How Do You Deal With Uncertainty? Cochlear Implant Users Differ in the Dynamics of Lexical Processing of Noncanonical Inputs

Objectives: Work in normal-hearing (NH) adults suggests that spoken language processing involves coping with ambiguity. Even a clearly spoken word contains brief periods of ambiguity as it unfolds over time, and early portions will not be sufficient to uniquely identify the word. However, beyond this temporary ambiguity, NH listeners must also cope with the loss of information due to reduced forms, dialect, and other factors. A recent study suggests that NH listeners may adapt to increased ambiguity by changing the dynamics of how they commit to candidates at a lexical level. Cochlear implant (CI) users must also frequently deal with highly degraded input, in which there is less information available in the input to recover a target word. The authors asked here whether their frequent experience with this leads to lexical dynamics that are better suited for coping with uncertainty. Design: Listeners heard words either correctly pronounced (dog) or mispronounced at onset (gog) or offset (dob). Listeners selected the corresponding picture from a screen containing pictures of the target and three unrelated items. While they did this, fixations to each object were tracked as a measure of the time course of identifying the target. The authors tested 44 postlingually deafened adult CI users in 2 groups (23 used standard electric only configurations, and 21 supplemented the CI with a hearing aid), along with 28 age-matched age-typical hearing (ATH) controls. Results: All three groups recognized the target word accurately, though each showed a small decrement for mispronounced forms (larger in both types of CI users). Analysis of fixations showed a close time locking to the timing of the mispronunciation. Onset mispronunciations delayed initial fixations to the target, but fixations to the target showed partial recovery by the end of the trial. Offset mispronunciations showed no effect early, but suppressed looking later. This pattern was attested in all three groups, though both types of CI users were slower and did not commit fully to the target. When the authors quantified the degree of disruption (by the mispronounced forms), they found that both groups of CI users showed less disruption than ATH listeners during the first 900 msec of processing. Finally, an individual differences analysis showed that within the CI users, the dynamics of fixations predicted speech perception outcomes over and above accuracy in this task and that CI users with the more rapid fixation patterns of ATH listeners showed better outcomes. Conclusions: Postlingually deafened CI users process speech incrementally (as do ATH listeners), though they commit more slowly and less strongly to a single item than do ATH listeners. This may allow them to cope more flexible with mispronunciations. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal's Web site (www.ear-hearing.com). ACKNOWLEDGMENTS: The authors thank Hannah Rigler and Claire Goodwin for assistance with data collection and management, Camille Dunn for assistance with participant recruitment, and Bruce Gantz for support of the overall project. This project was funded by NIH Grants DC008089 awarded to B.M. and DC000242 awarded to Bruce Gantz and B.M. B.M. and K.S.A. conceptualized, designed, and implemented the study. B.M., T.P.E., and K.S.A. analyzed the results. B.M. and K.S.A. wrote the manuscript which all three authors extensively discussed and edited. The authors have no conflicts of interest to disclose. Address for correspondence: Bob McMurray, Department of Psychological and Brain Sciences, University of Iowa, W314 SSH, Iowa City, IA 52242, USA. E-mail: Bob-mcmurray@uiowa.edu Received August 7, 2017; accepted September 10, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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