The enigma of poor performance by adults with cochlear implants

Aaron C. Moberly, Chelsea Bates, Michael S. Harris, David B. Pisoni

Research output: Contribution to journalArticle

23 Scopus citations


Objective: Considerable unexplained variability and large individual differences exist in speech recognition outcomes for postlingually deaf adults who use cochlear implants (CIs), and a sizeable fraction of CI users can be considered "poor performers." This article summarizes our current knowledge of poor CI performance, and provides suggestions to clinicians managing these patients. Method: Studies are reviewed pertaining to speech recognition variability in adults with hearing loss. Findings are augmented by recent studies in our laboratories examining outcomes in postlingually deaf adults with CIs. Results: In addition to conventional clinical predictors of CI performance (e.g., amount of residual hearing, duration of deafness), factors pertaining to both "bottom-up" auditory sensitivity to the spectro-temporal details of speech, and "top-down" linguistic knowledge and neurocognitive functions contribute to CI outcomes. Conclusions: The broad array of factors that contribute to speech recognition performance in adult CI users suggests the potential both for novel diagnostic assessment batteries to explain poor performance, and also new rehabilitation strategies for patients who exhibit poor outcomes. Moreover, this broad array of factors determining outcome performance suggests the need to treat individual CI patients using a personalized rehabilitation approach.

Original languageEnglish (US)
Pages (from-to)1522-1528
Number of pages7
JournalOtology and Neurotology
Issue number10
StatePublished - Nov 28 2016


  • Adults
  • Cochlear implants
  • Sensorineural hearing loss
  • Speech perception

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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