An Exploratory Study of Image-Guided Cochlear Implant Intervention on Articulation and Phonological Processing in Children With Speech Sound Disorders

Purpose: Poor spectral clarity from cochlear implants (CIs) has been hypothesized to contribute to articulation and phonological processing deficits among children with CIs. Therefore, CI programming techniques that aim to improve spectral resolution may lead to improvements in articulation and phonological processing skills (i.e., phonological awareness as well as phonological and phonetic recoding). Method: We analyzed the articulation and phonological skills of 21 children with CIs (4.7–13.1 years old) with articulation and phonological processing deficits who were enrolled in a 2-year waitlist-deferred randomized controlled trial examining image-guided cochlear implant programming (IGCIP). In the clinical trial, participants were randomly assigned to receive IGCIP at varying time points throughout the study. Change over time in articulation and phonological processing was assessed in the subset of 21 children. Additionally, an exploratory analysis of the effect of IGCIP on articulation and phonological processing skills was completed. Results: Only articulation, not phonological processing, improved relative to age norms. IGCIP did not have a statistically significant effect on articulation or phonological processing in the first year of the study. However, participants who received IGCIP within the first year of the study did exhibit larger and clinically meaningful improvements in articulation scores compared with those who did not receive IGCIP. Conclusions: Articulation deficits, but not phonological processing deficits, improved over time among children with CIs. Future studies should assess the impact of IGCIP on articulation within a larger sample of CI users with articulation deficits to clarify its role in such improvements.