Department of Special Education & Communication Disorders, New Mexico State University, Las Cruces, New Mexico, USA.
Ear Hear. 2018 Jan/Feb;39(1):48-59. doi: 10.1097/AUD.0000000000000462.
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.
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.
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.
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.
理解噪声中的言语是人工耳蜗植入者面临的最大挑战。提高人工耳蜗植入儿童的噪声言语感知能力仍然是所有利益相关者的首要任务。本研究旨在探讨工作记忆训练对改善人工耳蜗植入儿童噪声言语识别能力的疗效。
14 名人工耳蜗植入儿童（年龄 6 至 15 岁）接受了为期 5 周的自适应、家庭本位的前向数字跨度任务训练，而 13 名人工耳蜗植入儿童则接受了后向数字跨度训练。17 名年龄匹配的对照组人工耳蜗植入儿童接受安慰剂。在训练前、训练后和 5 周随访时，评估的结果包括前向和后向数字跨度以及噪声中数字三重复识别阈值。还仅在基线时获得了 26 名年龄匹配的正常听力儿童的绩效测量值，以生成用于比较的规范标准。
前向和后向训练组的数字跨度评分在训练后和随访时均明显高于训练前。两个训练组都显示出类似的训练诱导变化。对照组则没有这种改善。训练对言语识别阈值没有影响。与正常听力儿童相比，人工耳蜗植入儿童的数字跨度得分较低，言语识别阈值较高。
训练可提高人工耳蜗植入儿童的工作记忆能力，表现为数字跨度增加。训练诱导的改善至少稳定 5 周。学习效果表现出近迁移，从前向数字跨度到后向数字跨度，反之亦然，但未能显示出对噪声中言语识别的远迁移。目前的证据不支持认知训练对提高人工耳蜗植入儿童噪声言语表现的作用。
