title: Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception.
abstract: Spatial hearing skills are essential for children as they grow, learn and play. These skills provide critical cues for determining the locations of sources in the environment, and enable segregation of important sounds, such as speech, from background maskers or interferers. Spatial hearing depends on availability of monaural cues and binaural cues. The latter result from integration of inputs arriving at the two ears from sounds that vary in location. The binaural system has exquisite mechanisms for capturing differences between the ears in both time of arrival and intensity. The major cues that are thus referred to as being vital for binaural hearing are: interaural differences in time (ITDs) and interaural differences in levels (ILDs). In children with normal hearing (NH), spatial hearing abilities are fairly well developed by age 4-5 years. In contrast, most children who are deaf and hear through cochlear implants (CIs) do not have an opportunity to experience normal, binaural acoustic hearing early in life. These children may function by having to utilize auditory cues that are degraded with regard to numerous stimulus features. In recent years there has been a notable increase in the number of children receiving bilateral CIs, and evidence suggests that while having two CIs helps them function better than when listening through a single CI, these children generally perform worse than their NH peers. This paper reviews some of the recent work on bilaterally implanted children. The focus is on measures of spatial hearing, including sound localization, release from masking for speech understanding in noise and binaural sensitivity using research processors. Data from behavioral and electrophysiological studies are included, with a focus on the recent work of the authors and their collaborators. The effects of auditory plasticity and deprivation on the emergence of binaural and spatial hearing are discussed along with evidence for reorganized processing from both behavioral and electrophysiological studies. The consequences of both unilateral and bilateral auditory deprivation during development suggest that the relevant set of issues is highly complex with regard to successes and the limitations experienced by children receiving bilateral cochlear implants. This article is part of a Special Issue entitled <Annual Reviews 2016>.
authors.affiliation: University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI, 53705, United States. Electronic address: litovsky@waisman.wisc.edu.
authors.forename: Ruth Y
authors.initials: RY
authors.lastname: Litovsky
authors.affiliation: University of Toronto, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Gordon
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D001303:Auditory Cortex / Q000502:physiology; D001307:Auditory Perception / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000503:physiopathology / Q000628:therapy*; D006309:Hearing; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D009622:Noise; D019986:Persons with Hearing Disabilities; D013017:Sound Localization / Q000502:physiology*; D013067:Speech Perception
references.citation: Scand Audiol Suppl. 1988;30:71-4
references.pmid: 3227285
references.citation: Neuroscience. 2013 Sep 5;247:117-33
references.pmid: 23707979
references.citation: Audiol Neurootol. 2015;20 Suppl 1:87-9
references.pmid: 25998097
references.citation: Audiol Neurootol. 2015;20 Suppl 1:13-20
references.pmid: 25998954
references.citation: Ann Otol Rhinol Laryngol. 2009 May;118(5):336-44
references.pmid: 19548382
references.citation: Ear Hear. 2010 Aug;31(4):457-70
