J Am Acad Audiol
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For pediatric cochlear implant (CI) users, CI processor technology, map characteristics, and fitting strategies are known to have a substantial impact on speech perception scores at young ages. It is unknown whether these benefits continue over time as these children reach adolescence. ⋯ Significant improvement in speech scores was observed between elementary grades and high school for children who had used a CI since preschool. On average, T levels (nC) and electrode function remained stable for these long-term pediatric users. Analyses of maps did not allow for the determination of the exact cause of C level reductions, though power limitations in new processor systems and changes in perceived loudness over time are possible. Larger EDRs and higher C levels were associated with better speech scores. Newer speech processor technology was associated with better speech scores at a softer level.
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Cochlear implants provide access to soft intensity sounds and therefore improved audibility for children with severe-to-profound hearing loss. Speech processor programming parameters, such as threshold (or T-level), input dynamic range (IDR), and microphone sensitivity, contribute to the recipient's program and influence audibility. When soundfield thresholds obtained through the speech processor are elevated, programming parameters can be modified to improve soft sound detection. Adult recipients show improved detection for low-level sounds when T-levels are set at raised levels and show better speech understanding in quiet when wider IDRs are used. Little is known about the effects of parameter settings on detection and speech recognition in children using today's cochlear implant technology. ⋯ In pediatric recipients of the Advanced Bionics cochlear implant device, manually setting T-levels with ascending loudness judgments should be considered when possible or when low-level sounds are inaudible. Study findings confirm the need to determine program settings on an individual basis as well as the importance of speech recognition verification measures in both quiet and noise. Clinical guidelines are suggested for selection of programming parameters in both young and older children.