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Tracking Development of Speech Recognition: Longitudinal Data From Hierarchical Assessments in the Childhood Development After Cochlear Implantation Study

Wang, Nae-Yuh*; Eisenberg, Laurie S.; Johnson, Karen C.; Fink, Nancy E.*; Tobey, Emily A.; Quittner, Alexandra L.§; Niparko, John K.The CDaCI Investigative Team

doi: 10.1097/MAO.0b013e3181627a37
Original Articles

Objective: To develop a speech recognition index that summarizes data collected through an array of age-appropriate hierarchical speech recognition tests in a longitudinal study.

Study Design: Prospective cohort.

Setting: Six tertiary referral centers in the Childhood Development after Cochlear Implantation (CDaCI) Study.

Patients: One hundred eighty-eight children implanted at age 5 years or younger and 97 age-comparable normal-hearing controls.

Intervention: Cochlear implantation.

Main Outcome Measures: Outcome measures were the following: Infant-Toddler Meaningful Auditory Integration Scale, Meaningful Auditory Integration Scale, Early Speech Perception Test, Pediatric Speech Intelligibility Test, Multisyllabic Lexical Neighborhood Test, Lexical Neighborhood Test, and Hearing in Noise Test, obtained before implantation and at 6, 12, 18, and 24 months postimplant.

Results: A speech recognition cumulative index, speech recognition index in quiet (SRI-Q), was created to combine information from tests administered in quiet. This index allows simultaneous display of data from all tests in the speech recognition hierarchy and is sensitive to improvements in performance over time as a function of age. SRI-Q also provides a composite of performance on multiple tests, allowing both the tracking of "growth curve" in speech recognition across a wide age range over an extended follow-up period and the comparison of normal-hearing and implanted children on multiple measures. The data range for individual tests is also preserved for ease of interpretation.

Conclusion: SRI-Q allows tracking of global development of speech recognition over time as children progress through a hierarchy of speech perception measures and complements the more detailed assessments obtained from individual tests within the hierarchy.

*Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; †House Ear Institute, Los Angeles, California; ‡Callier Advanced Hearing Research Center, University of Texas-Dallas, Dallas, Texas; §Department of Psychology, University of Miami, Miami, Florida; and ∥Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A.

Address correspondence and reprint requests to Nae-Yuh Wang, Ph.D., Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins Medical Institutions, 2024 E. Monument St, Suite 2-500, Baltimore, MD 21205; E-mail:

This research project was supported by Grant R0l DC004797 from the National Institute on Deafness and Other Communication Disorders.

The funding agencies played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Deafness and Other Communication Disorders or the National Institutes of Health.

© 2008 Otology & Neurotology, Inc.