Auditory-Cognitive Training for Hearing Loss
(ARCog Trial)
Recruiting in Palo Alto (17 mi)
+1 other location
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Gallaudet University
Disqualifiers: Single-sided deafness, Non-fluent English
No Placebo Group
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?The proposed study will investigate whether an auditory brain training program can improve cochlear implant (CI) outcomes in older post-lingually deafened CI users. The study will evaluate the potential benefit of training on speech recognition performance, psychosocial and cognitive function.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Auditory-Cognitive Training for Hearing Loss?
Research shows that auditory-cognitive training can improve both auditory and cognitive skills, which are important for language development and speech perception in cochlear implant users. Additionally, studies indicate that such training can enhance memory and executive functions, which are crucial for understanding speech in noisy environments.
12345Is auditory-cognitive training safe for humans?
Auditory-cognitive training, often used in cochlear implant rehabilitation, is generally considered safe as it involves listening exercises to improve hearing and cognitive skills. No specific safety concerns have been reported in the studies reviewed.
678910How is Auditory-Cognitive Training different from other treatments for hearing loss?
Auditory-Cognitive Training is unique because it combines listening exercises with cognitive tasks to improve both hearing and mental processing, which is especially beneficial for cochlear implant users who may struggle with understanding speech. Unlike other treatments that focus solely on hearing, this approach also enhances working memory, helping users better comprehend language in challenging listening environments.
36789Eligibility Criteria
This trial is for older individuals, aged 60 and above, who have had a cochlear implant activated between 3 months to 3 years ago. They must pass a cognitive test and have speech recognition scores within a specific range. People with single-sided deafness or non-fluent English speakers cannot participate.Inclusion Criteria
My cochlear implant was activated between 3 months and 3 years ago.
I am 60 years old or older.
Your ability to understand speech (using the AZBio test) falls between 10% and 85%.
+1 more
Exclusion Criteria
You are deaf in one ear.
I am not fluent in English.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants complete auditory-cognitive or non-auditory cognitive training sessions at home or office, with weekly virtual clinician meetings
8 weeks
8 virtual visits
Follow-up
Participants are monitored for changes in cognitive and auditory performance post-training
8 weeks
3 assessment appointments
Participant Groups
The study tests if an auditory brain training program can help improve outcomes for older people with cochlear implants. It looks at how the training affects their ability to recognize speech, as well as their social and mental functions.
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Treatment: Auditory-Cognitive TrainingExperimental Treatment1 Intervention
Behavioral: AR Group will complete sessions in their home or office via internet. Sessions will include independent work using computer software two hours per week and one hour meeting with the clinician each week. One half of the training is devoted to auditory training and one half to auditory cognitive activities. Three assessment appointments are required. The goal is to evaluate the benefit of training on performance with cochlear implant.
Group II: Control: Non-auditory Cognitive TrainingPlacebo Group1 Intervention
Behavioral: The CT Group will complete two hours of training in their home or office via internet. Sessions will include independent work using computer software two hours per week. Training exercises will be chosen from: Ken-Ken, Sudoku, Crosswords, Word Search, Spot the Differences. Three assessment appointments are required. The goal is to evaluate the benefit of training on performance with cochlear implant.
Auditory-Cognitive Training is already approved in Australia, United States, European Union for the following indications:
🇦🇺 Approved in Australia as Auditory-Cognitive Training for:
- Improvement of speech recognition performance in older post-lingually deafened CI users
- Enhancement of psychosocial function in older CI users
- Improvement of cognitive function in older CI users
🇺🇸 Approved in United States as Auditory Brain Training for:
- Rehabilitation of hearing communication through cochlear implantation in elderly patients
- Improvement of cognitive abilities in older CI users
🇪🇺 Approved in European Union as Cochlear Implant Rehabilitation for:
- Enhancement of speech perception and cognitive abilities in older CI users
- Improvement of quality of life in older CI users
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Gallaudet UniversityWashington, United States
Center for Hearing and CommunicationNew York, NY
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Who Is Running the Clinical Trial?
Gallaudet UniversityLead Sponsor
Department of Health and Human ServicesCollaborator
References
Impact of Hearing Rehabilitation Using Cochlear Implants on Cognitive Function in Older Patients. [2022]To assess the effects of hearing rehabilitation with cochlear implants on a subset of cognitive domains in older patients (≥65 yr).
Training to improve language outcomes in cochlear implant recipients. [2022]Cochlear implants (CI) have brought with them hearing ability for many prelingually deafened children. Advances in CI technology have brought not only hearing ability but speech perception to these same children. Concurrent with the development of speech perception has come spoken language development, and one goal now is that prelingually deafened CI recipient children will develop spoken language capabilities on par with those of normal hearing (NH) children. This goal has not been met purely on the basis of the technology, and many CI recipient children lag behind their NH peers with large variability in outcomes, requiring further behavioral intervention. It is likely that CI recipient children struggle to develop spoken language at NH-like levels because they have deficits in both auditory and cognitive skills that underlie the development of language. Fortunately, both the auditory and cognitive training literature indicate an improvement of auditory and cognitive functioning following training. It therefore stands to reason that if training improves the auditory and cognitive skills that support language learning, language development itself should also improve. In the present manuscript we will review the auditory and cognitive training and their potential impact on speech outcomes with an emphasis on the speech perception literature.
