Measures of Speech Understanding in Noise for Young Children with a Cochlear Implant in Mainstream and Special Education.

The study did not include standardized language tests, so it cannot show whether language skills caused the difference on the open-set word test. Only 11 children with cochlear implants attended special education and 19 attended mainstream education, and the authors noted limited power for demographic analyses. The mainstream and special-education cochlear implant groups differed in hearing status at birth and in whether Dutch was spoken at home, so test differences may reflect those group differences rather than education alone. Children with additional disabilities unrelated to hearing loss were excluded, although many children with cochlear implants have comorbid disorders. Not all children were born deaf, and the sample was too small to analyse hearing status at birth in detail. The digit triplet test allowed answering during stimulus presentation, so children who must remember the full triplet until after presentation may find it harder. The tests measured single words or digits in noise, not sentence listening, so they may not capture everyday speech-in-noise demands. No bilingual normal-hearing children were included, so language background effects could not be compared across hearing groups.

The authors declared no potential conflicts of interest. The work was supported by a TBM-FWO grant from the Research Foundation-Flanders (grant number T002216N), the Legacy Ghislaine Heylen (Tyberghein), and a senior clinical investigator fund from the Flemish Research Foundation (1804816N).

Do not read the special-education group's poorer single-word test score as proof that the test is unreliable for all children with cochlear implants in special education. The study did not include standardized language tests, and the mainstream and special-education groups differed in hearing status at birth and home language.