Speech recognition in children with unilateral and bilateral cochlear implants in quiet and in noise
Individuals are increasingly undergoing bilateral cochlear implantation in an attempt to benefit from binaural hearing. The main aim of the present study was to compare the speech recognition of children fitted with bilateral cochlear implants, under binaural and monaural listening conditions, in quiet and in noise. Ten children, ranging in age from 5 years 7 months to 15 years 4 months, were tested using the Children’s Realistic Index for Speech Perception (CRISP). All the children were implanted with Nucleus multi-channel cochlear implant systems in sequential operations and used the ACE coding strategy bilaterally. The duration of cochlear implant use ranged from 4 years to 8 years 11 months for the first implant and 7 months to 3 years 5 months for the second implant. Each child was tested in eight listening conditions, which included testing in the presence and absence of competing speech. Performance with bilateral cochlear implants was not statistically better than performance with the first cochlear implant, for both quiet and noisy listening conditions. A ceiling effect may have resulted in the lack of a significant finding as the scores obtained during unilateral conditions were already close to maximum. A positive correlation between the length of use of the second cochlear implant and speech recognition performance was established. The results of the present study strongly indicated the need for testing paradigms to be devised which are more sensitive and representative of the complex auditory environments in which cochlear implant users communicate.