Speech perception scores in cochlear implant recipients: An analysis of ceiling effects in the CUNY sentence test (Quiet) in post-lingually deafened cochlear implant recipients

Abstract

Objectives: To evaluate the clinical utility of the City University of New York sentence test in a cohort of post-lingually deafened cochlear implants recipients over time.

Methods: 117 post-lingually deafened, Australian English-speaking CI recipients aged between 23 and 98 years (M = 66 years; SD = 15.09) were recruited. CUNY sentence test scores in quiet were collated and analysed at two cut-offs, 95% and 100%, as ceiling scores.

Results: CUNY sentence scores ranged from 4% to 100% (M = 86.75; SD = 20.65), with 38.8% of participants scoring 95% and 16.5% of participants reaching the 100% scores. The percentage of participants reaching the 95% and 100% ceiling scores increased over time (6 and 12 months post-implantation).

The distribution of all post-operative CUNY test scores skewed to the right with 82% of test scores reaching above 90%.

Discussion: This study demonstrates that the CUNY test cannot be used as a valid tool to measure the speech perception skills of post-lingually deafened CI recipients over time. This may be overcome by using adaptive test protocols or linguistically, cognitively or contextually demanding test materials.

Conclusion: The high percentage of CI recipients achieving ceiling scores for the CUNY sentence test in quiet at 3 months post-implantation, questions the validity of using CUNY in CI assessment test battery and limits its application for use in longitudinal studies evaluating CI outcomes. Further studies are required to examine different methods to overcome this problem.

Keywords:

• Cochlear Implant
• Ceiling Effect
• CUNY Sentence Test
• Speech Perception
• Long-term Outcome
• Candidacy

Acknowledgements

The authors would like to acknowledge and recognise the contribution of Quartika Habsari and other staff at Ear Science Institute Australia-Hearing Implant Centre in assisting in the data collection for this study and thank the management at the Ear Science Institute Australia-Hearing Implant Centre in providing access to the database and support during this study.

Disclaimer statements

This project was supported by the Ear Science Institute Australia's Gift of Hearing Appeal. There are no competing interests for this paper.