Spoken Language Processing in Cochlear Implant Users Under Perceptually Challenging Conditions: Fluent-Automatic Versus Slow-Effortful Neurocognitive Processing
Gretchen N.L. Smith1, William G. Kronenberger1, David B. Pisoni2; 1Indiana University School of Medicine, 2Indiana University
Reduced early exposure to auditory experience and language in deaf children with cochlear implants (CIs) may impact the self-organizing processes of central nervous system connectivity recruited for fluent-automatic spoken language processing (Kral et al., 2016), increasing reliance on slow-effortful language processing strategies compared to normal-hearing (NH) peers. This effect may be particularly strong under challenging language processing tasks such as when the speech of different talkers must be processed and recognized or when down-stream contextual cues are minimal or ambiguous. The present study tested two hypotheses:(1) that CI users with stronger fluent-automatic phonological coding skills would perform better on challenging-complex sentence recognition tasks; and (2) that CI users would show a greater decrement in performance than NH peers on challenging-complex sentence recognition tasks compared to simple/basic sentence recognition tasks. CI (n=49) and NH (n=56) samples were scored on measures of rapid phonological coding and challenging sentence recognition including the Perceptually Robust English Sentence Test Open-set (PRESTO) and Harvard Anomalous Sentence Recognition Test (Harvard-A). CI users scored lower than NH peers on PRESTO and Harvard-A (p<.001) tests even when basic sentence perception skills were controlled. Correlations between rapid phonological coding and PRESTO and Harvard-A scores were stronger for the CI sample (r=.84,r=.89,p<.001) than for the NH sample (r=.27,r=.36,p<.05). These findings are consistent with the Auditory Neurocognitive Model (Kronenberger & Pisoni, in press) which proposes that CI users are more dependent on slow, controlled-effortful language processing strategies, including recruitment of executive functions, during complex-challenging spoken language processing tasks compared to NH peers.
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