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Background: Limited access of oral language caused by hearing loss poses a risk for the development of reading problems. A functional overlap in outcomes between children fit with hearing aids (HAs) and children provided with cochlear implants (CIs) results in a gray area in pediatric CI candidacy criteria. This gray area makes it more difficult to determine which device will provide the best developmental outcomes for children with borderline CI eligibility.
Objective: In an effort to gain outcome data that could inform decision-making regarding CI versus HA candidacy, the question posed in this study concerned the speech intelligibility index (SII) levels of children with HAs that were comparable to children with CIs based upon reading outcomes of both groups.
Methods: The study sample comprised of 77 children between the ages of 6;10 and 9;6 with hearing loss: 58 children with HAs and 19 children with CIs. Reading performance data was obtained using the Word Attack and Passage Comprehension subtests of the Woodcock Reading Mastery Tests. SII information was obtained for the HA group. To allow a comparison of reading performance relative to SII between children with CIs and children with HAs, multiple imputation was used to estimate a functional SII for the CI group based off the available reading information.
Results: Children in the HA and CI groups demonstrated overall similar reading performance. The relationship between aided SII and reading in the HA group was found to be three times as large as that found for unaided PTA and reading. Children in the CI group were found to have reading abilities similar to children in the HA group with known SIIs of 0.73. Functional SII was imputed for the CI group with strong relative efficiency, but because confidence intervals were rather large, more data is needed in order to make statements with greater levels of confidence regarding implications for CI candidacy criteria.