Targeted Auditory Rehabilitation Employing Direct Audio Input in Children With Single-Sided Deafness Using a Cochlear Implant.

OBJECTIVES: Rehabilitation of children with single-sided deafness (SSD) who use a cochlear implant (CI) poses significant challenges, highlighting the need to develop a tailored protocol that addresses the unique needs of this population. One approach to addressing these challenges is direct streaming to the implant, a technological innovation that allows isolated training of the implanted ear without involving the normal-hearing ear. The growing number of children with SSD receiving a CI and the absence of customized rehabilitation guidelines were the primary motivators for this study. The study aimed to introduce an auditory rehabilitation protocol that incorporates auditory training through audio streaming, developed exclusively for children with SSD who use a CI and evaluate its outcomes after implementation. DESIGN: The protocol was implemented in 33 children with SSD who had received a CI at a mean age of 4.2 yr (ranging from 0.9 to 8.8 yr). Outcome measures included speech perception results, cortical auditory evoked potentials, parental questionnaire scores, and data-logging information. RESULTS: The protocol included 12 consecutive therapy sessions focused on (a) isolated training of the implanted ear using audio streaming to promote audibility and speech perception abilities, (b) binaural training by stimulating the implanted and normal-hearing ears to promote binaural processing, and (c) post-therapy follow-up visits every 3 mo. Most (82%) of the children attained word-identification abilities with the CI (67% open-set and 15% closed-set); the remaining 18% of the children reached the detection level. The cortical auditory evoked potentials to speech sounds were elicited in 82% of the children, indicating cortical detection of speech sounds reflecting audibility at normal conversational levels. The mean daily hours of CI use were 7.5, and the mean parent-reported Speech, Spatial, and Qualities of Hearing Scale score was high (7.1). CONCLUSIONS: The newly developed protocol addresses the unique challenges of rehabilitating children with SSD who use a CI. The study outcomes support the feasibility and efficacy of the protocol, which may serve as a guideline for clinicians rehabilitating this population.