: Weak phonological processing skills have been associated with poor speech recognition outcomes in postlingually deaf adult CI users. Phonological processing can be captured in nonauditory measures of reading efficiency, which may have wide use in patients with hearing loss. This study examined reading efficiency in adults CI users, and its relation to speech recognition outcomes.

Methods: Forty-eight experienced, postlingually deaf adult CI users (ECIs) and 43 older age-matched peers with age-normal hearing (ONHs) completed the Test of Word Reading Efficiency (TOWRE-2), which measures word and nonword reading efficiency. Participants also completed a battery of nonauditory neurocognitive measures and auditory sentence recognition tasks.

Results: ECIs and ONHs did not differ in word (ECIs: M = 78.2, SD = 11.4; ONHs: M = 83.3, SD = 10.2) or nonword reading efficiency (ECIs: M = 42.0, SD = 11.2; ONHs: M = 43.7, SD = 10.3). For ECIs, both scores were related to untimed word reading with moderate to strong effect sizes (r = 0.43-0.69), but demonstrated differing relations with other nonauditory neurocognitive measures with weak to moderate effect sizes (word: r = 0.11-0.44; nonword: r = (-)0.15 to (-)0.42). Word reading efficiency was moderately related to sentence recognition outcomes in ECIs (r = 0.36-0.40).

Conclusion: Findings suggest that postlingually deaf adult CI users demonstrate neither impaired word nor nonword reading efficiency, and these measures reflect different underlying mechanisms involved in language processing. The relation between sentence recognition and word reading efficiency, a measure of lexical access speed, suggests that this measure may be useful for explaining outcome variability in adult CI users.
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http://dx.doi.org/10.1097/MAO.0000000000002925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874984PMC
March 2021

Functional hearing quality in prelingually deaf school-age children and adolescents with cochlear implants.

Int J Audiol 2021 Apr 1;60(4):282-292. Epub 2020 Oct 1.

Department of Otolaryngology - Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Objective: This study investigated differences in functional hearing quality between youth with cochlear implants (CIs) and normal hearing (NH) peers, as well as associations between functional hearing quality and audiological measures, speech perception, language and executive functioning (EF).

Design: Youth with CIs and NH peers completed measures of audiological functioning, speech perception, language and EF. Parents completed the Quality of Hearing Scale (QHS), a questionnaire measure of functional hearing quality.

Study Sample: Participants were 43 prelingually-deaf, early-implanted, long-term CI users and 43 NH peers aged 7-17 years.

Results: Compared to NH peers, youth with CIs showed poorer functional hearing quality on the QHS Speech, Localization, and Sounds subscales and more hearing effort on the QHS Effort subscale. QHS scores did not correlate significantly with audiological/hearing history measures but were significantly correlated with most speech perception, language and EF scores in the CI sample. In the NH sample, QHS scores were uncorrelated with speech perception and language and were inconsistently correlated with EF.

Conclusions: The QHS is a valid measure of functional hearing quality that is distinct from office-based audiometric or hearing history measures. Functional hearing outcomes are associated with speech-language and EF outcomes in CI users.
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http://dx.doi.org/10.1080/14992027.2020.1826586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012403PMC
April 2021

Adherence is a human behaviour, assessing it requires multimethod evaluation with validated measures: Comment on Guedes VG et al (2019).

Haemophilia 2020 Nov 4;26(6):934-936. Epub 2020 May 4.

Indiana Hemophilia and Thrombosis Center, Inc., Indianapolis, IN, USA.

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http://dx.doi.org/10.1111/hae.14022DOI Listing
November 2020

Letter to the Editor: Do Pediatric Cochlear Implant Recipients Display Domain-General Sequencing Difficulties? A Comment on.

Ear Hear 2020 Jul/Aug;41(4):1051-1054

Department of Otolaryngology - Head and Neck Surgery, DeVault Otologic Research Laboratory, Indiana University School of Medicine, Indianapolis, Indiana, USA.

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http://dx.doi.org/10.1097/AUD.0000000000000841DOI Listing
January 2021

Longitudinal Development of Executive Functioning and Spoken Language Skills in Preschool-Aged Children With Cochlear Implants.

J Speech Lang Hear Res 2020 04 23;63(4):1128-1147. Epub 2020 Mar 23.

DeVault Otologic Research Laboratory, Department of Otolaryngology, Indiana University School of Medicine, Indianapolis.

Purpose Auditory deprivation has downstream effects on the development of language and executive functioning (EF) in prelingually deaf children with cochlear implants (CIs), but little is known about the very early development of EF during preschool ages in children with CIs. This study investigated the longitudinal development of EF and spoken language skills in samples of children with normal hearing (NH; = 40) or CIs ( = 41) during preschool ages. Method Participants were enrolled in the study between ages 3 and 6 years and evaluated annually up to the age of 7 years. Mixed-effects models were used to evaluate and predict growth of spoken language and EF skills over time. Results Children with CIs scored lower than NH peers on language measures but improved significantly over time. On performance-based neurocognitive measures of controlled attention, inhibition, and working memory, children with CIs scored more poorly than the sample of NH peers but comparable to norms, whereas on a parent report behavior checklist, children with CIs scored more poorly than both NH peers and norms on inhibition and working memory. Children with CIs had poorer EF than the sample of NH peers in most domains even after accounting for language effects, and language predicted only the verbal working memory domain of EF. In contrast, EF skills consistently predicted language skills at subsequent visits. Conclusions Findings demonstrate that, despite significant improvement over time, some domains of EF (particularly parent-reported EF) and language skills in children with CIs lag behind those of children with NH during preschool ages. Language delays do not fully explain differences in EF development between children with CIs and NH peers during preschool ages, but EF skills predict subsequent language development in children with CIs.
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http://dx.doi.org/10.1044/2019_JSLHR-19-00247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242982PMC
April 2020

Associations Between Parenting Stress, Language Comprehension, and Inhibitory Control in Children With Hearing Loss.

