Improving speech perception in noise for children with cochlear implants

Area of Science:

• Audiology and Speech-Language Pathology
• Biomedical Engineering
• Neuroscience

Background:

• Cochlear implant recipients achieve high speech recognition, but background noise remains a significant challenge.
• Nucleus sound processor SmartSound strategies improve speech understanding in noise for adults, but their efficacy in children is not well-established.

Purpose of the Study:

• To evaluate the effectiveness of Nucleus sound processor SmartSound strategies in pediatric cochlear implant recipients.
• To assess speech perception in a realistic restaurant noise simulation using an eight-loudspeaker array (R-SPACE™).

Main Methods:

• A prospective study with a single-subject, repeated-measures design.
• Twenty-two pediatric cochlear implant recipients and 25 normal-hearing controls participated.
• Speech reception thresholds (SRT) were measured using the Hearing In Noise Test (HINT) with Adaptive Dynamic Range Optimization (ADRO) alone and with the addition of Autosensitivity control (ASC).

Main Results:

• The addition of ASC to ADRO significantly improved speech recognition in noise for pediatric cochlear implant recipients by a mean of 3.5 dB SNR.
• The mean SRT for experimental subjects with ADRO + ASC was 10.9 dB SNR, compared to 0.0 dB SNR for normal-hearing controls.
• Despite improvements, cochlear implants still do not fully overcome speech perception deficits in noisy environments.

Conclusions:

• Nucleus SmartSound strategies, specifically ASC added to ADRO, significantly enhance speech understanding in realistic noise for pediatric cochlear implant users.
• The findings support the routine use of ASC with ADRO in everyday listening environments for children with cochlear implants.