Understanding speech produced by talkers with diverse voices and accents presents a challenge for adults with hearing loss (HL). Although cochlear implants (CIs) restore access to sound, many CI users continue to report difficulties in these multi-talker environments. The current study examined how auditory and cognitive-linguistic factors impact multi-talker speech recognition among adult CI candidates both before and after implantation, and explored post-CI changes in performance. Twenty-seven adults with bilateral HL completed a multi-talker sentence recognition task (Perceptually Robust English Sentence Test Open-Set; PRESTO) in quiet, at both pre-CI and 1-month post-CI time points, in best-aided conditions. Additional measures included clinical word and sentence recognition tests in quiet and multi-talker babble (MTB), hearing thresholds, and a reading span task of working memory. PRESTO sentences were significantly more difficult than clinical tests in quiet, but was comparable to sentence recognition performance in MTB. More accurate pre-CI PRESTO scores were associated with better residual hearing and stronger working memory. Post-CI PRESTO scores improved significantly, with residual hearing and working memory again contributing to performance. Findings demonstrate the ongoing challenge of multi-talker conditions for adults with HL and suggest that auditory and cognitive factors support degraded speech recognition and early adaptation following implantation.
Tamati et al. (2025) studied this question.