# Variability in Speech Recognition for Adults with Cochlear Implants:  Bottom-up and Top-down Factors

> **NIH NIH K23** · OHIO STATE UNIVERSITY · 2021 · $186,840

## Abstract

Project Summary/Abstract:
Acquired hearing loss is becoming increasingly common, especially with the growth of the aging
population. For many individuals, hearing loss is severe enough to warrant cochlear implantation. While
many adults with cochlear implants (CIs) understand speech well through their devices, enormous
unexplained variability exists in speech recognition outcomes. Unfortunately, because of this unexplained
variability, clinicians are unable to predict how an individual will perform with a CI, to explain why someone
has poor speech recognition with a CI, or to design appropriate rehabilitation strategies to help an
individual with poor performance. Currently, only half of this outcome variability can be explained, and
those factors that have been found to explain variability are limited primarily to “bottom-up” auditory
sensitivity processes related to the CI itself, or the condition of the peripheral auditory system. However, it
is likely that “top-down” cognitive and linguistic factors assist CI users to recognize speech. These factors
should explain additional variability in CI outcomes, but they have not previously been a research focus in
adult CI users. This project capitalizes on the expertise of investigators, mentors, and consultants with
broad experience studying bottom-up and top-down processes. The overall project objective is to
determine how top-down skills relate to speech recognition for adult CI users, how these skills interact with
bottom-up processes, and how the experience of auditory deprivation affects top-down abilities. Aim 1 will
examine the contributions of bottom-up auditory sensitivity and top-down linguistic knowledge on
recognition of speech materials. Aim 2 will investigate the effects of top-down cognitive skills on sentence
recognition. Aim 3 will compare top-down cognitive and linguistic skills between adult CI users and age-
matched normal-hearing peers, which will reveal the effects of auditory deprivation on these top-down
abilities. The findings from this research project will have important theoretical implications because they
will shed light on the processes used by adults with hearing loss to recognize speech, as well as the effects
of auditory deprivation on relevant top-down skills. The findings and training provided by the proposed
career development award will enhance the PIs prospects as a future independent investigator seeking to
improve outcomes for CI users. Results will lay the groundwork for future studies incorporating
individualized rehabilitation protocols for adults with CIs to optimize their speech recognition performance.

## Key facts

- **NIH application ID:** 10132285
- **Project number:** 5K23DC015539-05
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Aaron C Moberly
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $186,840
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10132285

## Citation

> US National Institutes of Health, RePORTER application 10132285, Variability in Speech Recognition for Adults with Cochlear Implants:  Bottom-up and Top-down Factors (5K23DC015539-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10132285. Licensed CC0.

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