The Integrated Neurofunctional Accessibility Model (MIAN): A Theoretical Framework for Speech Comprehension and Learning in Children with Cochlear Implants
Keywords:
Integrated neurofunctional accessibility model, Cochlear implants, Speech comprehension, Listening effort, Accessibility, Learning, Inclusive educationAbstract
Access to spoken language represents a fundamental prerequisite for learning in educational contexts. In children with cochlear implants, auditory perception is restored through technological mediation, but access to sound does not necessarily guarantee efficient speech comprehension or learning. The present paper introduces the Integrated Neurofunctional Accessibility Model (MIAN), a theoretical framework that conceptualizes accessibility as a neurofunctional condition emerging from the interaction between sensory signal quality, environmental structure, and cognitive resource availability. Within this model, accessibility is distinguished from audibility and defined as the degree to which linguistic information can be efficiently accessed, processed, and stabilized by the nervous system to support learning. Reduced accessibility increases listening effort, reallocates cognitive resources toward perceptual reconstruction, and constrains higher-order cognitive processes such as comprehension and memory encoding. The MIAN model integrates neuroscientific, cognitive, and educational perspectives to explain how variability in learning outcomes among children with cochlear implants may reflect differences in accessibility rather than intrinsic cognitive limitations. The framework highlights the role of environmental structuring in optimizing accessibility and reducing cognitive load.
References
Baddeley, A. D. (2000). The episodic buffer: A new component of working memory. Trends in Cognitive Sciences, 4(11), 417–423. https://doi.org/10.1016/S1364-6613(00)01538-2
Booth, T., & Ainscow, M. (2011). The index for inclusion: Developing learning and participation in schools (3rd ed.). Centre for Studies on Inclusive Education.
Clark, A. (2013). Whatever next? Predictive brains, situated agents, and the future of cognitive science. Behavioral and Brain Sciences, 36(3), 181–204. https://doi.org/10.1017/S0140525X12000477
Florian, L. (2014). What counts as evidence of inclusive education? European Journal of Special Needs Education, 29(3), 286–294. https://doi.org/10.1080/08856257.2014.933551
Florian, L., & Black-Hawkins, K. (2011). Exploring inclusive pedagogy. British Educational Research Journal, 37(5), 813–828. https://doi.org/10.1080/01411926.2010.501096
Friston, K. (2010). The free-energy principle: A unified brain theory? Nature Reviews Neuroscience, 11(2), 127–138. https://doi.org/10.1038/nrn2787
Klatte, M., Bergström, K., & Lachmann, T. (2013). Does noise affect learning? A short review on noise effects on cognitive performance in children. Frontiers in Psychology, 4, Article 578. https://doi.org/10.3389/fpsyg.2013.00578
Kronenberger, W. G., & Pisoni, D. B. (2019). Neurocognitive functioning in deaf children with cochlear implants. In M. Marschark & H. Knoors (Eds.), The Oxford handbook of deaf studies in learning and cognition (pp. 195–208). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780190054045.013.13
McGarrigle, R., Munro, K. J., Dawes, P., Stewart, A. J., Moore, D. R., Barry, J. G., & Amitay, S. (2014). Listening effort and fatigue: What exactly are we measuring? A British Society of Audiology cognition in hearing special interest group “white paper”. International Journal of Audiology, 53(7), 433–440. https://doi.org/10.3109/14992027.2014.890296
Nelson, P. B., Kohnert, K. J., Sabur, S. B., & Shaw, D. (2005). Classroom noise and children learning through a second language: Double jeopardy? Language, Speech, and Hearing Services in Schools, 36(3), 219–229. https://doi.org/10.1044/0161-1461(2005/022)
Pichora-Fuller, M. K., Kramer, S. E., Eckert, M. A., Edwards, B., Hornsby, B. W. Y., Humes, L. E., Lemke, U., Lunner, T., Matthen, M., Mackersie, C. L., Naylor, G., Phillips, N. A., Richter, M., Rudner, M., Sommers, M. S., Tremblay, K. L., & Wingfield, A. (2016). Hearing impairment and cognitive energy: The framework for understanding effortful listening (FUEL). Ear and Hearing, 37, 5S–27S. https://doi.org/10.1097/AUD.0000000000000312
Pisoni, D. B., & Kronenberger, W. G. (2010). Executive function in deaf children with cochlear implants. In M. Marschark & P. E. Spencer (Eds.), The Oxford handbook of deaf studies, language, and education (Vol. 2, pp. 439–457). Oxford University Press.
Pisoni, D. B., Kronenberger, W. G., Roman, A. S., & Geers, A. E. (2011). Measures of digit span and verbal rehearsal speed in deaf children after more than 10 years of cochlear implantation. Ear and Hearing, 32(1 Suppl.), 60S–74S. https://doi.org/10.1097/AUD.0b013e3181ffd58e
Shannon, R. V., Zeng, F. G., Kamath, V., Wygonski, J., & Ekelid, M. (1995). Speech recognition with primarily temporal cues. Science, 270(5234), 303–304. https://doi.org/10.1126/science.270.5234.303
Shield, B. M., & Dockrell, J. E. (2003). The effects of noise on children at school: A review. Journal of Building Acoustics, 10(2), 97–116. https://doi.org/10.1260/135101003768965960
Sweller, J. (1988). Cognitive load during problem solving: Effects on learning. Cognitive Science, 12(2), 257–285. https://doi.org/10.1207/s15516709cog1202_4
UNESCO. (2020). Global education monitoring report 2020: Inclusion and education: All means all. https://unesdoc.unesco.org/ark:/48223/pf0000373718
Wilson, B. S., & Dorman, M. F. (2008). Cochlear implants: A remarkable past and a brilliant future. Hearing Research, 242(1–2), 3–21. https://doi.org/10.1016/j.heares.2008.06.005
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