Novel Approaches to Measure Spatial Release From Masking in Children With Bilateral Cochlear Implants.
Z Ellen Peng, Ruth Y Litovsky
PMID 34133400WHAT IT FOUND
Children with bilateral cochlear implants gained speech-in-noise benefits from spatial separation, but needed much wider angles than normal-hearing peers to achieve the same improvement.
Positioning teachers or peers opposite the child, rather than just to the side, maximizes their access to auditory cues.
Key findings
01Children with bilateral cochlear implants showed a smaller benefit from the monaural head shadow cue compared to normal-hearing children, but similar benefits from interaural difference cues.
02To achieve a fixed 20% intelligibility benefit, children with implants required a mean minimum angular separation of 91.5 degrees, compared to 43.7 degrees for normal-hearing children.
03Most children with implants achieved the intelligibility benefit with a separation of less than 90 degrees, indicating they can use interaural cues when spatial separation is sufficient.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size of children with bilateral implants was small (9-11), which limits the generalizability of the findings to the broader clinical population. The study used virtual auditory space with direct audio input, which removes the impact of head movements and natural acoustic cues present in real-world listening. The devices used were not bilaterally synchronized, which may affect the fidelity of interaural timing cues. The study did not test children with unilateral implants or those with different device configurations, so findings apply specifically to bilateral users.
Declared interests
The study was supported by NIH grants and non-US government research support. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that all children with bilateral implants can benefit from narrow spatial separations. While some children achieved benefits at angles less than 90 degrees, the group average required a much wider separation than normal-hearing peers. Failing to account for this individual variability and the generally larger angular requirement could lead to underestimating the acoustic access needed for these children in classroom settings.