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-in-noise 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 backward-trained 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.