Assessing the cognitive effects of noise in children with cochlear implants: A proof-of-concept study

Children’s communication often occurs under suboptimal conditions, such as when speech is masked by noise. While hearing children can adapt to these situations, noise remains a significant barrier to communication for children with hearing loss. Moving from the Ease of Language Understanding (ELU) model, which describes speech processing as a verbal working-memory (WM) based system, we conducted a pilot trial to test an assessment protocol for investigating the effects of noise on the verbal WM performance of children with cochlear implants (CI). Five cochlear implanted children and 5 normally-hearing (NH) age-matched children (8-11 years) performed an auditory attention task and auditory digit span forward and backward tasks in a soundproof cabin under controlled quiet and babble noise conditions.  Behavioral (response accuracy), self-report, and psychophysiological (pupil dilation) measures were used to evaluate their performance and cognitive effort in noise. At the behavioral level, CI children performed worse than NH children in both acoustic conditions. Although no significant effects of acoustic condition (quiet/noise) were observed for either group, CI children’s pupil dilation measures revealed greater cognitive effort in noise. These preliminary findings suggest the need for integrating pupillometric measures in the assessment of CI children’s performance in noise.