Project Summary: One in three adults over the age of 65 years has hearing loss, which has significant negative communicative, cognitive, and social consequences. Although cochlear implants (Cls) restore access to sound, enormous individual differences in effective speech communication - a hearing health behavior typically assessed clinically with measures of speech recognition and hearing-related quality of life (HR-Qol) - are observed in adult Cl users. Further, older adults are at greater risk for poor communication outcomes. Our long-term goal is to better understand social networks and speech communication in new adult Cl users following rapid restoration of hearing through Cls, and the social, cognitive, and linguistic processes that support effective speech communication, in order to better understand underlying mechanisms and to guide clinical interventions. New adult Cl users improve their communication ability largely through everyday interactions and relationships with communication partners within their social networks. We propose that social networks represent important and potentially malleable factors that contribute to the communication ability of adult Cl users. Broadly, adult Cl users present a unique opportunity to study social parameters following rapid restoration of hearing. However, we do not have a good understanding of how Cl use impacts social networks, both in terms of social network structure and the interpersonal processes that occur within them, as well as how these social factors relate to communication ability. Therefore, the objectives of the proposed research are to characterize the effects of Cl use on social network structure and interpersonal processes in middle-aged and older adult Cl users following implantation, and to assess in what ways and why individual differences in social networks relate to communication outcomes. Our central hypothesis is that Cl use impacts both social network structure and interpersonal processes, and that social networks and communication ability have a bi-directional relationship over time. Aim 1 will characterize social network structure and processes among middle-aged and older adult Cl users both prior to implantation and after 12 months of Cl use. We will also compare Cl users' social networks to those of normal-hearing (NH) peers and evaluate the influence of age on social networks. Aim 2 will determine the degree to which social network structure and processes explain long-term clinical communication outcomes (i.e., speech recognition and HR-Qol) at 12 months of Cl use. Aim 3 will investigate cognitive compensation as a potential mechanism underlying the longitudinal and bi-directional relationship between social networks and speech recognition, over the first 12 months of Cl use. We will specifically evaluate the use of predictive sentence context in sentence recognition and its relationship to social network structure across individual Cl users. The proposed research will...