Auditory Cognitive Training for Pediatric Cochlear Implant Recipients

Objectives: Understanding speech in noise is the biggest challenge
faced by individuals with cochlear implants (CIs). Improving speech-innoise
perception for pediatric CI recipients continues to remain a high
priority for all stakeholders. This study was designed to investigate the
efficacy of working memory training for improving speech-in-noise recognition
for children with CIs.
Design: Fourteen children with CIs (aged 6 to 15 years) received adaptive,
home-based training on forward digit span task for 5 weeks,
while 13 children with CIs participated in backward digit span training.
Seventeen age-matched children with CIs in the control group received a
placebo. Outcome measures included forward and backward digit span
and speech recognition threshold for digit triplets in noise at pretraining,
post-training, and 5-week follow-up. Performance measures from
26 age-matched children with normal hearing were also obtained only
at the baseline session to generate normative standards for comparison.
Results: Digit span scores were significantly higher at post-training and
follow-up compared with pretraining for both forward- and backwardtrained
groups. Both trained groups showed similar training-induced
shifts. The control group showed no such improvement. There was no
effect of training on the speech recognition threshold. Children with CIs
showed significantly lower digit span scores and a higher speech recognition
threshold relative to children with normal hearing.
Conclusions: Training improves working memory capacity as measured
by digit spans for children with CIs. Training-induced improvements are
stable for at least 5 weeks. Learning effects demonstrate near-transfer,
from forward to backward digit span and vice versa, but failed to show
far-transfer to speech-in-noise recognition. Current evidence is not supportive
of cognitive training for improving speech-in-noise performance
for children with CIs.