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Objectives : Aim 1 was to use parent ratings of performance to indicate the relative degree of difficulty experienced in different everyday listening scenarios by children using bilateral cochlear implants (CIs). Aim 2 was to compare ratings with those from parents of children with normal hearing (NH). Materials/Methods: 81 parents of children aged 7.5-9.5y, including 21 with NH, participated. Mean age at first and bilateral implantation was 1.4y and 3.3y. The Speech, Spatial and Qualities of Hearing Scale for Parents was administered. The 9 items in Section A focused on speech perception in single speaker or group conversations in varied backgrounds. The 6 items in Section B focused on spatial hearing (i.e., location and movement of sound sources). The 8 items in Section C focused on other qualities of hearing, including sound segregation and listening effort. Results/Conclusions : In Section A, the parent ratings for the CI group were high (mean 9.6 out of 10) for a single speaker in quiet but decreased with the addition of more speakers, background noise and an absence of visual cues. Mean ratings in the most difficult scenarios involving group conversation in background noise were only around 4 to 5. In Section B, the CI group demonstrated more difficulty in locating environmental sounds than locating speakers. In Section C, there was more variation, with the lowest ratings were for items related to listening effort, ignoring extraneous sounds and identifying or distinguishing between environmental sounds. Across all items, except a single speaker in quiet, the group ratings were significantly lower for the CI group; however, on each item, ≥50% of CI children were rated at least equal to the lowest-rated NH children, and many CI children were rated as performing exceptionally well. There was a significant correlation between ratings for each group, indicating a similar pattern of low and high performance ratings across scenarios. [ABSTRACT FROM AUTHOR]

The number of cochlear implant users is predicted to increase over time. A cochlear implant is generally programmed throughout the user's lifetime. When setting the frequency of programming sessions over time, there is currently very little consideration and understanding of the changes in programming levels over time. The primary aim was to provide an evidence-based schedule for programming. Methods: The schedule was developed using evidence of change in programming levels for a large cohort of 680 adult implant users. For each participant, changes in levels were investigated as a function of dynamic range over 2 years post implantation. In addition, for 128 implant users, patterns of change in levels were investigated over 10 years post implantation. Associations of change with demographic characteristics were also investigated. Results: Findings showed little change from 3 to 6 months out to 10 years post implantation for more than 75% of the participants. For all participants, regardless of demographic characteristics, the mean amount of change over 10 years post implantation was less than 11 current levels. Conclusion: Interestingly, findings from this study showed that levels vary in the first few months post implantation, but once levels stabilize, little change in levels is expected over the first decade of implant use. The integration of these findings provided sufficient evidence to develop one of the first evidence-based schedules for programming. The proposed schedule recommends 5 sessions over the first 6 months post implantation, and to program on patient and clinician request thereafter. The schedule recommends a 5-year check-up programming session, and for subsequent sessions to be based on the outcome of the 5-year session. Clinical application of the proposed evidence- based approaches will enable more efficient programming services for current and future implant users over time, without compromising patient care. [ABSTRACT FROM AUTHOR]