references.pmid: 20418771
references.citation: J Acoust Soc Am. 2016 Jul;140(1):59
references.pmid: 27475132
references.citation: Clin Neurophysiol. 2007 Aug;118(8):1671-84
references.pmid: 17588811
references.citation: Ear Hear. 2010 Aug;31(4):441-56
references.pmid: 20489647
references.citation: Pediatrics. 2010 Jun;125(6):e1348-55
references.pmid: 20457680
references.citation: Ear Hear. 2006 Feb;27(1):43-59
references.pmid: 16446564
references.citation: Brain. 2013 May;136(Pt 5):1609-25
references.pmid: 23576127
references.citation: Hear Res. 1997 Feb;104(1-2):183-90
references.pmid: 9119762
references.citation: Otol Neurotol. 2013 Jun;34(4):682-9
references.pmid: 23640090
references.citation: J Neurosci. 2012 Mar 21;32(12):4212-23
references.pmid: 22442083
references.citation: PLoS One. 2015 Feb 10;10(2):e0117611
references.pmid: 25668423
references.citation: J Acoust Soc Am. 2012 Jul;132(1):380-91
references.pmid: 22779485
references.citation: Ear Hear. 2003 Dec;24(6):485-500
references.pmid: 14663348
references.citation: Laryngoscope. 2012 Sep;122(9):2088-95
references.pmid: 22865630
references.citation: Cochlear Implants Int. 2014 May;15 Suppl 1:S43-6
references.pmid: 24869442
references.citation: Audiol Neurootol. 2015;20 Suppl 1:21-30
references.pmid: 25999052
references.citation: Laryngoscope. 2009 Dec;119(12):2444-8
references.pmid: 19718748
references.citation: Int J Pediatr Otorhinolaryngol. 2012 Sep;76(9):1245-8
references.pmid: 22721525
references.citation: Hum Brain Mapp. 2016 Jan;37(1):135-52
references.pmid: 26456629
references.citation: PLoS One. 2014 Dec 22;9(12):e114841
references.pmid: 25531107
references.citation: Otol Neurotol. 2008 Feb;29(2):193-8
references.pmid: 18223446
references.citation: Cochlear Implants Int. 2015 Sep;16(5):270-6
references.pmid: 25655134
references.citation: J Acoust Soc Am. 2001 Nov;110(5 Pt 1):2527-38
references.pmid: 11757942
references.citation: Ear Hear. 2010 Oct;31(5):702-13
references.pmid: 20548238
references.citation: J Acoust Soc Am. 2007 Feb;121(2):1047-55
references.pmid: 17348527
references.citation: Cochlear Implants Int. 2012 May;13(2):105-12
references.pmid: 22333112
references.citation: Trends Amplif. 2009 Sep;13(3):190-205
references.pmid: 19713210
references.citation: J Acoust Soc Am. 2017 Jun;141(6):4264
references.pmid: 28618809
references.citation: J Acoust Soc Am. 2005 May;117(5):3091-9
references.pmid: 15957777
references.citation: Audiol Neurootol. 2001 Nov-Dec;6(6):363-80
references.pmid: 11847464
references.citation: Int J Pediatr Otorhinolaryngol. 2015 Jun;79(6):786-792
references.pmid: 25912629
references.citation: Pediatrics. 1984 Aug;74(2):206-16
references.pmid: 6462820
references.citation: Ear Hear. 2012 Jan-Feb;33(1):57-68
references.pmid: 21730858
references.citation: J Acoust Soc Am. 2010 Jan;127(1):400-14
references.pmid: 20058986
references.citation: Otolaryngol Head Neck Surg. 2011 Apr;144(4):602-11
references.pmid: 21493243
references.citation: Cochlear Implants Int. 2013 Nov;14(5):257-65
references.pmid: 23510638
references.citation: Neuroreport. 2010 Feb 17;21(3):163-7
references.pmid: 20042902
references.citation: J Acoust Soc Am. 2003 Jun;113(6):2984-7
references.pmid: 12822768
references.citation: J Speech Lang Hear Res. 2013 Apr;56(2):643-55
references.pmid: 23275406
references.citation: B-ENT. 2013;Suppl 21:107-15
references.pmid: 24383229
references.citation: Physiol Rev. 2010 Jul;90(3):983-1012
references.pmid: 20664077
references.citation: Front Hum Neurosci. 2014 Mar 25;8:164
references.pmid: 24723873
references.citation: J Acoust Soc Am. 1997 Sep;102(3):1739-45
references.pmid: 9301051
