Are Psychoacoustic Tests Enough? Exploring Their Relationship With Self-Reported Hearing Outcomes in CI Users
Abstract
Objective: Cochlear implant (CI) users are typically assessed using behavioral psychoacoustic measures. However, these evaluations may not adequately reflect real-world listening experiences. This study aimed to examine the relationship between psychoacoustic performance and self-reported hearing abilities in daily life among CI users.
Material and Methods: Twenty-four adult unilateral CI recipients (mean age=34.98±8.85 years; range: 19–50 years) were included in the study. The study utilized behavioral measures [Spectral-Temporally Modulated Ripple Test (SMRT), and Temporal Modulation Transfer Function (TMTF), Turkish Matrix Test (Matrix)], self-reported questionnaires [Speech, Spatial and Qualities of Hearing Scale (SSQ) and the hearing handicap inventory for adults (HHI-A). The TMTF evaluation was performed at a modulation frequency of 10 Hz, and the Matrix test was applied in adaptive mode.
Results: No significant overall correlation was observed between TMTF, SMRT, Matrix, self-reported assessments (p>.05). Although no significant differences (p>.05) were observed, weak positive correlations were found between the Matrix test and the HHI-A Emotional (r=.318) and Social (r=.385) subdomains, as well as between the TMTF and the SSQ Hearing Qualities subdomain (r=.295). SMRT and Matrix scores moderate correlated significantly (r=–.492, p=.015); HHI-A Emotional scores were moderate correlated with SSQ Hearing Qualities (r=–.420, p=.041); HHI-A Social scores moderate correlated with SSQ Hearing Qualities (r=–.447, p=.029).
Conclusions: Although behavioral assessments hold a primary place within test protocols, self-report questionnaires provide important complementary information by reflecting the impact of hearing loss on daily life from the individual’s perspectives. Therefore, incorporating self-report scales into test batteries designed for the evaluation of cochlear implant users offers substantial value, as it allows auditory performance to be approached comprehensively from both behavior-based measurements and subjective dimensions.
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References
- Callen JL, Westbrook JI, Georgiou A, Li J. Failure to follow-up test results for ambulatory patients: A systematic review. J Gen Intern Med 2012;27(10):1334-48. google scholar
- Prentiss S, Snapp H, Zwolan T. Audiology practices in the preoperative evaluation and management of adult cochlear implant candidates. JAMA Otolaryngol Head Neck Surg 2020;146(2):136-42. google scholar
- Gatehouse S, Noble W. The speech, spatial and qualities of hearing scale (SSQ). Int J Audiol 2004;43(2):85-99. google scholar
- Newman CW, Weinstein BE, Jacobson GP, Hug GA. Test-retest reliability of the hearing handicap inventory for adults. Ear Hear 1991;12(5):355-7. google scholar
- Samuel AG. Speech perception. Annu. Rev Psychol 2011;62(1):49-72. google scholar
- Ali F. The role of sound offsets in auditory temporal processing and perception Doctoral Thesis, University College London, 2021. google scholar
- Litvak LM, Spahr AJ, Saoji AA, Fridman GY. Relationship between perception of spectral ripple and speech recognition in cochlear implant and vocoder listeners. J Acoust Soc Am 2007;122(2):982-91. google scholar
- Moore BC. An introduction to the psychology of hearing. 6th ed: Brill; 2012. google scholar
Details
Primary Language
English
Subjects
Otorhinolaryngology
Journal Section
Research Article
Publication Date
January 16, 2026
Submission Date
October 22, 2025
Acceptance Date
December 12, 2025
Published in Issue
Year 2025 Volume: 35 Number: 4