Multisensory integration-attention trade-off in cochlear-implanted deaf individuals

A bstract The cochlear implant (CI) allows profoundly deaf individuals to partially recover hearing. Still, due to the coarse acoustic information provided by the implant, CI users have considerable difficulties in recognizing speech, especially in noisy environments. CI users therefore rely heavily on visual cues to augment speech comprehension, more so than normal-hearing individuals. However, it is unknown how attention to one (focused) or both (divided) modalities plays a role in multisensory speech recognition. Here we show that unisensory speech listening and reading were negatively impacted in divided-attention tasks for CI users - but not for normal-hearing individuals. Our psychophysical experiments revealed that, as expected, listening thresholds were consistently better for the normal-hearing, while lipreading thresholds were largely similar for the two groups. Moreover, audiovisual speech recognition for normal-hearing individuals could be described well by probabilistic summation of auditory and visual speech recognition, while CI users were better integrators than expected from statistical facilitation alone. Our results suggest that this benefit in integration comes at a cost. Unisensory speech recognition is degraded for CI users when attention needs to be divided across modalities. We conjecture that CI users exhibit an integration-attention trade-off. They focus solely on a single modality during focused-attention tasks, but need to divide their limited attentional resources in situations with uncertainty about the upcoming stimulus modality. We argue that in order to determine the benefit of a CI for speech comprehension, situational factors need to be discounted by presenting speech in realistic or complex audiovisual environments. S ignificance statement Deaf individuals using a cochlear implant require significant amounts of effort to listen in noisy environments due to their impoverished hearing. Lipreading can benefit them and reduce the burden of listening by providing an additional source of information. Here we show that the improved speech recognition for audiovisual stimulation comes at a cost, however, as the cochlear-implant users now need to listen and speech-read simultaneously, paying attention to both modalities. The data suggests that cochlear-implant users run into the limits of their attentional resources, and we argue that they, unlike normal-hearing individuals, always need to consider whether a multisensory benefit outweighs the unisensory cost in everyday environments.