Academic journal article The Volta Review

Speech Intelligibility in Young Cochlear Implant Recipients: Gains during Year Three

Academic journal article The Volta Review

Speech Intelligibility in Young Cochlear Implant Recipients: Gains during Year Three

Article excerpt

This investigation sought to answer two questions: (1) Do children who receive cochlear implants (CIs) by 3;0 (years; months) improve speech intelligibility significantly during their third year of cochlear implant use? (2) How do the intelligibility scores of young CI recipients compare to those reported in the literature for children who receive CIs at older ages? These questions were addressed through a prospective, longitudinal research study in which children imitated short sentences at 24, 30 and 36 months post-activation. The sentences were played for adult listeners who were instructed to orthographically transcribe the words they recognized. Percent intelligibility scores then were calculated for each speech sample. Mean intelligibility scores increased significantly from 28% to 62% during the third year of CI use. The participants also reached comparable or higher levels of intelligibility within fewer months of CI experience than reported for children who received a CI at older ages. These findings support the notion that receiving a CI by 3 years of age is advantageous for developing connected speech that can be understood by unfamiliar listeners.


Two recent events have revolutionized communication intervention for children with hearing loss in the United States. First, the widespread implementation of newborn hearing screening procedures has made it possible to identify children with hearing loss and begin aural habilitation within the first year of life. Second, decreases in age criterion for cochlear implantation have enabled children to begin to hear within an age range when many foundational spoken language skills typically are acquired. As a result, hearing loss now is identified routinely before a child's first birthday, and cochlear implants (CIs), if indicated, are provided commonly within the first three years of life.

The primary benefits of cochlear implantation are increased auditory sensitivity and improved speech perception ability. Greatly increased access to adult speech models and auditory feedback also has led to secondary improvements in spoken language development in children (see American Speech-Language-Hearing Association, 2004, for a review). In particular, children who receive CIs before their third birthdays have been shown to make accelerated progress in prelinguistic vocal development (e.g., Ertmer, Young, & Nathani, 2007; Moore & Bass-Ringdahl, 2002), phonological development (e.g., Connor, Craig, Raudenbush, Heavner, & Zwolan, 2006) and spoken language development (e.g., Svirsky, Teoh, & Neuberger, 2004). To date, however, very little is known about the time course for developing intelligible speech in this population.

Speech intelligibility has been defined as "the degree to which the speaker's intended message is recovered by the listener" (Kent, Weismer, Kent, & Rosenbeck, 1989; p. 483). As Subtelney (1977) noted 30 years ago, "Intelligibility is considered the most practical single index to apply in assessing competence in oral communication" (p. 183). This very functional communication ability commonly is measured through rating scales, transcription analysis and word identification procedures (see Osberger, 1992, for review). The current investigation used word identification procedures to assess the intelligibility of sentences produced by children with prelingual deafness who received a CI before their third birthdays. The studies reviewed below used similar methods with children who received a CI at various ages. The purpose of this review is to establish benchmarks for comparison with the outcomes of the present study.

A mixed-model research design (i.e., cross-sectional and longitudinal) was used by Miyamoto, Svirsky, Kirk, Robbins, Todd and Riley (1997) to track improvements in speech intelligibility in children who received a CI at an average age of 5;0. Speech samples were collected prior to implantation and at six-month intervals through 90 months (7;6) of CI experience. …

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