Children With Bilateral Cochlear Implants Show Emerging Spatial Hearing of Stationary and Moving Sound

Spatial hearing in children with bilateral cochlear implants (BCIs) was assessed by: (a) comparing localization of stationary and moving sound, (b) investigating the relationship between sound localization and sensitivity to interaural level and timing differences (ILDs/ITDs), (c) evaluating effects of aural preference on sound localization, and (d) exploring head and eye (gaze) movements during sound localization. Children with BCIs (n = 42, M_Age = 12.3 years) with limited duration of auditory deprivation and peers with typical hearing (controls; n = 37, M_Age = 12.9 years) localized stationary and moving sound with unrestricted head and eye movements. Sensitivity to binaural cues was measured by a lateralization task to ILDs and ITDs. Spatial separation effects were measured by spondee-word recognition thresholds (SNR thresholds) when noise was presented in front (colocated/0°) or with 90° of left/right separation. BCI users had good speech reception thresholds (SRTs) in quiet but higher SRTs in noise than controls. Spatial separation of noise from speech revealed a greater advantage for the right ear across groups. BCI users showed increased errors localizing stationary sound and detecting moving sound direction compared to controls. Decreased ITD sensitivity occurred with poorer localization of stationary sound in BCI users. Gaze movements in BCI users were more random than controls for stationary and moving sounds. BCIs support symmetric hearing in children with limited duration of auditory deprivation and promote spatial hearing which is albeit impaired. Spatial hearing was thus considered to be "emerging." Remaining challenges may reflect disruptions in ITD sensitivity and ineffective gaze movements.