Acoustic and semantic enhancements for children with cochlear implants.

Purpose: In this study, the authors examined how signal clarity interacts with the use of sentence context information in determining speech-in-noise recognition for children with cochlear implants and children with normal hearing.

Method: One hundred and twenty sentences in which the final word varied in predictability (high vs. low semantic context) were produced in conversational and clear speech. Nine children with cochlear implants and 9 children with normal hearing completed the sentence-in-noise listening tests and a standardized language measure.

Results: Word recognition in noise improved significantly for both groups of children for high-predictability sentences in clear speech. Children with normal hearing benefited more from each source of information compared with children with cochlear implants. There was a significant correlation between more developed language skills and the ability to use contextual enhancements. The smaller context gain in clear speech for children with cochlear implants is in accord with the effortfulness hypothesis (McCoy et al., 2005) and points to the cumulative effects of noise throughout the processing system.

Conclusion: Modifications of the speech signal and the context of the utterances through changes in the talker output hold substantial promise as a communication enhancement technique for both children with cochlear implants and children with normal hearing.