Background. Speech recognition in cochlear implant (CI) recipients are quite variable, particularly in challenging listening conditions. Demographic, audiological, and cognitive factors explain some, but not all, of this variance. The literature suggests that rapid auditory perceptual learning explains unique variance in speech recognition in listeners with normal hearing and those with hearing loss. We now ask if rapid auditory learning can be observed in adult CI recipients and if so if it also accounts for portions of the variance in fast speech and speech in noise recognition in CI recipients.
Methods. 36 adult CI recipients (ages 35-77, M=55) completed a comprehensive battery of challenging speech recognition tests (sentences in speech shaped noise, four-talker babble noise and natural-fast speech), cognitive measures (vocabulary, working memory, attention, and verbal processing speed), and a rapid perceptual learning task (time-compressed speech). Accuracy in the speech tasks was modeled with a series of generalized mixed linear models that accounted for demographic, cognitive and speech-related factors before accounting for the contribution of the perceptual learning task.
Results. Learning (indicated by a positive slope) was present in 27 of the 36 participants. Mean recognition accuracies in the learning task improved from 0.28 to 0.49 over the course of 40 sentences. Perceptual learning had unique contribution to the recognition of both natural fast speech and speech in noise. For individuals with similar demographic and cognitive characteristics, an increase of 1 SD in the perceptual learning slope was associated with ~59% and ~25% increase in the odds of correctly recognizing natural fast speech and speech in noise (respectively). Of the cognitive measures assessed, working memory and attention each had a unique positive contribution to speech recognition in both tasks.
Conclusions. The majority of CI recipients exhibited learning, suggesting that rapid auditory perceptual learning can be restored with the use of the implant even in adult recipients. This learning accounts for some of the individual differences in the recognition of speech in noise and natural fast speech, consistent with findings from age-related hearing loss. Thus, across populations, rapid auditory perceptual learning might serve as a skill that supports speech recognition in various adverse conditions. In CI users, the ability to rapidly adjust to on-going acoustical challenges is one of the factors associated with good CI outcomes. Overall, CI recipients with better working memory and attention and with faster learning rates had better speech recognition.

**Background.** Speech recognition in cochlear implant (CI) recipients are quite variable, particularly in challenging listening conditions. Demographic, audiological, and cognitive factors explain some, but not all, of this variance. The literature suggests that rapid auditory perceptual learning explains unique variance in speech recognition in listeners with normal hearing and those with hearing loss. We now ask if rapid auditory learning can be observed in adult CI recipients and if so if it also accounts for portions of the variance in fast speech and speech in noise recognition in CI recipients.
**Methods.** 36 adult CI recipients (ages 35-77, M=55) completed a comprehensive battery of challenging speech recognition tests (sentences in speech shaped noise, four-talker babble noise and natural-fast speech), cognitive measures (vocabulary, working memory, attention, and verbal processing speed), and a rapid perceptual learning task (time-compressed speech). Accuracy in the speech tasks was modeled with a series of generalized mixed linear models that accounted for demographic, cognitive and speech-related factors before accounting for the contribution of the perceptual learning task.
**Results.** Learning (indicated by a positive slope) was present in 27 of the 36 participants. Mean recognition accuracies in the learning task improved from 0.28 to 0.49 over the course of 40 sentences. Perceptual learning had unique contribution to the recognition of both natural fast speech and speech in noise. For individuals with similar demographic and cognitive characteristics, an increase of 1 SD in the perceptual learning slope was associated with ~59% and ~25% increase in the odds of correctly recognizing natural fast speech and speech in noise (respectively). Of the cognitive measures assessed, working memory and attention each had a unique positive contribution to speech recognition in both tasks.
**Conclusions.** The majority of CI recipients exhibited learning, suggesting that rapid auditory perceptual learning can be restored with the use of the implant even in adult recipients. This learning accounts for some of the individual differences in the recognition of speech in noise and natural fast speech, consistent with findings from age-related hearing loss. Thus, across populations, rapid auditory perceptual learning might serve as a skill that supports speech recognition in various adverse conditions. In CI users, the ability to rapidly adjust to on-going acoustical challenges is one of the factors associated with good CI outcomes. Overall, CI recipients with better working memory and attention and with faster learning rates had better speech recognition.

Rapid Perceptual Learning in Adult Cochlear Implant Recipients: What Does it Mean for Speech Recognition

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,