# Cochlear implants and listening effort: the interaction of cognitive and sensory constraints

> **NIH NIH R01** · BRANDEIS UNIVERSITY · 2022 · $502,196

## Abstract

PROJECT SUMMARY
Older adults are the fastest growing segment of the U.S. population, with hearing loss the third most prevalent
chronic medical condition. Untreated, hearing loss can interfere with effective communication, quality of life,
and potentially accelerate cognitive decline. Cochlear implants (CI) have seen increasing use for older adults,
with one implant center reporting a nearly 500% increase over a recent ten-year period in the number of
individuals aged 60 or older receiving CIs. The auditory input provided by a CI is sharply degraded with respect
to that of a person with normal hearing or even with mild to moderate hearing loss, but patients can adapt well
to this novel input- at least when measured by standard clinical tests of word identification (e.g., CNC words) or
perception of simple sentences (e.g., AzBio sentences). However, clinicians are often puzzled by patients,
especially older adults, who seem to do well on standard tests but report major difficulties in everyday speech
interactions.
This grant builds upon the hypothesis that the combined constraints of the sharply degraded signal provided by
a CI and finite cognitive resources may lead to a “tipping point” when listeners are confronted with complex
sentences and discourse arriving at normally rapid speech rates. Beyond this tipping point communication may
become too difficult, even for CI recipients whose standard speech intelligibility scores are above average. This
grant brings together a unique combination of three converging approaches: (1) We examine the ability of
younger adult and older adult CI users to comprehend and remember the content of linguistically complex
sentences and multi-sentence discourse, and probe potential effects on the cognitive mechanisms listeners
use to process speech input, an underlying issue as yet unexplored in CI research; (2) For each experiment we
will conduct a parallel study with normal-hearing younger and older adults using channel vocoded and
unprocessed speech, with the former allowing a systematic determination of the interaction between signal
degradation and the complexity of the speech materials on their recall, and the latter to illustrate a baseline of
optimal performance on the same tasks for age-matched adults; (3) We will use modern pupillometry
measures as an objective index of cognitive effort time-locked to the content of the speech input. The
knowledge gained will test current models of resource allocation and listening effort as mechanisms underlying
effects of cognitive load when younger and older adult CI users face the natural complexity of everyday
sentences and discourse. Results of the studies will be valuable for counseling CI recipients and their families
and will help develop more comprehensive evaluation batteries and rehabilitative strategies for the older adult
CI recipient.

## Key facts

- **NIH application ID:** 10434890
- **Project number:** 5R01DC016834-05
- **Recipient organization:** BRANDEIS UNIVERSITY
- **Principal Investigator:** Mario A Svirsky
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $502,196
- **Award type:** 5
- **Project period:** 2018-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10434890

## Citation

> US National Institutes of Health, RePORTER application 10434890, Cochlear implants and listening effort: the interaction of cognitive and sensory constraints (5R01DC016834-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10434890. Licensed CC0.

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