Spoken Word Recognition Development in Children with Residual Hearing Using Cochlear Implants and Hearing Aids in Opposite Ears

OBJECTIVE: With broadening candidacy criteria for cochlear implantation, a greater number of pediatric candidates have usable residual hearing in their nonimplanted ears. This population potentially stands to benefit from continued use of conventional amplification in their nonimplanted ears. The purposes of this investigation were to evaluate whether children with residual hearing in their nonimplanted ears benefit from bilateral use of cochlear implants and hearing aids and to investigate the time course of adaptation to combined use of the devices together. DESIGN: Pediatric cochlear implant recipients with severe sensorineural hearing loss in their nonimplanted ears served as participants. Ten children continued to use hearing aids in their nonimplanted ears after cochlear implantation; 12 children used their cochlear implants exclusively. Participants were tested longitudinally on spoken word recognition measures at 6-month intervals. The children who continued wearing hearing aids were tested in three sensory aid conditions: cochlear implants alone, hearing aids alone, and cochlear implants in conjunction with hearing aids. The children who did not continue hearing aid use were tested after surgery in their only aided condition, cochlear implant alone. RESULTS: The results suggest that children with severe hearing loss who continued using hearing aids in their nonimplanted ears benefited from combining the acoustic input received from a hearing aid with the input received from a cochlear implant, particularly in background noise. However, this benefit emerged with experience. CONCLUSIONS: Our findings suggest that it is appropriate to encourage pediatric cochlear implant recipients with severe hearing loss to continue wearing an appropriately fitted hearing aid in the nonimplanted ear to maximally benefit from bilateral stimulation.