Vol. 7, Issue 2, Part B (2025)

Background: Speech intelligibility is a critical outcome in pediatric habilitation of children with hearing impairment. While cochlear implants (CIs) and hearing aids (HAs) are established interventions, the benefit of bimodal stimulation (CI in one ear, HA in the other) on speech intelligibility remains underexplored.

Objective: To assess and compare perceptual speech intelligibility among children with normal hearing (NH), children using bilateral hearing aids, children with unilateral cochlear implants, and children using bimodal devices. Methods: Fifty-five children aged 5.5-7 years were recruited across four groups: NH (n=15), HA users (n=15), unilateral CI users (n=15), and bimodal users (n=10). Speech intelligibility was evaluated using the Picture Speech Intelligibility Evaluation Test (SPINE), featuring bisyllabic words. Speech samples were rated by three trained listeners. Statistical analyses included one-way ANOVA and LSD post hoc tests.

Results: Significant differences were observed among groups (p<0.001). Mean intelligibility scores were highest in NH children (97.9%), followed by bimodal users (56.8%), unilateral CI users (49.8%), and HA users (27.6%). Post hoc comparisons revealed significant differences between all pairs, with bimodal users performing better than unilateral CI users (p=0.016).

Conclusion: Bimodal stimulation offers perceptual intelligibility advantages over unilateral CI or HA alone, though NH children still demonstrate superior outcomes. Findings underscore the potential benefit of bimodal fitting for improving speech production outcomes in children with hearing impairment.