# Speech Production Intelligibility Is Associated with Speech Recognition in Adult Cochlear Implant Users

## TL;DR

This study explores how speech intelligibility in adult cochlear implant users relates to their ability to recognize speech and process phonological information.

## Contribution

The study reveals a relationship between speech intelligibility and speech recognition accuracy in cochlear implant users.

## Key findings

- CI users with more understandable speech showed better sentence recognition accuracy.
- Vowel distinctiveness was marginally linked to sentence recognition but not to phonological processing.
- Intelligibility ratings had only a marginal connection to phonological processing.

## Abstract

Background/Objectives: Adult cochlear implant (CI) users exhibit broad variability in speech perception and production outcomes. Cochlear implantation improves the intelligibility (comprehensibility) of CI users’ speech, but the degraded auditory signal delivered by the CI may attenuate this benefit. Among other effects, degraded auditory feedback can lead to compression of the acoustic–phonetic vowel space, which makes vowel productions confusable, decreasing intelligibility. Sustained exposure to degraded auditory feedback may also weaken phonological representations. The current study examined the relationship between subjective ratings and acoustic measures of speech production, speech recognition accuracy, and phonological processing (cognitive processing of speech sounds) in adult CI users. Methods: Fifteen adult CI users read aloud a series of short words, which were analyzed in two ways. First, acoustic measures of vowel distinctiveness (i.e., vowel dispersion) were calculated. Second, thirty-seven normal-hearing (NH) participants listened to the words produced by the CI users and rated the subjective intelligibility of each word from 1 (least understandable) to 100 (most understandable). CI users also completed an auditory sentence recognition task and a nonauditory cognitive test of phonological processing. Results: CI users rated as having more understandable speech demonstrated more accurate sentence recognition than those rated as having less understandable speech, but intelligibility ratings were only marginally related to phonological processing. Further, vowel distinctiveness was marginally associated with sentence recognition but not related to phonological processing or subjective ratings of intelligibility. Conclusions: The results suggest that speech intelligibility ratings are related to speech recognition accuracy in adult CI users, and future investigation is needed to identify the extent to which this relationship is mediated by individual differences in phonological processing.