Verbal Processing Speed and Executive Functioning in Long-Term Cochlear Implant Users

AuBuchon, Angela M.; Pisoni, David B.; Kronenberger, William G. · 2015 · Crossref

DOI: 10.1044/2014_jslhr-h-13-0259

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Summary

This study investigates the relationship between verbal processing speed and executive functioning (EF) in long-term cochlear implant (CI) users. While CI users often achieve speech and language scores comparable to normally hearing (NH) peers, they exhibit greater variability in outcomes and known deficits in EF domains such as verbal working memory, fluency-speed, and inhibition-concentration. The research aims to determine if slower verbal rehearsal speed (VRS), a measure of covert speech efficiency, and perceptual encoding speed contribute to these EF deficits. The authors hypothesized that CI users would display slower processing speeds and that VRS would correlate with EF in NH individuals but potentially not in CI users, suggesting differences in cognitive strategies. The study included 55 prelingually deaf, long-term CI users and 55 matched NH controls, aged 7–25 years. Participants were matched on nonverbal IQ and age. CI users had severe-to-profound hearing loss prior to age 3, received implants before age 7, and had at least 7 years of implant use. VRS was estimated via articulation rate during sentence repetition tasks. Perceptual encoding speed was measured using digit and color naming tasks. EF was assessed through composite scores for verbal working memory, fluency-speed, and inhibition-concentration, derived from a battery of laboratory-based tasks. Speech perception and language outcomes were also measured for the CI group. Correlational analyses examined the relationships between processing speed measures and EF domains in both groups. Results indicated that CI users displayed significantly slower verbal processing speeds than NH controls. In the NH sample, VRS was significantly related to two EF domains, supporting the role of covert speech in executive control. However, VRS was unrelated to EF outcomes in the CI user group. In contrast, perceptual encoding speed was significantly related to all three EF domains in both CI and NH groups. These findings suggest that while rapid automatized labeling skills are closely tied to EF quality in both populations, the specific mechanism of verbal rehearsal differs. The study concludes that verbal rehearsal speed may be less influential for EF quality in CI users than in NH controls. This implies that CI users may develop alternative processing strategies for EF tasks that do not rely on the covert speech strategies routinely employed by NH individuals. The findings highlight that while perceptual encoding speed remains a critical factor for executive functioning across both groups, the disruption in the link between VRS and EF in CI users points to distinct neurocognitive adaptations or deficits resulting from early sensory deprivation. Understanding these underlying mechanisms is crucial for identifying factors contributing to the variability in speech, language, and EF outcomes in the CI population.

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• cognitive capacity variation