J Speech Lang Hear Res 2020 01 15;63(1):321-333. Epub 2020 Jan 15.

DeVault Otologic Research Laboratory, Department of Otolaryngology, Indiana University School of Medicine, Indianapolis.

Purpose Parenting stress has been studied as a potential predictor of developmental outcomes in children with normal hearing and children who are deaf and hard of hearing. However, it is unclear how parenting stress might underlie at-risk spoken language and neurocognitive outcomes in this clinical pediatric population. We investigated parenting stress levels and the shared relations between parenting stress, language comprehension, and inhibitory control skills in children with and without hearing loss (HL) using a cross-sectional design. Method Families of children with HL ( 39) and with normal hearing ( 41) were tested. Children completed an age-appropriate version of the Concepts & Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the NIH Toolbox Flanker Test of Attention and Inhibitory control. Caregivers completed the Parenting Stress Index-Short Form 4. Results Parenting stress levels were not significantly different between parents of children with and without HL. A significant negative association was observed between parenting stress and our measure of language comprehension in children with HL. A negative association between parenting stress and inhibitory control skills was also found in families of children with HL, but not hearing children. The parenting stress-inhibitory control relationship was indirectly accounted for by delayed language comprehension skills in children with HL. Conclusion Even at moderate levels of parenting stress similar to parents of children with normal hearing, increases in parenting stress were associated with lower scores on our measures of language comprehension and inhibitory control in children with HL. Thus, parenting stress may underlie some of the variability in at-risk pediatric HL outcomes.
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http://dx.doi.org/10.1044/2019_JSLHR-19-00230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213483PMC
January 2020

Executive Functioning and Language Development in Children with Cochlear Implants.

Cochlear Implants Int 2019 ;20(Suppl 1):2-5

Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952116PMC
June 2020

Cognitive Functions in Adults Receiving Cochlear Implants: Predictors of Speech Recognition and Changes After Implantation.

Otol Neurotol 2020 03;41(3):e322-e329

Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Hypotheses: Significant variability in speech recognition outcomes is consistently observed in adults who receive cochlear implants (CIs), some of which may be attributable to cognitive functions. Two hypotheses were tested: 1) preoperative cognitive skills assessed visually would predict postoperative speech recognition at 6 months after CI; and 2) cochlear implantation would result in benefits to cognitive processes at 6 months.

Background: Several executive functioning tasks have been identified as contributors to speech recognition in adults with hearing loss. There is also mounting evidence that cochlear implantation can improve cognitive functioning. This study examined whether preoperative cognitive functions would predict speech recognition after implantation, and whether cognitive skills would improve as a result of CI intervention.

Methods: Nineteen post-lingually deafened adult CI candidates were tested preoperatively using a visual battery of tests to assess working memory (WM), processing speed, inhibition-concentration, and nonverbal reasoning. Six months post-implantation, participants were assessed with a battery of word and sentence recognition measures and cognitive tests were repeated.

Results: Multiple speech measures after 6 months of CI use were correlated with preoperative visual WM (symbol span task) and inhibition ability (stroop incongruent task) with moderate-to-large effect sizes. Small-to-large effect size improvements in visual WM, concentration, and inhibition tasks were found from pre- to post-CI. Patients with lower baseline cognitive abilities improved the most after implantation.

Conclusions: Findings provide evidence that preoperative cognitive factors contribute to speech recognition outcomes for adult CI users, and support the premise that implantation may lead to improvements in some cognitive domains.
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http://dx.doi.org/10.1097/MAO.0000000000002544DOI Listing
March 2020

Family Environment in Children With Hearing Aids and Cochlear Implants: Associations With Spoken Language, Psychosocial Functioning, and Cognitive Development.

Ear Hear 2020 Jul/Aug;41(4):762-774

Department of Speech and Hearing Sciences, Indiana University, Bloomington, Indiana, USA.

Objectives: To examine differences in family environment and associations between family environment and key speech, language, and cognitive outcomes in samples of children with normal hearing and deaf and hard-of-hearing (DHH) children who use hearing aids and cochlear implants.

Design: Thirty families of children with normal hearing (n = 10), hearing aids (n = 10), or cochlear implants (n = 10) completed questionnaires evaluating executive function, social skills, and problem behaviors. Children's language and receptive vocabulary were evaluated using standardized measures in the children's homes. In addition, families were administered a standardized in-home questionnaire and observational assessment regarding the home environment.

