Aural Rehabilitation for Cochlear Implant Users Via Telerehab Technology

Study Overview
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Brief Summary
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This study evaluates the benefits of short-term training via telehealth for post-lingually deafened adult cochlear implant users. Half the participants will receive aural rehabilitation and the other half cognitive training. The hypothesis is that short-term aural rehabilitation via telerehab technology will improve outcomes for post-lingually deafened cochlear implant users

Detailed Description
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Aural rehabilitation training (AR) has been demonstrated to improve outcomes for adult cochlear implant users. There are both financial and non-financial barriers to AR service delivery including accessibility (mobility, distance and transportation problems), accommodation (time off work impossible, caring for family) and availability (limited providers in rural areas, financial constraints, and lack of transportation. In this study the investigators will measure the impact of telerehab delivery on optimizing speech recognition, communication function, goals, social participation and hearing handicap. Twenty-four participants will be randomly assigned to one of two treatment groups: aural rehabilitation (AR) and cognitive training (CT). Participants will complete six 90-minute treatment sessions in their home or office via a telerehab platform. Participants will come to a center for three 90-minute assessment sessions: pre-treatment, 1 week, and 2 months post-treatment.

Official Title
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Enhanced Aural Rehabilitation for Cochlear Implant Users Via Telerehab Technology

Conditions
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Hearing Loss, Deafness

Intervention / Treatment
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* Behavioral: Aural Rehabilitation Group
* Behavioral: Cognitive Training Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Speech Tracking rate of at least 20 words per minute Sentence recognition scores (CasperSent) between 10% and 85% Passing score on cognitive screener (Callahan et al., 2002) Exclusion Criteria: Less than 18 years of age Pre-lingually deafened Prior Aural Rehabilitation with cochlear implant Greater than three years post-activation of CI

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants are randomly assigned to either AR Treatment or Active (Cognitive Training) Control Group. Participants are not told they are in the control group. After the final assessment (two-month post-treatment), control group participants are offered the AR treatment.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Aural Rehabilitation Group<br>The AR Group will receive six 90-minute sessions including auditory training, informational counseling, and communication strategies. | Behavioral: Aural Rehabilitation Group<br>* Participants will complete sessions in their home or office via the internet. Sessions will include listening activities, informational counseling and communication strategies training. Three assessment appointments are required. The goal is to evaluate the benefit of training on performance with a cochlear implant.<br>|
| Sham Comparator: Cognitive Training Group<br>The Cognitive Training Group will receive six 90-minute sessions including training exercises (Ken-Ken, Sudoku, Crosswords, Word Search, Spot the Difference) to improve speed and accuracy. | Behavioral: Cognitive Training Group<br>* The Cognitive Training Group will receive six 90-minute sessions including training exercises (Ken-Ken, Sudoku, Crosswords, Word Search, Spot the Difference) to improve speed and accuracy. Three assessment sessions are also required.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Sentence Recognition CasperSent (Boothroyd, 2008) | Percent correct scores on CasperSent topic-related recorded sentences. | Pre-training, One-week and Two-months post-training | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Client Oriented Scale of Improvement (COSI) (Dillon, James & Ginis, 1997) | Participant rates hearing ability and degree of change due to treatment for three self- selected listening situations most important to them. | Pre-training, One-week and Two-months post-training | 
| Change in Hearing Handicap Inventory (HHI) (Ventry & Weinstein,1982) | Participant rates 25 statements as true Always, Sometimes, or Never. Two subscales are Emotional and Social/situational. | Pre-training, One-week and Two-months post-training | 
| Change in Glasgow Benefit Inventory (GBI) (Robinson et al.,1996 | Participant rates change statements of change post-treatment. | One-week and Two-months post-training | 
| Change in Nijmegen Cochlear Implant Questionnaire (NCIQ) (Hinderdink et al., 2000) | 60-item questionnaire with three domains: Physical, Social and Psychological. | Pre-training, One-week and Two-months post-training | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adult, Post-lingual, Auditory training, Communication strategies, Speech tracking, Speech recognition, Quality of Life