1. Localisation and speech perception UK National Paediatric Bilateral Audit. Helen Cullington 11 April 2013

2. Results 2 THE RESULTS

3. Results 3 THE RESULTS

4. Notes about results… This is not a research project This was not designed to answer questions This is a real picture of what children in the UK with bilateral CI can do 4

5. Localisation.

6. 6 Localisation Judgement about direction and distance of sound Main method is comparison of signals received at each ear –level difference –time difference

7. 7 vital

8. Can my child localise? Parent report of real life Test in clinic

9. 9 Scoring localisation

10. 10 Speech Scoring localisation

11. 11 Speech

12. 12 Child answers Scoring localisation Speech Error = 45 degrees

13. Localisation error = average error over 25 trials 13

14. 14 n= 8 230 44 221 41 124 25 30 chance Lower is better

15. What is standard deviation? A measure of how spread out numbers are … how tightly the results are clustered around the average 15

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17. 17 About 2/3 of the results are in this range

18. 18 n= 8 230 44 221 41 124 25 30 chance Lower is better

19. Bilateral

20. Unilateral

21. Time in sound Sequential/Unilateral: time from first implant to test Simultaneous/Bilateral: time from bilateral implants to test 21

22. 22 n= 44 3 41 8 25 24 chance Lower is better n= 44 3 41 8 25 24

23. 23 Higher is better seq

24. 24 n= 35 55 13 Higher is better seq

25. Caution These are average results Individual results will vary 25

26. 26 Higher is better seq

27. 14 year old Age at first CI = 6, age at second CI = 13 1 year after 2 nd CI, localisation improved from 51 to 13 degrees 27

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29. Speech perception

30. 30 Automated Toy Test (ATT) BKB for children with language age of 6 or more Speech perception in quiet and noise

31. Speech perception in quiet Speech goes quieter and quieter to reach threshold of where child can still understand it Results is speech level where child can just understand speech (lower is better) 31

32. 32 n= 7 199 57 249 53 151 37 35 Lower is better

33. 33 n= 23 48 10 Higher is better seq

34. Speech perception in noise Noise stays at a constant level; speech goes quieter and quieter to reach threshold of where child can still understand it Result is signal to noise ratio where child can just understand speech (lower is better) 34

35. BKB sentences in noise 35

36. 36 Speech and noise in front Speech perception noise centre

37. 37 n= 11 36 8 Higher is better seq

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42. 42 Speech always in front Noise Improvement from moving noise to 1 st side 1 st side seq

43. 43 Speech always in front Noise Improvement from moving noise to non- implanted/new side new side seq

44. 44 n= 40 38 62 65 33 31 7 8 Higher is better seq

45. 45 n= 32 91 19 Higher is better seq

46. Localisation - simultaneous Children with bilateral CI localise significantly better than children with unilateral CI 46 sim

47. Localisation - sequential 1 year after receiving the 2 nd CI, on average children can localise significantly better This localisation improvement appears to decrease as the gap between the implants increases 47 seq

48. Speech perception in noise - sequential After receiving the 2 nd CI, childrens listening in noise improves This improvement appears to decrease as the gap between the implants increases As time progresses, children begin to use the 2 nd ear to help when noise is separated from speech 48 seq

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