Efficacy of Aural Rehabilitation Intervention with Adult Cochlear Implant Users

Background: Increasing numbers of adults who receive cochlear implants achieve high levels of speech perception (Gifford et al, 2008). For those who do not achieve such high levels of success, audiologic rehabilitation (AR) therapy may be warranted. There is evidence that brain plasticity through the lifespan could allow a listener to learn to code new auditory information provided by cochlear implantation (Ponton et al, 2001). Short term AR intervention may be able to take advantage of neuroplasticity to further improve the CI benefits. Currently, there is limited evidence of the efficacy of AR programs. With current emphasis on evidence-based practice there is clearly a need for research that examines the clinical effectiveness of short-term AR with adult CI users. Objectives: The study was designed to provide evidence of benefits resulting from short-term aural rehabilitation for post-lingually deafened cochlear implant users in a randomized controlled clinical trial. Study Population: Post-lingually deafened adult cochlear implant users , with at least 3 months post –activation, and no more than 3 years post-activation and no prior AR therapy. Persons who are pre-lingually deafened or are non-native speakers of English or present with signs of cognitive disease, will be excluded from the study. Study Design: Participants will randomly be assigned to one of two groups: 1) Control group or 2) Aural Rehabilitation (AR) intervention group. All participants from both groups will attend ten 90 minute individual sessions, one each for pre-test, immediate post-test, two months and six months post-intervention in addition to six weeks of individual sessions. There will be a total of 10 participants randomized to Group 1 or Group 2. Activities in the control group will include cognitive training exercises ("brain exercises" such as puzzles, word games) with a clinician in the clinic. The AR Group will undergo Informational counseling and communication strategies training in addition to traditional auditory training with a clinician in the clinic. Outcome Measures: Participants will complete outcome measures at four points: pre-intervention, immediately post-intervention and again at two and six months post intervention. Outcome measures include both subjective and objective assessments which are routinely clinically with cochlear implanted adults