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Purpose

This study examines how cochlear implant users understand and comprehend speech in realistic communication situations. Through six experiments measuring listening effort via pupillometry and discourse comprehension, we will investigate how linguistic context, cognitive demands, and processing time affect speech understanding in CI users, and in normal-hearing controls) to identify factors underlying communication resilience versus vulnerability and develop improved, ecologically valid assessment and rehabilitation strategies.

Condition

Eligibility

Eligible Ages
Between 18 Years and 80 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Subjects will be otherwise healthy normal-hearing and cochlear implant (CI) adult listeners (between 18 and 80 years old).

Exclusion Criteria

  • Individuals below 18 years of age. - Individuals with evidence of neurologic, vascular or psychiatric disease or dementia, and taking medications that might interfere with task performance. - Individuals with a history of language disorders (besides those associated with hearing loss for the CI users). Individuals who are non-native speakers of American English.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Other
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Cochlear Implant Users 		Postlingually deaf adults (age 18-80) with at least one year of CI experience. Participants will complete behavioral speech perception and comprehension tasks with pupillometry measurement.
  • Behavioral: Experiment 1: Syntactic and Semantic Context
    - Recall of meaningful sentences, anomalous word strings, and unstructured word lists - Measurement of syntactic and semantic gain - Pupillometry during auditory and visual presentation
  • Behavioral: Experiment 2: False Hearing and Context Overuse
    - Two-choice word recognition task with semantic priming/luring in multi-talker babble - Three Signal-to-Noise Ratio (SNR) levels (heavy, medium, light noise) - Confidence ratings for responses - Pupillometry measurement
  • Behavioral: Experiment 3: Two-Sentence Problem
    - Speech recognition and recall of single sentences vs. paired sentences - Manipulation of inter-sentence semantic predictability (high vs. low) - Four test conditions: 1-sentence, 2-sentences, 2-sentences+pre-prompt, 2-sentences+post-prompt - Pupillometry during task
  • Behavioral: Experiment 4: Cascading Effects on Discourse Comprehension
    - Recall of 27 narrative passages (67-97 words each) - Propositional analysis scoring (main ideas, mid-level ideas, details) - Measurement of semantic hierarchy effect - Pupillometry during listening
  • Behavioral: Experiment 5: Self-Paced Discourse Comprehension
    - 24 discourse passages (150 words each): 12 narrative, 12 expository - Continuous presentation vs. self-paced presentation (stops at clause/sentence boundaries) - Measurement of pause times and comprehension recall - Pupillometry during task
  • Behavioral: Experiment 6: Clinical Application
    - Self-Paced Sentence Comprehension - Sentences with varying syntactic complexity (active-conjoined, subject-relative, object-relative) - Continuous vs. self-paced (with pause at major clause boundary) presentation - True/false comprehension verification statements - Pupillometry measurement
Active Comparator
Normal-Hearing Controls (Vocoder Simulation) 		Normal-hearing adults (age 18-80) listening to degraded speech via 4- and 8-channel vocoders. Participants will complete the same behavioral tasks as CI users but with (or without) acoustically degraded speech simulation.
  • Behavioral: Experiment 1: Syntactic and Semantic Context
    - Recall of meaningful sentences, anomalous word strings, and unstructured word lists - Measurement of syntactic and semantic gain - Pupillometry during auditory and visual presentation
  • Behavioral: Experiment 2: False Hearing and Context Overuse
    - Two-choice word recognition task with semantic priming/luring in multi-talker babble - Three Signal-to-Noise Ratio (SNR) levels (heavy, medium, light noise) - Confidence ratings for responses - Pupillometry measurement
  • Behavioral: Experiment 3: Two-Sentence Problem
    - Speech recognition and recall of single sentences vs. paired sentences - Manipulation of inter-sentence semantic predictability (high vs. low) - Four test conditions: 1-sentence, 2-sentences, 2-sentences+pre-prompt, 2-sentences+post-prompt - Pupillometry during task
  • Behavioral: Experiment 4: Cascading Effects on Discourse Comprehension
    - Recall of 27 narrative passages (67-97 words each) - Propositional analysis scoring (main ideas, mid-level ideas, details) - Measurement of semantic hierarchy effect - Pupillometry during listening
  • Behavioral: Experiment 5: Self-Paced Discourse Comprehension
    - 24 discourse passages (150 words each): 12 narrative, 12 expository - Continuous presentation vs. self-paced presentation (stops at clause/sentence boundaries) - Measurement of pause times and comprehension recall - Pupillometry during task
  • Behavioral: Experiment 6: Clinical Application
    - Self-Paced Sentence Comprehension - Sentences with varying syntactic complexity (active-conjoined, subject-relative, object-relative) - Continuous vs. self-paced (with pause at major clause boundary) presentation - True/false comprehension verification statements - Pupillometry measurement

Recruiting Locations

Brandeis University
Waltham 4954380, Massachusetts 6254926 02453

NYU Langone Health
New York 5128581, New York 5128638 10016

More Details

Status
Recruiting
Sponsor
NYU Langone Health

Study Contact

Mario A. Svirsky, PhD
212-263-7217
Mario.svirsky@nyulangone.org

Detailed Description

This research study examines how adults using cochlear implants (CIs) understand and comprehend speech in realistic communication situations. While current clinical tests focus on how well CI users can recognize single words and simple sentences, this study investigates whether success in recognizing speech sounds actually translates to understanding the meaning and content of longer conversations and discourse. The study will include six interconnected experiments examining: (1) how CI users use linguistic context (both adaptively and maladaptively) to understand degraded speech; (2) how listening effort affects comprehension when faced with communicative challenges like remembering multiple sentences or narratives; (3) whether giving listeners control over the speed of speech presentation improves comprehension; and (4) a clinically-applicable version of these assessments. Throughout the experiments, researchers will measure listening effort using pupillometry (tracking pupil dilation as an index of cognitive effort) combined with behavioral measures of speech recognition and comprehension. Comprehension will be assessed using a validated framework that distinguishes between understanding main ideas versus minor details in discourse passages. The study will include cochlear implant users and normal-hearing adults listening to degraded speech simulations via vocoders. Participants will range in age from 18 to 80 years. A comprehensive baseline battery will assess perceptual abilities (speech recognition, spectral resolution, temporal processing) and cognitive abilities (working memory, processing speed, executive function). OBJECTIVES: Primary objectives are to identify mechanisms underlying successful speech comprehension in CI users and to determine factors associated with resilience versus vulnerability to communicative challenges. Secondary objectives include examining relationships between cognitive abilities, listening effort, and discourse comprehension outcomes. OUTCOMES: This research is expected to provide more ecologically valid assessment methods for CI users, identify which individuals may benefit from specific communication strategies (such as self-paced speech), and inform development of improved rehabilitation approaches that enhance real-world communication success rather than just word recognition ability.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.