Electrode discrimination and speech perception in young children using cochlear implants.

OBJECTIVE The aim was to determine the efficacy of a child-appropriate procedure to assess electrode discrimination ability in young children using cochlear implants and to investigate the relationship of electrode discrimination ability and speech perception performance in children implanted at a young age. DESIGN An adaptation of the play audiometry procedure was used to assess electrode discrimination in seventeen 4- to 10-yr-old children. The children were required to respond with a game-like motor response when a repeating stimulation on a reference electrode "changed" to a different electrode. They were also assessed on a speech feature discrimination test, a closed-set word recognition test and a nonverbal intelligence task. RESULTS Sixty-five percent of subjects demonstrated ability to discriminate adjacent electrodes in mid and apical regions of the cochlea, whilst the remaining subjects needed electrode separations of between two and nine electrodes for successful discrimination. In a forward stepwise regression analysis electrode discrimination ability was found to be the strongest factor in accounting for variance in the speech perception scores. Subject variables such as duration of deafness, nonverbal intelligence and implant experience did not significantly account for further variance in the speech perception scores for this group of children. CONCLUSIONS Electrode discrimination ability was the strongest factor in predicting performance on speech perception measures in a group of children using cochlear implants.