Results: Family environment overall was similar across hearing level and sensory aid, although some differences were found on parental responsivity and physical environment. The level of supportiveness and enrichment within family relationships accounted for much of the relations between family environment and the psychosocial and neurocognitive development of DHH children. In contrast, the availability of objects and experiences to stimulate learning in the home was related to the development of spoken language.

Conclusions: Whereas broad characteristics of the family environments of DHH children may not differ from those of hearing children, variability in family functioning is related to DHH children's at-risk speech, language, and cognitive outcomes. Results support the importance of further research to clarify and explain these relations, which might suggest novel methods and targets of family-based interventions to improve developmental outcomes.
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http://dx.doi.org/10.1097/AUD.0000000000000811DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190421PMC
July 2021

Assessing Higher Order Language Processing in Long-Term Cochlear Implant Users.

Am J Speech Lang Pathol 2019 11 16;28(4):1537-1553. Epub 2019 Oct 16.

Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.

Purpose The purpose of this study was to describe and explain individual differences in complex/higher order language processing in long-term cochlear implant (CI) users relative to normal-hearing (NH) peers. Method Measures of complex/higher order language processing indexed by the Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4) Core Language subtests were obtained from 53 long-term (≥ 7 years) CI users aged 9-29 years and 60 NH controls who did not differ in age, gender, or nonverbal IQ. Vocabulary knowledge and fast, automatic language processing (rapid phonological coding, verbal rehearsal speed, and speech intelligibility) were also assessed. Results CI users showed weaker performance than NH controls on all CELF-4 Core Language subtests. These differences remained for Formulated Sentences and Recalling Sentences even when vocabulary knowledge was statistically controlled. About 50% of the CI sample scored within the range of the NH sample on Formulated Sentences and Recalling Sentences, while the remaining 50% scored well below the NH sample on these subtests. Vocabulary knowledge, rapid phonological coding, verbal rehearsal speed, and speech intelligibility were more strongly correlated with CELF-4 subtest scores in the CI sample than in the NH sample. Conclusions Weaknesses in complex, higher order language processing shown by a subgroup of CI users compared to NH peers may result from delays in fast, automatic processing of language. These at-risk domains of language functioning could serve as targets for novel interventions for deaf children who experience suboptimal spoken language outcomes following cochlear implantation.
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http://dx.doi.org/10.1044/2019_AJSLP-18-0138DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251594PMC
November 2019

Projected Retained Ability Score (PRAS): A New Methodology for Quantifying Absolute Change in Norm-Based Psychological Test Scores Over Time.

Assessment 2021 03 13;28(2):367-379. Epub 2019 Sep 13.

Shire, a Takeda company, Lexington, MA, USA.

A limitation of norm-based ability test scores is that they can only be used to evaluate relative change (compared with change in the norm sample), as opposed to absolute (raw) change in performance from Time 1 to Time 2. To address this limitation, a novel method (Projected Retained Ability Score [PRAS]) was developed to characterize absolute change in norm-based ability test scores. The PRAS method was applied to Differential Ability Scales®-Second Edition (DAS-II) General Conceptual Ability (GCA) scores in three cases of children with the neurodegenerative condition mucopolysaccharidosis type II (MPS II) who were assessed at two visits, 16 to 23 months apart. Although all three cases showed declines in norm-based GCA scores, the PRAS method revealed differences in absolute change in performance. The PRAS method allows for differentiation of slower-than-average improvement or stabilization versus deterioration of cognitive ability when norm-based scores decline from Time 1 to Time 2.
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http://dx.doi.org/10.1177/1073191119872250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882996PMC
March 2021

Verbal Learning and Memory in Early-Implanted, Prelingually Deaf Adolescent and Adult Cochlear Implant Users.

J Speech Lang Hear Res 2019 04;62(4):1033-1050

Speech Research Laboratory, Department of Psychological and Brain Sciences, Indiana University, Bloomington.

Purpose The purpose of this study was to investigate the information-processing strategies of early-implanted, prelingually deaf cochlear implant (CI) users with the California Verbal Learning Test-Second Edition (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000 ), a well-established normed measure of verbal learning and memory used in neuropsychological assessments of memory loss. Method Verbal learning and memory skills were compared in 20 older adolescent and young adult prelingually deaf long-term early-implanted CI users and their 24 normal hearing (NH) peers using the CVLT-II, a widely used multitrial free recall test of verbal learning and memory. Results On average, CI users recalled fewer words than their NH peers across the immediate, delayed, and cued recall trials of the CVLT-II but were comparable to their NH peers on yes/no recognition memory. CI users showed little evidence of semantic clustering of words during free recall but greater serial clustering compared to their NH peers, suggesting fundamental disturbances in automatic semantic activation of words from long-term memory. No differences were found in verbal memory between CI users and their NH peers on measures of retroactive interference and encoding/retrieval interactions. Performance on the 2nd word list of the CVLT-II (List B) and amount of semantic clustering of words during recall were correlated with sentence recognition in the CI group. Conclusion Study findings demonstrate significant differences in free recall performance and information-processing strategies that early-implanted, prelingually deaf CI users use to encode, organize, store, and retrieve spoken words in conventional verbal list learning paradigms, compared to their NH peers. Because verbal learning and memory are core foundational processes routinely used in daily functioning for a wide range of neurocognitive and language processing operations, these findings suggest potential domains for assessment and novel interventions to promote the development of optimal outcomes in prelingually deaf early-implanted long-term CI users.
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http://dx.doi.org/10.1044/2018_JSLHR-H-18-0125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802885PMC
April 2019

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

J Speech Lang Hear Res 2019 04;62(4):1016-1032

Indiana University School of Medicine, Indianapolis.

