(PP1103) Limitations of the Speech Test Battery for Nontraditional Pediatric Cochlear Implant Recipients

Over the last several years, researchers have identified a battery of speech perception materials for children being evaluated for or who have received a cochlear implant (CI). At the same time, CI candidacy criteria have expanded to include patients with more acoustic hearing sensitivity, and those with unilateral hearing loss. While these patients have shown benefit from cochlear implantation, more complex testing arrangements are needed to demonstrate this benefit. The primary goal of this poster is to review the advantages and disadvantages of current pediatric test materials given the expansion of cochlear implant candidacy criteria. 

Summary: 

Rationale: Over the last several years, efforts have been made to standardize the protocol used to measure speech perception performance in pediatric cochlear implant (CI) users. The Pediatric Minimum Speech Test Battery (PMSTB) (Uhler et al 2017) identifies a battery of speech perception measures appropriate for pediatric patients with hearing loss at various stages of auditory development. At the same time, CI candidacy criteria has continued to change, including children with more acoustic hearing sensitivity, and those with unilateral hearing loss. These CI recipients require more complex testing configurations to fully evaluate device benefit. The protocol for evaluating these patients should include separate word lists presented in quiet to each ear individually and bilaterally, as recommended in the PMSTB (Uhler et al 2017). Additionally, to assess binaural hearing abilities, testing should include sentences presented in noise with speech and noise collocated and noise presented to each ear, with device on and off (Park et al 2021). The purpose of this poster is to examine the advantages and disadvantages of current pediatric speech perception materials outlined in the PMSTB given the complexity of testing required for this population of pediatric CI recipients.

Methods: Using speech perception materials recommended in the Pediatric Minimum Speech Test Battery, the number of available test lists for each measure was compared to the number of lists required to complete a protocol to assess binaural hearing abilities: Three lists for single words and 3-6 for a spatial release form masking paradigm. These numbers were extrapolated to consider patient age, test conditions, and the number of follow-up visits expected for each year of device use. 

Results and

Conclusions: Current pediatric speech perception materials are too limited to appropriately evaluate complex pediatric CI patients. Additional assessments with a variety of lists that are sensitive to different language levels are needed to fully evaluate binaural hearing abilities in this population.