title: The effect of early auditory experience on the spatial listening skills of children with bilateral cochlear implants.
abstract: OBJECTIVE
  Both electrophysiological and behavioural studies suggest that auditory deprivation during the first months and years of life can impair listening skills. Electrophysiological studies indicate that 3½ years may be a critical age for the development of symmetrical cortical responses in children using bilateral cochlear implants. This study aimed to examine the effect of auditory experience during the first 3½ years of life on the behavioural spatial listening abilities of children using bilateral cochlear implants, with reference to normally hearing children. Data collected during research and routine clinical testing were pooled to compare the listening skills of children with bilateral cochlear implants and different periods of auditory deprivation.
  
  
  METHODS
  Children aged 4-17 years with bilateral cochlear implants were classified into three groups. Children born profoundly deaf were in the congenital early bilateral group (received bilateral cochlear implants aged ≤3½ years, n=28) or congenital late bilateral group (received first implant aged ≤3½ years and second aged >3½ years, n=38). Children with some bilateral acoustic hearing until the age of 3½ years, who subsequently became profoundly deaf and received bilateral cochlear implants, were in the acquired/progressive group (n=16). There were 32 children in the normally hearing group. Children completed tests of sound-source localization and spatial release from masking (a measure of the ability to use both ears to understand speech in noise).
  
  
  RESULTS
  The acquired/progressive group localized more accurately than both groups of congenitally deaf children (p<0.05). All three groups of children with cochlear implants showed similar spatial release from masking. The normally hearing group localized more accurately than all groups with bilateral cochlear implants and displayed more spatial release from masking than the congenitally deaf groups on average (p<0.05).
  
  
  CONCLUSIONS
  Children with bilateral cochlear implants and early experience of acoustic hearing showed more accurate localization skills, on average, than children born profoundly deaf.
authors.affiliation: Yorkshire Auditory Implant Service, Bradford Royal Infirmary, Bradford, UK. Electronic address: catherine.killan@bthft.nhs.uk.
authors.forename: Catherine F
authors.initials: CF
authors.lastname: Killan
authors.affiliation: Yorkshire Auditory Implant Service, Bradford Royal Infirmary, Bradford, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Royle
authors.affiliation: Yorkshire Auditory Implant Service, Bradford Royal Infirmary, Bradford, UK.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Totten
authors.affiliation: Yorkshire Auditory Implant Service, Bradford Royal Infirmary, Bradford, UK.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Raine
authors.affiliation: Ear Institute, University College London, London, UK.
authors.forename: Rosemary E S
authors.initials: RE
authors.lastname: Lovett
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000151:congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D013017:Sound Localization
keywords: Auditory deprivation; Child; Cochlear implant; Deafness; Localization; Spatial