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.
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http://dx.doi.org/10.1044/2018_JSLHR-H-18-0201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802891PMC
April 2019

Assessment of the Effects of Pediatric Attention Deficit Hyperactivity Disorder on Family Stress and Well-Being: Development of the IMPACT 1.0 Scale.

Glob Pediatr Health 2019 15;6:2333794X19835645. Epub 2019 Mar 15.

Indiana University, Indianapolis, IN, USA.

Medications may lessen core symptoms of attention deficit hyperactivity disorder (ADHD), yet families continue to report stress and have a low quality of life. Primary care providers manage almost half of all children with ADHD but do not have a brief measure to assess ADHD impacts on family in the context of everyday family life. The IMPACT (Impact Measure of Parenting-Related ADHD Challenges and Treatment) 1.0 Scale was codeveloped with input from parent advisors and administered to 79 parents of children with ADHD. Exploratory factor analysis, correlations with validated instruments, and test-retest reliability were examined. Exploratory factor analysis resulted in 4 subscales (Misbehavior, Siblings, Time, School), which demonstrated moderate to high test-retest reliability. Scale domains were related to severity and change in ADHD symptoms. Significant correlations were found between IMPACT scores, adaptive functioning in the home, and ADHD-related quality of life. The IMPACT 1.0 Scale provides a novel, reliable, and valid method to assess family impact of ADHD.
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http://dx.doi.org/10.1177/2333794X19835645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421607PMC
March 2019

High-Variability Sentence Recognition in Long-Term Cochlear Implant Users: Associations With Rapid Phonological Coding and Executive Functioning.

Ear Hear 2019 Sep/Oct;40(5):1149-1161

Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Objectives: The objective of the present study was to determine whether long-term cochlear implant (CI) users would show greater variability in rapid phonological coding skills and greater reliance on slow-effortful compensatory executive functioning (EF) skills than normal-hearing (NH) peers on perceptually challenging high-variability sentence recognition tasks. We tested the following three hypotheses: First, CI users would show lower scores on sentence recognition tests involving high speaker and dialect variability than NH controls, even after adjusting for poorer sentence recognition performance by CI users on a conventional low-variability sentence recognition test. Second, variability in fast-automatic rapid phonological coding skills would be more strongly associated with performance on high-variability sentence recognition tasks for CI users than NH peers. Third, compensatory EF strategies would be more strongly associated with performance on high-variability sentence recognition tasks for CI users than NH peers.

Design: Two groups of children, adolescents, and young adults aged 9 to 29 years participated in this cross-sectional study: 49 long-term CI users (≥7 years) and 56 NH controls. All participants were tested on measures of rapid phonological coding (Children's Test of Nonword Repetition), conventional sentence recognition (Harvard Sentence Recognition Test), and two novel high-variability sentence recognition tests that varied the indexical attributes of speech (Perceptually Robust English Sentence Test Open-set test and Perceptually Robust English Sentence Test Open-set test-Foreign Accented English test). Measures of EF included verbal working memory (WM), spatial WM, controlled cognitive fluency, and inhibition concentration.

Results: CI users scored lower than NH peers on both tests of high-variability sentence recognition even after conventional sentence recognition skills were statistically controlled. Correlations between rapid phonological coding and high-variability sentence recognition scores were stronger for the CI sample than for the NH sample even after basic sentence perception skills were statistically controlled. Scatterplots revealed different ranges and slopes for the relationship between rapid phonological coding skills and high-variability sentence recognition performance in CI users and NH peers. Although no statistically significant correlations between EF strategies and sentence recognition were found in the CI or NH sample after use of a conservative Bonferroni-type correction, medium to high effect sizes for correlations between verbal WM and sentence recognition in the CI sample suggest that further investigation of this relationship is needed.

Conclusions: These findings provide converging support for neurocognitive models that propose two channels for speech-language processing: a fast-automatic channel that predominates whenever possible and a compensatory slow-effortful processing channel that is activated during perceptually-challenging speech processing tasks that are not fully managed by the fast-automatic channel (ease of language understanding, framework for understanding effortful listening, and auditory neurocognitive model). CI users showed significantly poorer performance on measures of high-variability sentence recognition than NH peers, even after simple sentence recognition was controlled. Nonword repetition scores showed almost no overlap between CI and NH samples, and correlations between nonword repetition scores and high-variability sentence recognition were consistent with greater reliance on engagement of fast-automatic phonological coding for high-variability sentence recognition in the CI sample than in the NH sample. Further investigation of the verbal WM-sentence recognition relationship in CI users is recommended. Assessment of fast-automatic phonological processing and slow-effortful EF skills may provide a better understanding of speech perception outcomes in CI users in the clinical setting.
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http://dx.doi.org/10.1097/AUD.0000000000000691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504907PMC
March 2020

The Role of Statistical Learning in Understanding and Treating Spoken Language Outcomes in Deaf Children With Cochlear Implants.

