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Speech Perception Development from Childhood to Adulthood Following Pediatric Cochlear Implantation: A 30-Year Longitudinal Study
Journal article   Open access   Peer reviewed

Speech Perception Development from Childhood to Adulthood Following Pediatric Cochlear Implantation: A 30-Year Longitudinal Study

Chieh Kao, Kathryn B. Wiseman, Sophie E. Ambrose, Jacquelyn L. Baudhuin, Adam K. Bosen, Amberlee Haggerty, Melissa R. Henry, Kristen L. Janky, Elizabeth A. Kelly, Jessie N. Patterson, …
Journal of pediatrics. Clinical practice, 200213
04/2026
DOI: 10.1016/j.jpedcp.2026.200213
url
https://doi.org/10.1016/j.jpedcp.2026.200213View
Published (Version of record) Open Access

Abstract

Speech perception development in pediatric cochlear implant (CI) users varies widely, and its progression into late childhood and early adulthood remains unclear. This study examines long-term developmental trajectories and influencing factors using a longitudinal clinical dataset. Speech perception data collected across 22 clinical tests conducted in English and in quiet were retrospectively analyzed with a hierarchical scoring system to understand development of 294 pediatric CI users between 1992 and 2024 at Boys Town National Research Hospital. Medical records provided data on CI activation age, year of first CI implantation, device configuration, daily device use, hearing loss etiology, revision history, primary language use, insurance type, race, and comorbidities. These variables were incorporated into statistical models to predict longitudinal speech perception outcomes. Pediatric CI users generally show steady improvement in speech perception with chronological age. Faster early development of speech perception was associated with implantation before 18 months old, bilateral CI use, longer daily device use, spoken English as a primary language, having private insurance, and better vestibular function. Alternatively, auditory neuropathy, syndromic hearing loss, hearing loss due to prenatal infections and low socioeconomic status were associated with poorer speech perception. Auditory neuropathy or syndromic hearing loss and low socioeconomic status are key factors associated with slower speech perception development. Improving access to CI specialists and encouraging consistent device use—especially for later implantees—may enhance outcomes. Additional support for families and educators is recommended to promote increased device use.
 age at implantation etiologies of hearing loss longitudinal outcomes pediatric cochlear implant users socioeconomic status speech perception development

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