Visual working memory span in adults with cochlear implants: Some preliminary findings

OBJECTIVE: Neurocognitive functions, specifically verbal working memory (WM), contribute to speech recognition in postlingual adults with cochlear implants (CIs) and normal-hearing (NH) listener shearing degraded speech. Three hypotheses were tested: (1) WM accuracy as assessed using three visual span measures — digits, objects, and symbols — would correlate with recognition scores for spectrally degraded speech (through a CI or when noise-vocoded); (2) WM accuracy would be best for digit span, intermediate for object span, and lowest for symbol span, due to the increasing cognitive demands across these tasks. Likewise, response times, relating to processing demands, would be shortest for digit span, intermediate for object span, and longest for symbol span; (3) CI users would demonstrate poorer and slower performance than NH peers on WM tasks, as a result of less efficient verbally mediated encoding strategies associated with a period of prolonged auditory deprivation. METHODS: Cross-sectional study of 30 postlingually deaf adults with CIs and 34 NH controls. Participants were tested for sentence recognition in quiet (CI users) or after noise-vocoding (NH peers), along with WM using visual measures of digit span, object span, and symbol span. RESULTS: Of the three measures of WM, digit span scores alone correlated with sentence recognition for CI users; no correlations were found using these three measures for NH peers. As predicted, WM accuracy (and response times) were best (and fastest) for digit span, intermediate for object span, and worst (and slowest) for symbol span. CI users and NH peers demonstrated equivalent WM accuracy and response time for digit span and object span, and similar response times for symbol span, but contrary to our original predictions, CI users demonstrated better accuracy on symbol span than NH peers. CONCLUSIONS: Verbal WM assessed using visual tasks relates weakly to sentence recognition for degraded speech. CI users performed equivalently to NH peers on most visual tasks of WM, but they outperformed NH peers on symbol span accuracy. This finding deserves further exploration but may suggest that CI users develop alternative or compensatory strategies associated with rapid verbal coding, as a result of their prolonged experience of auditory deprivation.