Lang Speech Hear Serv Sch 2018 08;49(3S):723-739

Department of Psychology, Georgia State University, Atlanta.

Purpose: Statistical learning-the ability to learn patterns in environmental input-is increasingly recognized as a foundational mechanism necessary for the successful acquisition of spoken language. Spoken language is a complex, serially presented signal that contains embedded statistical relations among linguistic units, such as phonemes, morphemes, and words, which represent the phonotactic and syntactic rules of language. In this review article, we first review recent work that demonstrates that, in typical language development, individuals who display better nonlinguistic statistical learning abilities also show better performance on different measures of language. We next review research findings that suggest that children who are deaf and use cochlear implants may have difficulties learning sequential input patterns, possibly due to auditory and/or linguistic deprivation early in development, and that the children who show better sequence learning abilities also display improved spoken language outcomes. Finally, we present recent findings suggesting that it may be possible to improve core statistical learning abilities with specialized training and interventions and that such improvements can potentially impact and facilitate the acquisition and processing of spoken language.

Method: We conducted a literature search through various online databases including PsychINFO and PubMed, as well as including relevant review articles gleaned from the reference sections of other review articles used in this review. Search terms included various combinations of the following: sequential learning, sequence learning, statistical learning, sequence processing, procedural learning, procedural memory, implicit learning, language, computerized training, working memory training, statistical learning training, deaf, deafness, hearing impairment, hearing impaired, DHH, hard of hearing, cochlear implant(s), hearing aid(s), and auditory deprivation. To keep this review concise and clear, we limited inclusion to the foundational and most recent (2005-2018) relevant studies that explicitly included research or theoretical perspectives on statistical or sequential learning. We here summarize and synthesize the most recent and relevant literature to understanding and treating language delays in children using cochlear implants through the lens of statistical learning.

Conclusions: We suggest that understanding how statistical learning contributes to spoken language development is important for understanding some of the difficulties that children who are deaf and use cochlear implants might face and argue that it may be beneficial to develop novel language interventions that focus specifically on improving core foundational statistical learning skills.
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http://dx.doi.org/10.1044/2018_LSHSS-STLT1-17-0138DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198910PMC
August 2018

Language processing fluency and verbal working memory in prelingually deaf long-term cochlear implant users: A pilot study.

Cochlear Implants Int 2018 11 5;19(6):312-323. Epub 2018 Jul 5.

b DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery , Indiana University School of Medicine , Indianapolis , IN , USA.

Objective: Verbal working memory (WM) is more strongly correlated with spoken language skills in prelingually deaf, early-implanted cochlear implant (CI) users than in normal-hearing (NH) peers, suggesting that CI users access WM in order to support and compensate for their slower, more effortful spoken language processing. This pilot study tested the feasibility and validity of a dual-task method for establishing the causal role of WM in basic language processing (lexical access speed) in samples of 9 CI users (ages 8-26 years) and 9 NH peers.

Methods: Participants completed tests of lexical access speed (rapid automatized picture naming test and lexical decision test) under two administration conditions: a standard condition and a dual-task WM condition requiring participants to hold numerals in WM during completion of the lexical access speed tests.

Results: CI users showed more dual-task interference (decline in speed during the WM condition compared to the standard condition) than NH peers, indicating that their lexical access speed was more dependent on engagement of WM resources. Furthermore, dual-task interference scores were significantly correlated with several measures of speed-based executive functioning (EF), consistent with the hypothesis that the dual-task method reflects the involvement of EF in language processing.

Conclusion: These pilot study results support the feasibility and validity of the dual-task WM method for investigating the influence of WM in the basic language processing of CI users. Preliminary findings indicate that CI users are more dependent on the use of WM as a compensatory strategy during slow-effortful basic language processing than NH peers.
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http://dx.doi.org/10.1080/14670100.2018.1493970DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247421PMC
November 2018

Verbal learning and memory in prelingually deaf children with cochlear implants.

Int J Audiol 2018 10 22;57(10):746-754. Epub 2018 Jun 22.

b Department of Otolaryngology-Head and Neck Surgery , DeVault Otologic Research Laboratory , Indiana University School of Medicine , Indianapolis , IN , USA.

Objective: Deaf children with cochlear implants (CIs) show poorer verbal working memory compared to normal-hearing (NH) peers, but little is known about their verbal learning and memory (VLM) processes involving multi-trial free recall.

Design: Children with CIs were compared to NH peers using the California Verbal Learning Test for Children (CVLT-C).

Study Sample: Participants were 21 deaf (before age 6 months) children (6-16 years old) implanted prior to age 3 years, and 21 age-IQ matched NH peers.

Results: Results revealed no differences between groups in number of words recalled. However, CI users showed a pattern of increasing use of serial clustering strategies across learning trials, whereas NH peers decreased their use of serial clustering strategies. In the CI sample (but not in the NH sample), verbal working memory test scores were related to resistance to the build-up of proactive interference, and sentence recognition was associated with performance on the first exposure to the word list and to the use of recency recall strategies.

Conclusions: Children with CIs showed robust evidence of VLM comparable to NH peers. However, their VLM processing (especially recency and proactive interference) was related to speech perception outcomes and verbal WM in different ways from NH peers.
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http://dx.doi.org/10.1080/14992027.2018.1481538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215502PMC
October 2018

Three challenges for future research on cochlear implants.

