Cortical P1 Latency, Sound Field Audiometry, and Speech Audiometry in Children with Sequential Bilateral Cochlear...

Background/Objectives: Objective assessment of auditory rehabilitation in children with cochlear implants (CIs) is challenging, as behavioral tests require cooperation that young children cannot always provide. The P1 component of the cortical auditory evoked potential (CAEP) is a marker of central auditory maturation, but few studies have compared it directly with behavioral measures in children with sequential bilateral CIs. Methods: Eight children (median age 8.4 years) with prelingual profound sensorineural hearing loss treated with sequential bilateral CI underwent CAEP (speech tokens/m/,/g/,/t/at 55 and 65 dB sound pressure level (SPL)), sound field audiometry and speech audiometry. An a priori physiological plausibility criterion excluded all detected responses in one child and one further response in a second child; correlations were therefore based on seven children and were assessed by Spearman rank correlation with exact permutation p-values. Results: P1 latency showed a frequency-specific association with sound field thresholds, strongest for the high-frequency/t/stimulus at 4 kHz (rho = 0.836, exact p = 0.056), which remained between +0.70 and +0.92 in leave-one-out analysis. Longer P1 latency tended to accompany poorer speech reception (mean latency at 65 dB SPL, rho = 0.679, exact p = 0.110), but this association was unstable, and no consistent relationship with duration of implant use was found Two coefficients reached nominal significance at 55 dB SPL but did not persist at 65 dB SPL, no other association was significant. Conclusions: In this pilot study P1 latency was associated with to frequency-matched aided thresholds, whereas its relationship with speech reception was directional but unconfirmed. CAEP may complement behavioral testing in this population, but larger longitudinal studies using sensation-level-matched stimulation are required.