Speech-in-noise perception in school-age cochlear implants users compared to their peers with normal hearing: evidence of a critical condition

Abstract

Abstract Background: Although cochlear implants (CIs) is the state-of-the-art therapy for individuals with hearing impairment to process the acoustic-phonetic cues of speech during the sensitive period of spoken language development and to access optimal auditory performance, previous research findings demonstrated that the users have essential challenges with speech recognition in the presence of background noise. Therefore, the aim of this study was to determine speech-in-noise (SiN) perception in Persian school-age CIs/hearing aids (HAs) users compared to their peers with normal hearing (NH). Methods: The research was administered as a cross-sectional study. Speech-in-noise performance in thirty-three school-age children with hearing loss (19 unilateral CIs users and 14 bilateral HAs users) was compared to twenty school-age children with normal hearing by using the Persian Lexical Neighborhood Tests (PLNTs) include: Persian Monosyllabic Lexical Neighborhood Test (PMLNT)-easy, PMLNT-hard, Persian Disyllabic Lexical Neighborhood Test (PDLNT)-easy, and PDLNT -hard. To make sure that floor or ceiling effects would not effect on the children’s performance, the PLNTs were performed by sound field at different levels of signal to noise ratio (SNR). Results: The SiN performance on all four the subscales of the PLNTs was significantly poorer in Persian school-age CIs/HAs users than their peers with NH for all stepwise increases in the SNR (P < 0.001).Conclusions: The Persian school-age CIs users experience a critical condition related to listening spectrally degraded speech in noisy environments such as home, school, and classroom due to SiN perception insufficiency. Accordingly, it can be concluded that they are potentially at-risk of literacy difficulties. Therefore, it is suggested that SiN perception in school-age CIs users be systematically assessed and monitored through valid tests in order to managing their listening problems in the situations with background noise.