Macquarie University
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Effectiveness of auditory training for adult cochlear implant users

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posted on 2022-03-28, 23:29 authored by Mariana Citton Padilha dos Reis
Clinicians working with adult cochlear implant (CI) users often recommend auditory training (AT) as an intervention to improve listening abilities. Lack of robust evidence and inconsistencies in AT studies, however, limits confidence in the usefulness of this intervention. This thesis assessed the effectiveness of AT for adult CI users in the context of clinical decision-making, resource allocation and evidence-based practice in a series of three manuscripts. First, AT practices and their associated costs were assessed using data from a survey distributed to Australian audiologists working with adult CI users (n=78, 33% response rate). Is was demonstrated that clinicians believe AT is beneficial, and adopt varied methods to deliver AT. Costs incurred for clients who receive AT were estimated to range from AUD 0 to AUD 1438.98 per program, depending on the AT method of delivery. Second, a randomised crossover study investigated the effectiveness of a computer-based auditory training (CBAT) program, in comparison to a computer-based visual training (VT) program, on measures of listening and cognitive abilities, and self-reported communication and quality of life in 26 adult CI users. It was demonstrated that although on-task improvement occurred for both the AT and the VT programs, these improvements did not transfer to the outcome measures assessed post-training and at follow-up. Finally, a rapid review of nine CBAT studies in adult CI users was conducted. Inconsistencies in training stimuli, outcome measures and study findings associated to risk of bias present within and across studies, indicated that current evidence provides very low confidence that AT can improve speech perception, and low confidence that it can improve cognitive abilities, self-reported listening and quality of life in adult CI users. This thesis provides practical and up-to-date evidence about AT in adult CI users which can influence both current clinical practices and future research studies.


Table of Contents

Chapter 1. Introduction -- Chapter 2. Auditory training for adult cochlear implant users : a survey and cost analysis study -- Chapter 3. Effectiveness of computer-based auditory training for adult cochlear implant users : a randomised crossover study -- Chapter 4. Effectiveness of computer-based auditory training for adult cochlear implant users : a rapid review of the evidence -- Chapter 5. Final considerations -- Chapter 5. Reckoning with rape culture : individual and community in young adult rape fiction -- References -- Appendices.


Bibliography: pages 111-128 "Audiology Section, Department of Linguistics, Faculty of Human Sciences, Macquarie University, Sydney, Australia" -- title page. Empirical thesis.

Awarding Institution

Macquarie University

Degree Type

Thesis PhD


PhD, Macquarie University, Faculty of Human Sciences, Department of Linguistics

Department, Centre or School

Department of Linguistics

Year of Award


Principal Supervisor

Isabelle Boisvert

Additional Supervisor 1

Catherine McMahon

Additional Supervisor 2

Helen Henshaw


Copyright Mariana Citton Padilha dos Reis 2019. Copyright disclaimer:




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