[How Working Memory Supports Language Comprehension after Cochlear Implantation]. [2023]Language comprehension in challenging conditions requires the integration of multimodal information. Necessary resources are provided by the working memory. We discuss how adult cochlear implant users benefit from auditory-cognitive training during their rehabilitation process. Working memory capacity highly impacts language comprehension whenever listening effort is increased. Since CI users may have trouble to recover the phonological structure from the speech signal, working memory is required to provide necessary resources to disambiguate multiple interpretation options. However, either due to their hearing biography or due to their advanced age, CI user often show reduced working memory capacities. Previous studies with hearing-impaired adults provide evidence for the potential of combined auditory-cognitive training during the rehabilitation process of CI users.
Prospective Evaluation of Cognitive Functions After Rehabilitation With Cochlear Implant or Hearing Aids: Preliminary Results of a Multicentric Study on Elderly Patients. [2020]Objective Recent literature has shown a growing interest in the relationship between presbycusis and cognitive decline, but significant evidence about the long-term benefit of rehabilitation on cognitive functions has not been reported yet. The aim of the study was to analyze audiological and neuropsychological performances in patients with cochlear implant (CI) or hearing aids (HAs) over time. Materials and Method Forty-four bilaterally deaf patients aged more than 60 years (25 with CI candidacy and 19 with HA candidacy) were enrolled. Patients were subjected to audiological evaluation, to a battery of neuropsychological tests (Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Task [RAVLT], Rey-Osterreith Complex Figure Test, Digit/Corsi Span Forward and Backward, Multiple Features Target Cancellation, Trail-Making Test, Stroop Test, and Phonological and Semantic Word Fluency), and to a quality of life assessment (Short Form 36, Glasgow Benefit Inventory, Glasgow Health Status Inventory) at the baseline and after a long-term follow-up (6-12 months). Results Speech recognition scores in quiet and in noise were significantly improved even 6 months after auditory rehabilitation. Significant differences between pre- and post-rehabilitation scores were reported in physical and emotional impacts in life, general global health, vitality, and social activities. MMSE and RAVLT scores were significantly improved in both groups after 6 months of follow-up, suggesting a global involvement of memory domain. Mnesic performances remained unchanged between the first and second follow-up, but a further significant improvement in executive functions (Stroop Test) was detected in patients with CI reevaluated 12 months after implantation. A significant correlation of the RAVLT with signal-to-noise ratio at +10 dB speech-in-noise scores and the MMSE with signal-to-noise ratio at 0 dB speech-in-noise scores suggests the pivotal role of executive functions in recognition in noisy environment. Conclusions Our preliminary data confirm that hearing deprivation in aged patients represents a truly modifiable risk factor for cognitive decline, which can be positively faced by acoustic rehabilitation. The improvement of short- and long-term memory performances and the amelioration of executive and attentive functions suggest that hearing restoration with both HAs and CI may provide a recovery of superior cognitive domains probably through a reallocation of cortical resources altered by hearing deprivation.
How Does Auditory Training Work? Joined-Up Thinking and Listening. [2020]Auditory training aims to compensate for degradation in the auditory signal and is offered as an intervention to help alleviate the most common complaint in people with hearing loss, understanding speech in a background noise. Yet there remain many unanswered questions. This article reviews some of the key pieces of evidence that assess the evidence for whether, and how, auditory training benefits adults with hearing loss. The evidence supports that improvements occur on the trained task; however, transfer of that learning to generalized real-world benefit is much less robust. For more than a decade, there has been an increasing awareness of the role that cognition plays in listening. But more recently in the auditory training literature, there has been an increased focus on assessing how cognitive performance relevant for listening may improve with training. We argue that this is specifically the case for measures that index executive processes, such as monitoring, attention switching, and updating of working memory, all of which are required for successful listening and communication in challenging or adverse listening conditions. We propose combined auditory-cognitive training approaches, where training interventions develop cognition embedded within auditory tasks, which are most likely to offer generalized benefits to the real-world listening abilities of people with hearing loss.
[Phoneme discrimination training with experienced cochlear implant listeners]. [2018]Computer-based auditory training programmes seem to be a useful tool in the process of auditory rehabilitation after cochlear implantation (CI). Currently, little is known about the learning mechanism and efficiency of such programs. The aim of the study was to evaluate a specific auditory training programme for phoneme discrimination in experienced CI listeners.
[Auditory group therapy in adult cochlear implant rehabilitation]. [2020]Auditory training is an established intervention in adult cochlear implant (CI) aural rehabilitation. In most cases, training is implemented in an individual therapy setting. Increasing patient numbers and the associated time-economic and cost-related demands as well as psychosocial and communicative aspects support the use of aural group interventions.
Efficacy of individual computer-based auditory training for people with hearing loss: a systematic review of the evidence. [2022]Auditory training involves active listening to auditory stimuli and aims to improve performance in auditory tasks. As such, auditory training is a potential intervention for the management of people with hearing loss.
[The effectiveness of the auditory training of the subjects presenting with partial deafness following cochlear implantation as reported by the patients and speech therapists]. [2014]Auditory training consists of the exercises taking advantage of the environmental sounds and human speech; it is designed to ensure hearing for a person suffering its impairment within the range of acoustic experiences comparable with that of the normally hearing subjects. The successful treatment of partial deafness with the use of a cochlear implant (CI) resulted in the increase of the number of patients who needed auditory training to enable them to recognize mid-and high-frequency sounds. Bearing in mind the lack of the teaching aids permitting to adequately address the specific hearing problems in such patients, the Rehabilitation Clinic of the Institute of Physiology and Pathology of Hearing undertook to develop the relevant materials to satisfy the needs of auditory training following surgical cochlear implantation.
Auditory-cognitive training for adult cochlear implant recipients: a study protocol for a randomised controlled trial. [2021]There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant.