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Effects of Early Auditory Deprivation on Working Memory and Reasoning Abilities in Verbal and Visuospatial Domains for Pediatric Cochlear Implant Recipients

Davidson, Lisa S.1; Geers, Ann E.2; Hale, Sandra3; Sommers, Mitchell M.3; Brenner, Christine4; Spehar, Brent1

doi: 10.1097/AUD.0000000000000629
Research Article: PDF Only

Objectives: The overall goal of this study was to compare verbal and visuospatial working memory in children with normal hearing (NH) and with cochlear implants (CI). The main questions addressed by this study were (1) Does auditory deprivation result in global or domain-specific deficits in working memory in children with CIs compared with their NH age mates? (2) Does the potential for verbal recoding affect performance on measures of reasoning ability in children with CIs relative to their NH age mates? and (3) Is performance on verbal and visuospatial working memory tasks related to spoken receptive language level achieved by children with CIs?

Design: A total of 54 children ranging in age from 5 to 9 years participated; 25 children with CIs and 29 children with NH. Participants were tested on both simple and complex measures of verbal and visuospatial working memory. Vocabulary was assessed with the Peabody Picture Vocabulary Test (PPVT) and reasoning abilities with two subtests of the WISC-IV (Wechsler Intelligence Scale for Children, 4th edition): Picture Concepts (verbally mediated) and Matrix Reasoning (visuospatial task). Groups were compared on all measures using analysis of variance after controlling for age and maternal education.

Results: Children with CIs scored significantly lower than children with NH on measures of working memory, after accounting for age and maternal education. Differences between the groups were more apparent for verbal working memory compared with visuospatial working memory. For reasoning and vocabulary, the CI group scored significantly lower than the NH group for PPVT and WISC Picture Concepts but similar to NH age mates on WISC Matrix Reasoning.

Conclusions: Results from this study suggest that children with CIs have deficits in working memory related to storing and processing verbal information in working memory. These deficits extend to receptive vocabulary and verbal reasoning and remain even after controlling for the higher maternal education level of the NH group. Their ability to store and process visuospatial information in working memory and complete reasoning tasks that minimize verbal labeling of stimuli more closely approaches performance of NH age mates.

1Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri, USA;

2Department of Behavioral and Brain Sciences, University of Texas Dallas, Dallas, Texas, USA;

3Department of Psychology, Washington University St. Louis, Missouri, USA; and

4Moog Center for Deaf Education, St. Louis, Missouri, USA.

ACKNOWLEDGMENTS: This research was supported by the McDonnell Neuroscience Foundation at Washington University School of Medicine in St. Louis, MO, and National Institute of Deafness and Communication Disorders grant RO1 DC012778. Appreciation is expressed to the 54 students and their parents who graciously gave their time and effort to participate in this study and to Sarah Fessenden for conducting testing. This research was approved by the Human Studies Committee at Washington University School of Medicine (#201107375).

The authors have no conflicts of interest to disclose.

Address for correspondence: Lisa S. Davidson, Washington University School of Medicine, 4560 Clayton Ave, St. Louis, MO 63110, USA. E-mail:

Received March 22, 2017; accepted April 22, 2018.

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