Ceiling effects for speech perception tests in pediatric cochlear implant users

Abstract

Objectives

The purpose of this study was to determine the prevalence of ceiling effects for commonly used speech perception tests in a large population of children who received a cochlear implant (CI) before the age of four. A secondary goal was to determine the demographic factors that were relevant for predicting which children were more likely to reach ceiling level performance. We hypothesize that ceiling effects are highly prevalent for most tests.

Design

Retrospective chart review of children receiving a CI between 2002 and 2014.

Results

165 children were included. Median scores were above ceiling levels (≥90% correct) for the majority of speech perception tests and all distributions of scores were highly skewed. Children who were implanted earlier, received two implants, and were oral communicators were more likely to reach ceiling-level performance. Age and years of CI listening experience at time of test were negatively correlated with performance, suggesting a non-random assignment of tests. Many children were re-tested on tests for which they had already scored at ceiling.

Conclusions

Commonly used speech perception tests for children with CIs are prone to ceiling effects and may not accurately reflect how a child performs in everyday listening situations.

Keywords:

• Cochlear implants
• pediatric
• speech perception
• assessment

Additional information

Notes on contributors

Emily R. Spitzer

Emily R. Spitzer is Research Associate Professor at NYU Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery.

David M. Landsberger

David M. Landsberger is Assistant Professor at NYU Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery.

Alexandra J. Lichtl

Alexandra J. Lichtl is a medical student, NYU Grossman School of Medicine.

Susan B. Waltzman

Susan B. Waltzman is the Marica F. Vilcek Professor and Vice Chair, Faculty Development and Academic Affairs at NYU Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery.