Normal-like motor speech parameters measured in children with long-term cochlear implant experience using a novel objective analytic technique.

IMPORTANCE Although voice has been studied extensively in children who use cochlear implants (CIs), speech production has not been studied in this population using the Motor Speech Profile. Whether children who receive CIs gain normal speech production abilities is unknown. OBJECTIVE To assess speech and articulation in deaf, long-term CI users who had undergone early unilateral cochlear implantation, compared with their normal-hearing peers. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study at a tertiary pediatric hospital of 16 children aged 8 to 17 years who had undergone early implantation, are longstanding users, and had excellent audiogram and speech perception scores. Results were compared with a historical pediatric normal-hearing group. INTERVENTION Unilateral cochlear implantation. MAIN OUTCOMES AND MEASURES The Motor Speech Profile, an objective method for assessing motor speech in children. RESULTS The CI users had normal articulation and timing but poorer than normal intonation stimulability, particularly frequency variability. Diadochokinesis rates were within the 95% confidence interval of age-matched pediatric norms for 11 of 16 (69%) and 11 of 15 (73%) children with CI when they were performing /pa/ and /pataka/ tasks, respectively. The magnitude and rate of the second formant transitions were within normal limits for 9 of 16 (56%) and 10 of 12 (83%) children, respectively. The variability in frequency and amplitude of intonation stimulability domains were within normal limits for 7 of 16 (44%) and 16 of 16 (100%) children, respectively. The syllabic rate and duration were both within normal limits for 14 of 16 children (88%). CONCLUSIONS AND RELEVANCE Despite significant improvements in speech after cochlear implantation, abnormalities remain, particularly in frequency variability. Such deviations can present as a decreased expression of emotion in speech and likely reflects decreased auditory frequency resolution provided by the CI. These deficits have been the focus of ongoing work to advance CI technologies and speech-processing strategies.