Exzellencluster im Auditory Valley
Task Group 3: Functional Characterization of the Individual
There is a large variance in rehabilitation success with hearing aids and cochlear implants in patients with similar hearing impairment even if other factors, such as age of provisioning/implantation are excluded. This impedes an accurate prediction of the individual benefit by a given hearing instrument.
Since standard audiological factors cannot fully account for the observed variance, factors beyond these measures must contribute to the differences. While Task Group 1 will refine and formalize available audiological methods and develop new diagnostic approaches focussing on the peripheral auditory system, Task Group 3 will focus on cognitive, psycholinguistic, neural, genetic and sociodemographic factors usually not covered in audiological diagnostics. We propose a multifactorial and multidisciplinary approach that will close the diagnostic gap between the individual patient´s performance and the model-based predicted outcome.
A multidisciplinary ‘factor research panel’ consisting of basic researchers with expertise in cognitive, neural, genetic and socio-demographic factors as well as clinical experts and modelers will, by an iterative process, improve individualized diagnostics by assessing new research methods and modeling approaches with respect to their diagnostic utility. Since the relationship between auditory performance and individual factors is not well understood even in normally hearing listeners, the task group will focus on both patients and normal volunteers to isolate the influence of such factors on sensory performance. Cognitive factors of interest are selective attention, multisensory integration, verbal learning and phonological working memory. Psycholinguistic testing will address the role of sentence complexity and grammar in understanding speech. Neural factors will be gauged by state of the art neuroimaging and neurophysiological techniques.
The additional factors will be incorporated into theoretical models to evaluate which factors reliably improve patient performance prediction. The aim is to delineate the minimum set of parameters and examination methods necessary to obtain sufficient qualitative and quantitative information on patient performance outcome. This will help to determine the optimum therapy for each individual patient, and may involve decisions between CI implantation vs. hearing aids, decisions on individualized pre-settings of hearing aids or applying individualized auditory, or cognitive or language training strategies to facilitate maximum adaptation to hearing aid devices.