Evolving perspectives on speech perception assessment in adults with cochlear implants: Are we using the right tests?

Area of Science:

• Audiology
• Otorhinolaryngology
• Biomedical Engineering

Background:

• Speech perception outcomes are a primary benchmark for cochlear implant (CI) success.
• Current speech tests offer a time-efficient assessment of specific speech processing abilities.
• However, test scores may not fully represent individual communication needs.

Purpose of the Study:

• To review the evolution of speech perception testing in the USA for cochlear implants.
• To critically examine the current clinical roles of speech perception tests.
• To propose more comprehensive and ecologically meaningful assessment approaches for CI users.

Main Methods:

• Historical review of speech perception testing evolution in the USA.
• Critical examination of current clinical applications of speech tests.
• Analysis of factors influencing test selection and interpretation.

Main Results:

• Speech perception testing has evolved significantly since the advent of CIs.
• Current roles include candidacy, benefit measurement, and deficit identification.
• Conventional tests provide a limited view of overall CI outcomes.

Conclusions:

• Speech perception tests are valuable but insufficient for assessing real-world CI communication abilities.
• There is a need for more comprehensive outcome measures.
• Recommendations are provided for selecting measures that align with patient-centered care and real-world demands.