Optimization of programming parameters in children with the advanced bionics cochlear implant

Area of Science:

• Audiology
• Speech-Language Pathology
• Biomedical Engineering

Background:

• Cochlear implants (CIs) enhance audibility for children with severe-to-profound hearing loss.
• Speech processor parameters like T-level, input dynamic range (IDR), and microphone sensitivity impact CI function.
• Optimal CI programming for pediatric audibility and speech recognition remains under-researched.

Purpose of the Study:

• To determine optimal T-level, IDR, and sensitivity settings for pediatric Advanced Bionics CI users.
• To evaluate the impact of these parameters on audibility and speech recognition in children.

Main Methods:

• Two experiments were conducted with 11 children (ages 7-17) using Advanced Bionics CIs.
• Experiment 1 compared T-levels set at 10% M-levels versus 10 CUs below "soft" for sound detection.
• Experiment 2 assessed IDR/sensitivity combinations (50/0, 50/10, 70/0, 70/10) for speech recognition in quiet and noise.

Main Results:

• Setting T-levels 10 CUs below "soft" significantly improved detection of Ling sounds and FM tones.
• A 50 dB IDR with 0 sensitivity showed poorer thresholds for low-frequency sounds and voiced Ling sounds.
• No significant group differences in speech recognition (CNC words, HINT-C) were found across IDR/sensitivity settings, but individual results varied in noise.

Conclusions:

• Manually setting T-levels based on loudness judgments is recommended for pediatric CI users, especially for inaudible low-level sounds.
• Individualized programming and verification of speech recognition in both quiet and noise are crucial.
• Clinical guidelines for pediatric CI programming parameters are suggested.