Making Sense of Sentences: Top-Down Processing of Speech by Adult Cochlear Implant Users

Moberly, Aaron C.; Reed, Jessa · 2019 · Crossref

DOI: 10.1044/2019_jslhr-h-18-0472

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Summary

This study investigates the neurocognitive mechanisms underlying top-down speech processing in adult cochlear implant (CI) users. Because CIs provide spectrally degraded acoustic-phonetic input, listeners must rely heavily on semantic context to recognize speech. The research aimed to determine which specific neurocognitive functions—working memory, lexical access speed, inhibitory control, and nonverbal reasoning—facilitate the use of semantic context during sentence recognition. The study analyzed data from 41 experienced adult CI users (mean age 67.2 years). Participants performed speech recognition tasks in quiet conditions using two sentence types: semantically meaningful sentences and syntactically correct but semantically anomalous sentences. The anomalous sentences served as a proxy for bottom-up acoustic processing, while meaningful sentences required top-down semantic integration. Participants also completed four visual neurocognitive assessments to minimize auditory confounds: a visual digit span task for working memory, the Test of Word Reading Efficiency for lexical access speed, a visual Stroop task for inhibitory control, and Raven’s Progressive Matrices for nonverbal fluid reasoning. Statistical analyses controlled for individual differences in bottom-up processing by using performance on anomalous sentences as a covariate when predicting meaningful sentence recognition. The results indicated that individual differences in inhibitory control significantly predicted the recognition of meaningful sentences after accounting for performance on anomalous sentences. This finding suggests that inhibitory control is a key mechanism enabling listeners to utilize semantic context to disambiguate degraded speech signals. Conversely, speed of lexical access and nonverbal reasoning were associated with the recognition of anomalous sentences, indicating their role in processing the acoustic-phonetic input independent of semantic cues. Working memory capacity did not show the same specific predictive relationship for context use in this analysis. These findings clarify the distinct roles of neurocognitive functions in speech recognition for CI users. By identifying inhibitory control as critical for top-down processing, the study highlights that successful speech comprehension relies not just on auditory input quality but on specific cognitive resources. The authors conclude that these results support the development of comprehensive rehabilitative approaches for adult CI patients. Specifically, interventions could target underlying core neurocognitive functions, such as inhibitory control, to optimize the use of top-down processing and improve speech recognition outcomes in degraded listening conditions.

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• perceptual processing