title: The effect of front-end processing on cochlear implant performance of children.
abstract: OBJECTIVE
  Previous research shows that children using cochlear implants experience significant difficulty with speech perception in noisy listening situations. There are several types of input signal processing available for the cochlear implant sound processor; however, there is a paucity of research to support this technology for children. The primary objective of this study was to examine the potential benefits of 2 types of input signal processing, adaptive dynamic range optimization (ADRO) as compared with autosensitivity (ASC) plus ADRO for children using Cochlear Corporation implants.
  
  
  METHODS
  Cross-sectional repeated-measures design.
  
  
  METHODS
  Outpatient nonprofit foundation providing audiology services and auditory-verbal therapy.
  
  
  METHODS
  Eleven children, aged 4 years 4 months to 12 years, with unilateral or bilateral Cochlear Limited implants. All children used their cochlear implant(s) for at least 1 year, had no additional disabilities, were enrolled in preschool or elementary school, and had age-appropriate receptive and expressive language.
  
  
  METHODS
  All children used Cochlear Limited cochlear implants with either the Nucleus Freedom or Nucleus 5 cochlear implant sound processor. Performance was assessed while these children used ADRO-only input processing and ASC+ADRO input processing.
  
  
  METHODS
  Speech perception of PBK-50 monosyllabic words in quiet and BKB-SIN sentences in noise was measured for each child. In the noise conditions, children were using the ADRO-only or ASC+ADRO input signal processing strategies. The data in quiet were analyzed with descriptive statistics, and the conditions in noise were compared using a 1-way repeated-measures analysis of variance.
  
  
  RESULTS
  All children demonstrated word recognition in quiet at or above 90% correct. In noise, sentence-perception performance in the ASC+ADRO condition was significantly better than that in the ADRO-alone condition.
  
  
  CONCLUSIONS
  The results of the study suggest substantial benefit from combining 2 types of input signal processing, ASC and ADRO, for children with unilateral and bilateral cochlear implants. Specifically, signal processing to adjust the sensitivity of the sound processor microphone automatically has substantial positive effects on speech-perception thresholds in noise.
authors: Hearts for Hearing, Oklahoma City, Oklahoma, USA. jace.wolfe@heartsforhearing.org
authors: Jace
authors: J
authors: Wolfe
authors: Erin C
authors: EC
authors: Schafer
authors: Andrew
authors: A
authors: John
authors: Mary
authors: M
authors: Hudson
mesh_terms: D000161:Acoustic Stimulation; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D013067:Speech Perception / Q000502:physiology*