Which sensitivity setting should a child use?

The influence of the sensitivity setting of the cochlear implant speech processor on speech recognition is investigated with 15 experienced postlinguistically deafened adult cochlear implant users. We describe the use of loudness scaling in the course of speech processor fine tuning and checkup of the speech processor map to demonstrate how their speech processors are programmed. The Freiburg monosyllabic word test, a standardized German open set speech intelligibility test, is used in silence and the very difficult Göttingen sentence test is used in silence and noise to measure speech recognition scores as a function of sensitivity setting. The median of the optimal sensitivity setting was four steps higher than the value recommended by the manufacturer. In noisy everyday hearing situations patients generally use a sensitivity setting one step lower than the one we found to be optimal for openset word understanding under test room conditions. With children who cannot select optimal speech processor settings by themselves, we do not recommend the use of noise reduction and set the sensitivity three steps higher than the one recommended by the manufacturer.