World J Otorhinolaryngol Head Neck Surg 2017 Dec 2;3(4):240-254. Epub 2018 Jan 2.

Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, 43212, USA.

Cochlear implants (CIs) often work very well for many children and adults with profound sensorineural (SNHL) hearing loss. Unfortunately, while many CI patients display substantial benefits in recognizing speech and understanding spoken language following cochlear implantation, a large number of patients achieve poor outcomes. Understanding and explaining the reasons for poor outcomes following implantation is a very challenging research problem that has received little attention despite the pressing clinical significance. In this paper, we discuss three challenges for future research on CIs. First, we consider the issue of individual differences and variability in outcomes following implantation. At the present time, we still do not have a complete and satisfactory account of the causal underlying factors that are responsible for the enormous individual differences and variability in outcomes. Second, we discuss issues related to the lack of preimplant predictors of outcomes. Very little prospective research has been carried out on the development of preimplant predictors that can be used to reliably identify CI candidates who may be at high risk for a poor outcome following implantation. Other than conventional demographics and hearing history, there are no prognostic tools available to predict speech recognition outcomes after implantation. Finally, we discuss the third challenge - what to do with a CI-user who has a poor outcome. We suggest that new research efforts need to be devoted to studying this neglected clinical population in greater depth to find out why they are doing poorly with their CI and what novel interventions and treatments can be developed to improve their speech recognition outcomes. Using these three challenges as objectives for future research on CIs, we suggest that the field needs to adopt a new narrative grounded in theory and methods from Cognitive Hearing Science and information processing theory. Without knowing which specific biological and neurocognitive factors are responsible for individual differences or understanding the underlying sensory and neurocognitive basis for variability in performance, it is impossible to select a specific approach to habilitation after a deaf adult or child receives a CI. Deaf adults and children who are performing poorly with their CIs are not a homogeneous group and may differ in many different ways from each other, reflecting the dysfunction of multiple brain systems associated with both congenital and acquired deafness. Hearing loss is not only an ear issue, it is also a brain issue too reflecting close links between perception and action and brain, body and world working together as a functionally integrated information processing system to support robust speech recognition and spoken language processing after implantation.
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http://dx.doi.org/10.1016/j.wjorl.2017.12.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956139PMC
December 2017

Relations of Social Maturity, Executive Function, and Self-Efficacy Among Deaf University Students.

Deafness Educ Int 2018 17;20(2):100-120. Epub 2018 May 17.

Riley Child and Adolescent Psychiatry Clinic, Indiana University School of Medicine.

This study explored possible associations of social maturity, executive function (EF), self-efficacy, and communication variables among deaf university students, both cochlear implant (CI) users and nonusers. Previous studies have demonstrated differences between deaf and hearing children and young adults in EF and EF-related social and cognitive functioning. EF differences also have been demonstrated between hearing children and deaf children who use CIs. Long-term influences of cochlear implantation in the social domain largely have not been explored, but were examined in the present study in terms of social maturity, as it might be related to EF and communication variables. Replicating and extending recent findings, social maturity was found to be related to somewhat different aspects of EF in CI users, deaf nonusers, and hearing students, but unrelated to hearing status, CI use, or deaf students' use of sign language versus spoken language. Self-efficacy proved a predictor of self-reported socially mature and immature behaviours for all groups. Individuals' beliefs about their parents' views of such behaviours was a potent predictor of behaviours for deaf CI users and those deaf students who reported sign language as their best form of communication.
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http://dx.doi.org/10.1080/14643154.2018.1474330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756760PMC
May 2018

Verbal Learning and Memory After Cochlear Implantation in Postlingually Deaf Adults: Some New Findings with the CVLT-II.

Ear Hear 2018 Jul/Aug;39(4):720-745

Department of Otolaryngology, The Ohio State University, Columbus, Ohio, USA.

Objectives: Despite the importance of verbal learning and memory in speech and language processing, this domain of cognitive functioning has been virtually ignored in clinical studies of hearing loss and cochlear implants in both adults and children. In this article, we report the results of two studies that used a newly developed visually based version of the California Verbal Learning Test-Second Edition (CVLT-II), a well-known normed neuropsychological measure of verbal learning and memory.

Design: The first study established the validity and feasibility of a computer-controlled visual version of the CVLT-II, which eliminates the effects of audibility of spoken stimuli, in groups of young normal-hearing and older normal-hearing (ONH) adults. A second study was then carried out using the visual CVLT-II format with a group of older postlingually deaf experienced cochlear implant (ECI) users (N = 25) and a group of ONH controls (N = 25) who were matched to ECI users for age, socioeconomic status, and nonverbal IQ. In addition to the visual CVLT-II, subjects provided data on demographics, hearing history, nonverbal IQ, reading fluency, vocabulary, and short-term memory span for visually presented digits. ECI participants were also tested for speech recognition in quiet.

Results: The ECI and ONH groups did not differ on most measures of verbal learning and memory obtained with the visual CVLT-II, but deficits were identified in ECI participants that were related to recency recall, the buildup of proactive interference, and retrieval-induced forgetting. Within the ECI group, nonverbal fluid IQ, reading fluency, and resistance to the buildup of proactive interference from the CVLT-II consistently predicted better speech recognition outcomes.