references.citation: Arch Otolaryngol Head Neck Surg. 2002 Nov;128(11):1255-62
references.pmid: 12431166
references.citation: Neuroreport. 2007 Apr 16;18(6):613-7
references.pmid: 17413667
references.citation: Audiol Neurootol. 2010;15(1):44-56
references.pmid: 19468210
references.citation: Handb Clin Neurol. 2015;129:55-72
references.pmid: 25726262
references.citation: Audiol Neurootol. 2007;12(5):295-306
references.pmid: 17536198
references.citation: Ear Hear. 2010 Oct;31(5):645-56
references.pmid: 20592615
references.citation: Otol Neurotol. 2011 Sep;32(7):1057-64
references.pmid: 21725259
references.citation: Arch Otolaryngol Head Neck Surg. 2010 Jan;136(1):22-6
references.pmid: 20083773
references.citation: Otol Neurotol. 2009 Apr;30(3):319-31
references.pmid: 19318886
references.citation: Trends Neurosci. 2012 Feb;35(2):111-22
references.pmid: 22104561
references.citation: Brain. 2013 Jan;136(Pt 1):180-93
references.pmid: 23233722
references.citation: J Acoust Soc Am. 1989 May;85(5):2031-41
references.pmid: 2732384
references.citation: J Assoc Res Otolaryngol. 2011 Oct;12(5):659-70
references.pmid: 21656197
references.citation: Otol Neurotol. 2010 Oct;31(8):1287-92
references.pmid: 20864881
references.citation: Otol Neurotol. 2007 Aug;28(5):589-96
references.pmid: 17667768
references.citation: Cochlear Implants Int. 2009 Sep;10(3):119-41
references.pmid: 19593746
references.citation: Hear Res. 2007 Nov;233(1-2):97-107
references.pmid: 17850999
references.citation: PLoS One. 2015 Aug 19;10(8):e0135790
references.pmid: 26288142
references.citation: Annu Rev Psychol. 1991;42:135-59
references.pmid: 2018391
references.citation: J Acoust Soc Am. 2002 May;111(5 Pt 1):2219-36
references.pmid: 12051442
references.citation: Hear Res. 2015 Apr;322:138-50
references.pmid: 25456088
references.citation: Ear Hear. 2015 May-Jun;36(3):e62-8
references.pmid: 25565660
references.citation: Pediatrics. 2015 Jul;136(1):141-53
references.pmid: 26055845
references.citation: Clin Neurophysiol. 2007 Mar;118(3):676-89
references.pmid: 17223382
references.citation: J Acoust Soc Am. 2011 Sep;130(3):1463-74
references.pmid: 21895087
references.citation: Laryngoscope. 2014 Aug;124(8):1937-41
references.pmid: 24496728
references.citation: J Acoust Soc Am. 2015 Jul;138(1):319-31
references.pmid: 26233032
references.citation: Otol Neurotol. 2010 Sep;31(7):1055-61
references.pmid: 20418793
references.citation: J Acoust Soc Am. 2013 Apr;133(4):2272-87
references.pmid: 23556595
references.citation: Otol Neurotol. 2007 Aug;28(5):649-57
references.pmid: 17712290
references.citation: Annu Rev Psychol. 2014;65:187-207
references.pmid: 24016274
references.citation: J Am Acad Audiol. 2012 Jun;23(6):476-94
references.pmid: 22668767
references.citation: ORL J Otorhinolaryngol Relat Spec. 2009;71(2):112-21
references.pmid: 19246953
references.citation: J Acoust Soc Am. 2013 Oct;134(4):2923-36
references.pmid: 24116428
references.citation: Audiol Neurootol. 2006;11(1):7-23
references.pmid: 16219994
references.citation: PLoS One. 2015 Aug 28;10(8):e0136685
references.pmid: 26317976
references.citation: Hear Res. 2015 Apr;322:127-37
references.pmid: 25193553
references.citation: Cochlear Implants Int. 2012 Nov;13(4):220-7
references.pmid: 22325057
references.citation: Cochlear Implants Int. 2011 May;12 Suppl 1:S30-4
references.pmid: 21756469
references.citation: J Assoc Res Otolaryngol. 2007 Mar;8(1):134-51
references.pmid: 17225976
references.citation: Neuroreport. 2005 Apr 4;16(5):463-7
references.pmid: 15770152
references.citation: Cochlear Implants Int. 2009;10 Suppl 1:23-7
references.pmid: 19067435
references.citation: Clin Neurophysiol. 2013 Sep;124(9):1868-80
references.pmid: 23680008