Speech Recognition in Children with Cochlear Implants

Cochlear implantation in children was introduced more than 40 years ago. Since that time, we have seen technological advances in cochlear implant design, surgical advances intended to preserve residual hearing, and broadening of cochlear implant candidacy to include infants and children with usable residual hearing in the implanted ear as well as with typical hearing in the contralateral non-implanted ear. Today, children with cochlear implants can achieve unprecedented levels of speech recognition, and they use these skills to leverage the development of speech production, language, and literacy skills. The evolving nature of cochlear implant candidacy and outcomes has led to a concomitant evolution in the assessment of speech recognition outcomes in children with cochlear implants. In this chapter, we review current speech recognition assessment techniques in infants and children used in clinical or research settings. We also point out child and test characteristics requiring consideration when selecting a test battery for infants or children. Finally, we review several landmark longitudinal studies of cochlear implant outcomes in children with severe-to-profound hearing loss and identify factors that have been shown to influence their development of speech recognition and spoken language processing abilities.