Conclusions: Results from this study suggest that several underlying foundational neurocognitive abilities are related to core speech perception outcomes after implantation in older adults. Implications of these findings for explaining individual differences and variability and predicting speech recognition outcomes after implantation are discussed.
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http://dx.doi.org/10.1097/AUD.0000000000000530DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013309PMC
March 2019

Psychosocial Outcomes in Long-Term Cochlear Implant Users.

Ear Hear 2018 May/Jun;39(3):527-539

Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana.

Objectives: The objectives of this study were to investigate psychosocial outcomes in a sample of prelingually deaf, early-implanted children, adolescents, and young adults who are long-term cochlear implant (CI) users and to examine the extent to which language and executive functioning predict psychosocial outcomes.

Design: Psychosocial outcomes were measured using two well-validated, parent-completed checklists: the Behavior Assessment System for Children and the Conduct Hyperactive Attention Problem Oppositional Symptom. Neurocognitive skills were measured using gold standard, performance-based assessments of language and executive functioning.

Results: CI users were at greater risk for clinically significant deficits in areas related to attention, oppositional behavior, hyperactivity-impulsivity, and social-adaptive skills compared with their normal-hearing peers, although the majority of CI users scored within average ranges relative to Behavior Assessment System for Children norms. Regression analyses revealed that language, visual-spatial working memory, and inhibition-concentration skills predicted psychosocial outcomes.

Conclusions: Findings suggest that underlying delays and deficits in language and executive functioning may place some CI users at a risk for difficulties in psychosocial adjustment.
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http://dx.doi.org/10.1097/AUD.0000000000000504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6217966PMC
March 2019

Early Postimplant Speech Perception and Language Skills Predict Long-Term Language and Neurocognitive Outcomes Following Pediatric Cochlear Implantation.

J Speech Lang Hear Res 2017 08;60(8):2321-2336

Speech Research Laboratory, Department of Psychological and Brain Sciences, Indiana University, Bloomington.

Purpose: We sought to determine whether speech perception and language skills measured early after cochlear implantation in children who are deaf, and early postimplant growth in speech perception and language skills, predict long-term speech perception, language, and neurocognitive outcomes.

Method: Thirty-six long-term users of cochlear implants, implanted at an average age of 3.4 years, completed measures of speech perception, language, and executive functioning an average of 14.4 years postimplantation. Speech perception and language skills measured in the 1st and 2nd years postimplantation and open-set word recognition measured in the 3rd and 4th years postimplantation were obtained from a research database in order to assess predictive relations with long-term outcomes.

Results: Speech perception and language skills at 6 and 18 months postimplantation were correlated with long-term outcomes for language, verbal working memory, and parent-reported executive functioning. Open-set word recognition was correlated with early speech perception and language skills and long-term speech perception and language outcomes. Hierarchical regressions showed that early speech perception and language skills at 6 months postimplantation and growth in these skills from 6 to 18 months both accounted for substantial variance in long-term outcomes for language and verbal working memory that was not explained by conventional demographic and hearing factors.

Conclusion: Speech perception and language skills measured very early postimplantation, and early postimplant growth in speech perception and language, may be clinically relevant markers of long-term language and neurocognitive outcomes in users of cochlear implants.

Supplemental Materials: https://doi.org/10.23641/asha.5216200.
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http://dx.doi.org/10.1044/2017_JSLHR-H-16-0152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829806PMC
August 2017

Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants.

J Deaf Stud Deaf Educ 2017 Jul;22(3):278-289

The Ohio State University.

Deaf children with cochlear implants (CIs) are at risk for psychosocial adjustment problems, possibly due to delayed speech-language skills. This study investigated associations between a core component of spoken-language ability-speech intelligibility-and the psychosocial development of prelingually deaf CI users. Audio-transcription measures of speech intelligibility and parent reports of psychosocial behaviors were obtained for two age groups (preschool, school-age/teen). CI users in both age groups scored more poorly than typically hearing peers on speech intelligibility and several psychosocial scales. Among preschool CI users, five scales were correlated with speech intelligibility: functional communication, attention problems, atypicality, withdrawal, and adaptability. These scales and four additional scales were correlated with speech intelligibility among school-age/teen CI users: leadership, activities of daily living, anxiety, and depression. Results suggest that speech intelligibility may be an important contributing factor underlying several domains of psychosocial functioning in children and teens with CIs, particularly involving socialization, communication, and emotional adjustment.
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http://dx.doi.org/10.1093/deafed/enx001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074820PMC
July 2017

Some Neurocognitive Correlates of Noise-Vocoded Speech Perception in Children With Normal Hearing: A Replication and Extension of ).

Ear Hear 2017 May/Jun;38(3):344-356

1Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA; 2Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA; and 3Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Objectives: Noise-vocoded speech is a valuable research tool for testing experimental hypotheses about the effects of spectral degradation on speech recognition in adults with normal hearing (NH). However, very little research has utilized noise-vocoded speech with children with NH. Earlier studies with children with NH focused primarily on the amount of spectral information needed for speech recognition without assessing the contribution of neurocognitive processes to speech perception and spoken word recognition. In this study, we first replicated the seminal findings reported by ) who investigated effects of lexical density and word frequency on noise-vocoded speech perception in a small group of children with NH. We then extended the research to investigate relations between noise-vocoded speech recognition abilities and five neurocognitive measures: auditory attention (AA) and response set, talker discrimination, and verbal and nonverbal short-term working memory.

