Factors contributing to limited open-set speech perception in children whouse a cochlear implant

Cochlear implants have enabled many children with severe to profound sensor ineural hearing loss to develop speech perception skills. However, some chi ldren experience few gains while others develop high levels of speech perce ption. We identified potential factors contributing to poor performance wit h an implant by studying implanted children who do not develop functional s peech perception. Five children were identified as developing no open-set w ord recognition skills after at least 2 years of implant use. This study gr oup was compared to a randomly selected control group (n = 10) and an age-m atched control group (n = 5). Pre-implant factors were examined using a Gra ded Profile Analysis and post-implant factors were assessed in a retrospect ive chart review. A greater number of pre-implant concerns were raised in t he study group than in randomized controls (P < 0.01). Chronological age an d duration of deafness were pre-implant concerns in all study group subject s. A greater number of post-implant concerns were found in the study group than in randomly selected controls (P < 0.005). We conclude that while appr opriate selection of candidates for cochlear implantation is important in p redicting speech perception outcomes, post-implant follow-up is also essent ial and must include regular monitoring of equipment, monitoring of stimula tion levels with use of objective measures of stimulation levels if necessa ry, and consistent habilitation. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.