Considerations in pediatric device candidacy: An emphasis on spoken language

Area of Science:

• Audiology
• Speech-Language Pathology

Background:

• Cochlear implant (CI) candidacy is expanding to include children with more residual hearing.
• The use of bimodal devices (a CI in one ear and a hearing aid (HA) in the other) is increasing in pediatric populations.
• Understanding the contributions of acoustic and electric input is crucial for optimizing speech perception in bimodal device users.

Purpose of the Study:

• To examine the contributions of acoustic and electric input to speech perception in a pediatric bimodal device user.
• To compare the performance of a borderline bilateral CI candidate using bimodal devices to peers with severe-profound hearing loss using bilateral devices.

Main Methods:

• A case study design was employed with a single pediatric bimodal device user (S1).
• Speech perception tests evaluated performance in CI-only, HA-only, and bimodal conditions.
• Tests assessed both segmental and suprasegmental speech perception, and spoken language skills were compared to a normative group.

Main Results:

• Speech perception performance was generally similar across CI-only, HA-only, and bimodal conditions, with no clear device-condition benefit observed.
• S1's speech perception and spoken language scores were average or above-average when compared to children with prelingual severe-profound hearing loss using bilateral devices.

Conclusions:

• For borderline CI candidates, bimodal device use may not show a distinct advantage over single-device use in this case.
• Comprehensive assessment of segmental and suprasegmental speech perception, alongside spoken language skills, is recommended for evaluating bimodal recipients.
• These findings inform decisions regarding the transition from bimodal devices to bilateral cochlear implantation.