SPEECH-PERCEPTION SKILLS AND SPEECH PRODUCTION INTELLIGIBILITY IN FRENCH CHILDREN WITH PRELINGUAL DEAFNESS AND COCHLEAR IMPLANTS

Objective: To examine speech perception and production intelligibility in French children with prelingual deafness who received multichannel cochlear implants. Design: Within-subject, repeated-measures design f or assessing speech perception and a cross-sectional design for assess ing overall speech intelligibility. Setting: A pediatric cochlear impl ant center. Subjects: Sixty-four French children with prelingual deafn ess who received multichannel cochlear implants (mean age at time of i mplantation, 3 years 11 months) underwent assessment for speech percep tion. A subset of 16 children who received implants by 3 years of age underwent assessment for speech intelligibility. Main Outcome Measures : Speech perception skills were assessed using phoneme detection, clos ed-set word and sentence recognition, and modified open-set (MOS) reco gnition. Speech intelligibility was assessed by asking 50 listeners to identify recorded speech samples from the subjects. Dependent variabl es for the studies consisted of percent of correct items. Results: Aft er implantation, all children were able to detect phonemes by 3 months . Closed-set word and sentence identification reached 100% accuracy by 48 months (7 children with 4 years of implantation experience). Some children (8 of 48) demonstrated some MOS recognition after 1 year. Mod ified open-set recognition averaged 67.9% by 42 months (12 children av ailable) and 80% by 48 months (7 children available). Overall speech i ntelligibility was 4.2% after 1 year, 30.7% after 2 years, 55.2% after 3 years, and 74.2% after 4 years. Within-subject comparisons of MOS r ecognition and overall speech intelligibility scores revealed an insig nificant trend for high perceptual performance to be associated with h igher speech intelligibility scores (P=.17). There also was a tendency for higher performance to be associated with longer implantation expe rience. Conclusions: Speech perception scores appear to increase with increased experience using a cochlear implant. Overall speech intellig ibility appears to steadily improve with increased experience and appe ars to be poorly related to perceptual performance on MOS recognition tasks.