Design: Thirty-one children with NH between 5 and 13 years of age were assessed on their ability to perceive lexically controlled words in isolation and in sentences that were noise-vocoded to four spectral channels. Children were also administered vocabulary assessments (Peabody Picture Vocabulary test-4th Edition and Expressive Vocabulary test-2nd Edition) and measures of AA (NEPSY AA and response set and a talker discrimination task) and short-term memory (visual digit and symbol spans).

Results: Consistent with the findings reported in the original ) study, we found that children perceived noise-vocoded lexically easy words better than lexically hard words. Words in sentences were also recognized better than the same words presented in isolation. No significant correlations were observed between noise-vocoded speech recognition scores and the Peabody Picture Vocabulary test-4th Edition using language quotients to control for age effects. However, children who scored higher on the Expressive Vocabulary test-2nd Edition recognized lexically easy words better than lexically hard words in sentences. Older children perceived noise-vocoded speech better than younger children. Finally, we found that measures of AA and short-term memory capacity were significantly correlated with a child's ability to perceive noise-vocoded isolated words and sentences.

Conclusions: First, we successfully replicated the major findings from the ) study. Because familiarity, phonological distinctiveness and lexical competition affect word recognition, these findings provide additional support for the proposal that several foundational elementary neurocognitive processes underlie the perception of spectrally degraded speech. Second, we found strong and significant correlations between performance on neurocognitive measures and children's ability to recognize words and sentences noise-vocoded to four spectral channels. These findings extend earlier research suggesting that perception of spectrally degraded speech reflects early peripheral auditory processes, as well as additional contributions of executive function, specifically, selective attention and short-term memory processes in spoken word recognition. The present findings suggest that AA and short-term memory support robust spoken word recognition in children with NH even under compromised and challenging listening conditions. These results are relevant to research carried out with listeners who have hearing loss, because they are routinely required to encode, process, and understand spectrally degraded acoustic signals.
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http://dx.doi.org/10.1097/AUD.0000000000000393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404985PMC
March 2018

Visual-spatial sequence learning and memory in trained musicians.

Psychol Music 2017 Jan 13;45(1):5-21. Epub 2016 Apr 13.

DeVault Otologic Research Laboratory, Department of Otolaryngology-HNS, Indiana University School of Medicine, Indianapolis, IN, USA.

Previous research has shown that musicians have enhanced visual-spatial abilities and sensorymotor skills. As a result of their long-term musical training and their experience-dependent activities, musicians may learn to associate sensory information with fine motor movements. Playing a musical instrument requires musicians to rapidly translate musical symbols into specific sensory-motor actions while also simultaneously monitoring the auditory signals produced by their instrument. In this study, we assessed the visual-spatial sequence learning and memory abilities of long-term musicians. We recruited 24 highly trained musicians and 24 nonmusicians, individuals with little or no musical training experience. Participants completed a visual-spatial sequence learning task as well as receptive vocabulary, nonverbal reasoning, and short-term memory tasks. Results revealed that musicians have enhanced visual-spatial sequence learning abilities relative to nonmusicians. Musicians also performed better than nonmusicians on the vocabulary and nonverbal reasoning measures. Additional analyses revealed that the large group difference observed on the visualspatial sequencing task between musicians and nonmusicians remained even after controlling for vocabulary, nonverbal reasoning, and short-term memory abilities. Musicians' improved visualspatial sequence learning may stem from basic underlying differences in visual-spatial and sensorymotor skills resulting from long-term experience and activities associated with playing a musical instrument.
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http://dx.doi.org/10.1177/0305735616638942DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483398PMC
January 2017

Long-term musical experience and auditory and visual perceptual abilities under adverse conditions.

J Acoust Soc Am 2016 09;140(3):2074

Department of Otolaryngology-HNS, Indiana University School of Medicine, 705 Riley Hospital Drive, Indianapolis, Indiana 46202, USA.

Musicians have been shown to have enhanced speech perception in noise skills. It is unclear whether these improvements are limited to the auditory modality, as no research has examined musicians' visual perceptual abilities under degraded conditions. The current study examined associations between long-term musical experience and visual perception under noisy or degraded conditions. The performance of 11 musicians and 11 age-matched nonmusicians was compared on several auditory and visual perceptions in noise measures. Auditory perception tests included speech-in-noise tests and an environmental sound in noise test. Visual perception tasks included a fragmented sentences task, an object recognition task, and a lip-reading measure. Participants' vocabulary knowledge and nonverbal reasoning abilities were also assessed. Musicians outperformed nonmusicians on the speech perception in noise measures as well as the visual fragmented sentences task. Musicians also displayed better vocabulary knowledge in comparison to nonmusicians. Associations were found between perception of speech and visually degraded text. The findings show that long-term musical experience is associated with modality-general improvements in perceptual abilities. Possible systems supporting musicians' perceptual abilities are discussed.
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http://dx.doi.org/10.1121/1.4962628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734909PMC
September 2016