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Objective: In the United States, most adults who receive cochlear implants (CIs) do not undergo a comprehensive auditory rehabilitation (CAR) approach, which may result in suboptimal outcomes. The objectives of this pilot study were to demonstrate that a CAR approach incorporating auditory training (AT) by a speech‐language pathologist (SLP) is feasible in adults receiving CIs and to explore whether this approach results in improved outcomes. Methods: Twenty‐four postlingually deaf adult CI candidates were serially assigned to one of three groups: (a) a "CAR group" that received standard of care implantation, programming by an audiologist, an additional preoperative counseling session, and eight one‐hour AT sessions; (b) a "passive control" standard‐of‐care group; and (c) an "active control" group that also received the extra preoperative counseling session. Participants were tested preoperatively and 1, 3, and 6 months after CI using measures of word and sentence recognition in quiet and in babble, as well as measures of quality of life (QOL). Results: The CAR approach was feasible, but this pilot study was underpowered to determine efficacy. Differential time courses of speech recognition improvement were seen for sentence and word recognition. All QOL measurements showed improvement from pre‐CI to 1 month post‐CI activation. Results revealed issues to consider for a larger‐scale study of CAR revolving around participant selection, study measures, and sample size. Conclusion: The CAR approach is feasible in new CI users. A larger trial is needed to investigate whether CAR leads to better outcomes or faster improvement in this clinical population. Level of Evidence: 2. In the United States, most adults who receive cochlear implants (CIs) do not undergo a comprehensive auditory rehabilitation (CAR) approach, which may result in suboptimal outcomes. This pilot study investigated the feasibility and efficacy of applying a CAR approach to new adult CI users. The approach was found to be feasible, and a larger trial is needed to investigate whether CAR leads to better outcomes or faster improvement in this clinical population. [ABSTRACT FROM AUTHOR]

Cochlear implant recipients have demonstrated remarkable increases in speech perception since US FDA approval was granted in 1984. Improved performance is due to a number of factors including improved cochlear implant technology, evolving speech coding strategies, and individuals with increasingly more residual hearing receiving implants. Despite this evolution, the same recommendations for pre- and postimplant speech recognition testing have been in place for over 10 years in the United States. To determine whether new recommendations are warranted, speech perception performance was assessed for 156 adult, postlingually deafened implant recipients as well as 50 hearing aid users on monosyllabic word recognition (CNC) and sentence recognition in quiet (HINT and AzBio sentences) and in noise (BKB-SIN). Results demonstrated that for HINT sentences in quiet, 28% of the subjects tested achieved maximum performance of 100% correct and that scores did not agree well with monosyllables (CNC) or sentence recognition in noise (BKB-SIN). For a more difficult sentence recognition material (AzBio), only 0.7% of the subjects achieved 100% performance and scores were in much better agreement with monosyllables and sentence recognition in noise. These results suggest that more difficult materials are needed to assess speech perception performance of postimplant patients – and perhaps also for determining implant candidacy. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]