Speech recognition materials and ceiling effects: considerations for cochlear implant programs.

Area of Science:

• Audiology
• Otolaryngology
• Neuroscience

Background:

• Cochlear implant (CI) technology and patient profiles have advanced significantly since 1984.
• Current speech recognition testing protocols in the US have remained unchanged for over a decade.
• This stagnation necessitates re-evaluation of existing testing methods.

Purpose of the Study:

• To assess the adequacy of current speech recognition tests for postlingually deafened adult cochlear implant recipients.
• To determine if updated testing recommendations are warranted based on current patient performance.
• To compare performance across different speech recognition materials.

Main Methods:

• Speech perception was evaluated in 156 adult cochlear implant users and 50 hearing aid users.
• Tests included monosyllabic word recognition (CNC), sentence recognition in quiet (HINT, AzBio), and in noise (BKB-SIN).

Main Results:

• A high percentage (28%) of CI users achieved maximum scores on the HINT sentences in quiet, showing poor agreement with other tests.
• On the more difficult AzBio sentences, only 0.7% achieved maximum scores, with better agreement with monosyllabic and noise tests.
• This indicates current easy tests may not differentiate performance effectively.

Conclusions:

• Existing speech recognition tests, particularly easier ones like HINT in quiet, may not be sensitive enough for current cochlear implant recipients.
• More challenging speech perception materials, such as AzBio sentences, are likely needed to accurately assess performance.
• Updated testing protocols may be necessary for evaluating cochlear implant candidacy and post-operative progress.