Which Factor Has a Greater Impact on Speech Perception in Noise in School-Aged Children With Cochlear Implants: Chronological Age or Age at Implantation?

Purpose: The aims of this study were to (a) investigate speech-in-noise perception using an adaptive procedure in school-aged children with bilateral cochlear implants (CIs); (b) evaluate the impact of chronological age, age at the second implantation, and interimplant interval on auditory performance in children with bilateral CIs; and (c) determine the correlation between speech recognition performance and subjective parental questionnaire scores. Method: A total of 24 school-aged children with bilateral CIs participated in this study, divided into two groups: Group I (younger than 108 months of age, n = 12) and Group II (older than 108 months of age, n = 12). Speech recognition performance was assessed using sentences from the Turkish Hearing in Noise Test for Children under both quiet and noisy conditions at an adaptive signal-to-noise ratio. The auditory behavior of the children in daily life was evaluated by interviewing parents using the Parent's Evaluation of Aural/Oral Performance of Children (PEACH) scale. Results: The Quiet and Noise Composite Scores of Group II were significantly better than those of Group I ( p = .033 and p = .041, respectively). However, no significant difference was observed between the PEACH scores of the groups ( p = .378). A significant correlation was found between PEACH scores and speech recognition performance under both quiet ( p = .009) and noisy conditions ( p = .021). Conclusions: Chronological age had a greater impact on speech recognition performance than age at the second implantation and interimplant interval, emphasizing the role of age-related auditory development in speech perception. Additionally, parental perspective questionnaires may serve as a practical and efficient tool for assessing functional hearing abilities in children, particularly in educational settings where standard speech perception tests may not always be feasible.