J Am Acad Audiol 2019; 30(08): 703-711
DOI: 10.3766/jaaa.17126
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preimplant Hearing Aid Fittings and Aided Audibility for Pediatric Cochlear Implant Recipients

Alissa Nickerson
*   Department of Speech and Hearing Science, University of Illinois, Champaign, IL
Lisa S. Davidson
†   Program in Audiology and Communication Science, St. Louis, MO
‡   Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO
§   Central Institute for the Deaf, St. Louis, MO
Rosalie M. Uchanski
†   Program in Audiology and Communication Science, St. Louis, MO
‡   Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO
› Author Affiliations
Further Information

Publication History

22 May 2018

Publication Date:
25 May 2020 (online)



Audibility of speech for children with hearing loss (HL) depends on the degree of HL and the fitting of the hearing aids (HAs) themselves. Many studies on cochlear implant (CI) users have demonstrated that preimplant hearing is associated with postimplant outcomes, but there have been very few reports on the fitting of HAs before surgery.


The aims of this study were to characterize HA fittings and aided audibility of speech for pediatric HA users with severe to profound HL and to examine the relation between preimplant aided audibility and postimplant speech perception.

Research Design:

A descriptive/observational and correlational study. Audiologic records of pediatric CI participants involved in a larger study examining the effects of early acoustic hearing were analyzed retrospectively; when available, these records included HA verification and speech recognition performance.

Study Sample:

The CI participants were enrolled in audiology centers and oral schools for the deaf across the United States.

Data Collection and Analysis:

To determine whether deviations from prescribed DSL target were significantly greater than zero, 95% confidence intervals of the mean deviation were calculated for each frequency (250, 500, 1000, 2000, and 4000 Hz). Correlational analyses were used to examine the relationship between preimplant aided Speech Intelligibility Indices (SIIs) and postimplant speech perception in noise. Correlational analyses were also used to explore the relationship between preimplant aided SIIs and demographic data. T-tests were used to compare preimplant-aided SIIs of HAs of listeners who later became users of either sequential CIs, simultaneous CIs, or bimodal devices.


Preimplant fittings of HAs were generally very close to prescriptive targets, except at 4000 Hz for those HAs with active frequency-lowering processing, and preimplant SIIs, albeit low, were correlated with postimplant speech recognition performance in noise. These results suggest that aided audibility should be maximized throughout the HA trial for later speech recognition purposes.


It is recommended that HA fittings be optimized to support speech audibility even when considering implantation. In addition to the age at which HA use begins, the aided audibility itself is important in determining CI candidacy and decisions regarding bimodal HA use.

NIH T35 DC008765 (Washington University Program in Audiology and Communication Sciences) and NIH R01 DC012778 (PI: LSD).

Parts of this work were presented at the 43rd Annual meeting of the American Auditory Society (AAS) in Scottsdale, AZ, March 3–5, 2016 and at the International Hearing Aid Research Conference (IHCON) in Tahoe City, CA, August 10–14, 2016.


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