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The Relationship Between Environmental Sound Awareness and Speech Recognition Skills in Experienced Cochlear Implant Users

Harris, Michael S.*; Boyce, Lauren*; Pisoni, David B.; Shafiro, Valeriy; Moberly, Aaron C.*

doi: 10.1097/MAO.0000000000001514

Hypothesis: 1) Environmental sound awareness (ESA) and speech recognition skills in experienced, adult cochlear implant (CI) users will be highly correlated, and, 2) ESA skills of CI users will be significantly lower than those of age-matched adults with normal hearing.

Background: Enhancement of ESA is often discussed with patients with sensorineural hearing loss as a potential benefit of implantation and, in some cases, ESA may be a major motivating factor. Despite its ecological validity and patients’ expectations, ESA remains largely a presumed skill. The relationship between ESA and speech recognition is not well-understood.

Methods: ESA was assessed in 35 postlingually deaf, experienced CI users and a control group of 41 age-matched, normal hearing listeners using the validated, computerized familiar environmental sounds test—identification (FEST-I) and a diverse speech recognition battery. Demographic and audiological factors as well as nonverbal intelligence quotient (IQ)/nonverbal reasoning and spectral resolution were assessed.

Results: Six of the 35 experienced CI users (17%) demonstrated FEST-I accuracy within the range of the NH controls. Among CI users all correlations between FEST-I accuracy and speech recognition scores were strong. Chronological age at the time of testing, duration of deafness, spectral resolution, and nonverbal IQ/nonverbal reasoning were strongly correlated with FEST-I accuracy. Partial correlation analysis showed that correlations between FEST-I and speech recognition measures remained significant when controlling for the demographic and audiological factors.

Conclusion: Our findings reinforce the hypothesis that ESA and speech perception share common underlying processes rather than reflecting truly separate auditory domains.

*Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio

Speech Research Laboratory, Department of Psychology, Indiana University, Bloomington, Indiana

Department of Communication Disorders and Sciences, College of Health Sciences, Rush University, Chicago, Illinois

Address correspondence and reprint requests to Michael S. Harris, M.D., Department of Otolaryngology Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Eye and Ear Institute, 915 Olentangy River Road, Suite 4000, Columbus, OH 43212; E-mail:

Disclosures: Harris (none); Boyce (none); Pisoni (none); Shafiro (none); Moberly: Data collection for this manuscript was supported by the American Otological Society Clinician-Scientist Award to Aaron Moberly.

ResearchMatch, which was used to recruit some NH participants, is supported by National Center for Advancing Translational Sciences Grant UL1TR001070.

The authors disclose no conflicts of interest.

Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company