Use an abbreviated nonverbal reasoning test pre-operatively to identify CI candidates at risk for poor speech recognition outcomes¶

Strategy · All strategies
Evidence · 5 claims (5 for) · 1 study (1 associational), q3 · 1 of 1 report an effect size · 5 claims rest on one study

Description¶

The authors recommend administering a short nonverbal reasoning measure before implantation so clinicians can flag patients at risk, counsel realistically, and target weaknesses in rehabilitation. They write that predicting outcomes "could support identification of particular individuals who are at risk for poor post-operative outcomes, improve patient counseling regarding expected post-operative outcomes, and provide the opportunity to target particular weaknesses that could be addressed in a rehabilitative program." The abbreviated RPM is proposed as the feasible instrument for this purpose, likely in combination with other measures.

Design Implications¶

Context¶

Requirements¶

• A brief, clinically feasible nonverbal reasoning assessment such as the 12-item RPM subset, completable in three to four minutes

Constraints¶

• The article states additional studies are needed to determine the test's prognostic utility, and notes bottom-up and top-down processes likely interact, with a possible limit to the signal degradation top-down processes can compensate

Target Learners¶

• Post-lingually deafened adults considering cochlear implantation

Target Learning Goals¶

• Pre-operative prognostication of speech recognition outcomes and identification of rehabilitation targets

Claims¶

• An abbreviated 12-item RPM subset predicts sentence recognition in CI users with comparable validity to the full 48-item test [+M]
• Nonverbal reasoning (RPM) scores are positively correlated with sentence recognition in post-lingually deafened adult cochlear implant users [+W]
• Nonverbal reasoning scores also correlate with degraded (noise-vocoded) sentence recognition in age-matched normal-hearing listeners [+W]
• The 12-item RPM subset similarly predicts degraded sentence recognition in normal-hearing controls, replicating the CI finding [+M]
• Demographic and audiologic factors (age, duration of hearing loss, age at onset, residual hearing) were not significantly correlated with speech recognition in CI users [+W]

Related Strategies¶

Examples¶

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Key Sources¶

• Mattingly Jameson K MD, Castellanos Irina PhD, Moberly Aaron C MD. (2018). Nonverbal Reasoning as a Contributor to Sentence Recognition Outcomes in Adults with Cochlear Implants. Otology & Neurotology. https://doi.org/10.1097/MAO.0000000000001998