Foundational Questions: A Researcher’s ASHF-Launched Quest for Answers Name: Aaron Moberly, MD Title: Assistant Professor, Division of Otology, Neurology, & Cranial Base Surgery, Department of Otolaryngology–Head & Neck Surgery, Ohio State University Wexner Medical Center Contact: aaron.moberly@osumc.edu ASHFoundation Award: 2014 Speech Science Research Grant ($5,000), “Personalizing Aural Rehabilitation for Adults After Cochlear Implantation” My research focus is ... Foundational Questions
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Foundational Questions  |   October 01, 2016
Foundational Questions: A Researcher’s ASHF-Launched Quest for Answers
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ASHA News & Member Stories / Foundational Questions
Foundational Questions   |   October 01, 2016
Foundational Questions: A Researcher’s ASHF-Launched Quest for Answers
The ASHA Leader, October 2016, Vol. 21, online only. doi:10.1044/leader.FQ.21102016.np
The ASHA Leader, October 2016, Vol. 21, online only. doi:10.1044/leader.FQ.21102016.np
Name: Aaron Moberly, MD
Title: Assistant Professor, Division of Otology, Neurology, & Cranial Base Surgery, Department of Otolaryngology–Head & Neck Surgery, Ohio State University Wexner Medical Center
ASHFoundation Award: 2014 Speech Science Research Grant ($5,000), “Personalizing Aural Rehabilitation for Adults After Cochlear Implantation”
What is the focus of your research?
My research focus is two-fold and related to speech recognition outcomes for adults who are postlingually deafened and receive cochlear implants (CIs). I am interested, first, in identifying the auditory, linguistic and cognitive factors that explain variability in speech-recognition outcomes for this population of CI users. Second, I want to use this information to develop novel intervention strategies to improve speech-recognition outcomes in CI users using rehabilitation strategies that focus on auditory, linguistic and cognitive skills.
How did your award from the ASHFoundation lead to your current work?
The award from the ASHFoundation, the Speech Science Award, supported my study of verbal working-memory skills in postlingual adults with CIs, and related these skills to sentence-recognition abilities. In that study, 30 adult CI users and 30 age-matched controls with normal hearing were tested on tasks of digit span and serial recall of words, sentence recognition, and phonological sensitivity. That study found that phonological sensitivity was much poorer for CI users than for listeners with normal hearing, and these deficits appeared to contribute to poorer recognition of words in sentences in noise.
I used data from this study as preliminary data for a NIH (NIDCD) K23 career development award proposal, resubmitted this July, as well as for a proposal to the American Otological Society Clinician-Scientist Award, which was awarded to support my salary over three years, starting July 2016. This work will examine the contributions and interactions of bottom-up (auditory) and top-down (linguistic and cognitive) factors in speech recognition for adult CI users.
What do you hope to demonstrate through your research—or what has it already demonstrated?
My first goal is to demonstrate that top-down linguistic and cognitive factors contribute to speech recognition outcomes in adult CI users. In particular, as a CI surgeon, I want to share this perspective, and studies supporting it, with other CI surgeons, who tend to focus on the contributions to outcomes of factors primarily related to the implant itself. I believe my work supports the need for postoperative rehabilitation in adult CI users, which is not commonly done in adults in the United States.
Optimizing outcomes and quality of life in these patients requires a whole-brain approach to rehabilitation: It takes a whole brain to understand spoken language. Moreover, this approach seems especially applicable and necessary in older adults who may be experiencing aging-related cognitive declines. For example, my work demonstrates that speech recognition and working memory abilities in older CI users are significantly poorer than in younger adult CI users.
Why did you choose this particular research focus?
During my fellowship training in neurotology, I was struck during my time in clinic by the variable speech-recognition outcomes demonstrated by adult CI users. This clinical finding led me to search the literature for published work done to explain this variability. This literature search inevitably led me to work done on speech recognition in older adults and adults with lesser degrees of hearing loss, which suggested the effects of linguistic and cognitive functions in speech recognition for these populations. This approach was supported by literature suggesting that only about half of the outcome variability could be explained by peripheral/auditory factors and factors related to the CI device itself.
I discovered that adults who are postlingually deafened remain a relatively neglected clinical population in terms of outcomes research. Moreover, I realized that these findings—that linguistic and cognitive skills may contribute to speech-recognition outcomes for these patients—suggested that there are likely rehabilitative intervention approaches that would help these patients optimize outcomes, particularly for poor CI performers. Thus, this research focus developed from my desire to approach a real clinical problem in a translational fashion.
How has ASHFoundation funding affected your professional life?
Funding through the ASHFoundation supported some of my early work, providing preliminary data and allowing me to pursue additional funding to allow me to continue this line of research. This early funding was instrumental in supporting my career path as a surgeon-scientist.
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October 2016
Volume 21, Issue 10