Real-world Speech Communication Experiences of Cochlear Implant Users

Cochlear implants (CIs) enable adults with hearing loss to regain access to sound. However, many CI users continue to face difficulties in everyday communication, potentially resulting in fewer social interactions. This study aimed to identify CI users' self-reported hearing difficulties in everyday listening environments.

Cross-sectional survey-based study.

Tertiary care academic medical center; surveys were completed during visit.

Thirty-seven postlingually deafened adult CI users and 19 age-matched adults with normal hearing (NH) participated.

Participants completed the Personal Assessment of Communication Abilities survey, rating their communication difficulty in 12 everyday listening environments on a 5-point scale (1 = no difficulty, 5 = very much difficulty).

Self-reported communication difficulty levels in the 12 listening environments with comparisons between CI users and NH peers, and across different environments within each group.

CI users reported significantly more difficulty than NH peers in all 12 environments (P < 0.001). Listening context significantly affected difficulty ratings (P = 0.003), with a significant group-by-environment interaction (P = 0.006). CI users perceived large groups, concerts/movie theaters, and restaurants/cafés most challenging, while one-to-one conversations, outdoors, and conversations in small groups were the least difficult. Outdoor settings and landline phone use showed the greatest differences between groups.

Adult CI users face variable communication challenges in everyday environments. Identifying the everyday listening challenges of adult CI users will help shed light on real-world CI benefits and provide specific targets for rehabilitation.