Speech perception outcomes for children using cochlear implants who have a premature and/or low birth-weight history.

Ms Jacinta Pennacchia1, Dr Shani Dettman1, Ms Dawn Choo1, Dr Peter Carew1

 1The University Of Melbourne, Parkville, Australia


Purpose. Prematurity is a significant predictor of perinatal mortality and/or comorbid diagnoses; with greater gestational age and higher birth weight, both mortality and comorbid diagnoses decrease. Improved neonatal/medical care has increased survival rates for premature infants, but there is less available research regarding the nature, severity and impact of comorbid diagnoses on speech perception for children using cochlear implants (CIs). Method. This retrospective study examined a paediatric CI database to identify 35 children who had a gestational age of < 37 weeks, and/or birthweight of < 2500 grams. Speech perception testing completed between 3 and 9 years of age included a variety of speech perception protocols. To manage this, and to include as many participants as possible, data were coded using the Categories of Auditory Performance Index -Revised (CAPI-R). Results. The median CAPI-R score was 5 which corresponds to open-set phoneme understanding of 50-74%, word understanding of 14-43% and sentence understanding of 27-70% in quiet. There was a significant relationship between birthweight (grams) and CAPI-R (ρ=0.62; p=0.003). For the n=26 for whom cognitive diagnoses were documented, Group A with no additional cognitive diagnoses (n=19, median CAPI-R=6) and Group B with additional cognitive diagnoses (n=7, median CAPI-R=5) did not differ significantly on duration of profound hearing loss, best unaided Pure Tone Average, age-at-implant, nor age-at-test, but did differ significantly on median CAPI-R scores (p=0.021) and relative socio-economic advantage (p=0.014). Conclusions. Although the present study cannot describe the mechanism by which cognitive diagnoses impact speech perception, previous studies suggest poorer verbal rehearsal and auditory processing may affect the child’s use of the imperfect signal provided by CIs. The confounding impact of socio-economic status for Group B with additional cognitive diagnoses requires further investigation with a larger cohort. Further study regarding the linguistic impact of these cognitive and speech perception deficits is ongoing.


Peter is an audiologist and Lecturer in the Department of Audiology and Speech Pathology at The University of Melbourne. He has a special interest in the diagnosis and management of children born with milder degrees of hearing loss. His research focuses on exploring the population-level outcomes of these children. Peter works collaboratively with researchers around Australia and internationally, with the goal of positively influencing the whole-of-life outcomes for impacted individuals and their families. pcarew@unimelb.edu.au