Introduction & Objectives: Achieving age-appropriate speech, language, and voice (SLV) skills is the foremost goal for any young cochlear implant (CI) recipient. Amidst several other factors, sound processing technology can significantly impact CI individuals’ SLV outcomes. In this study, objective and subjective measures of speech perception, speech–language, voice, fluency, and articulation-phonological skills were obtained in CI recipients not undertaking formal speech language therapy. The objective is to assess if these skills are impacted by the introduction of new automatic noise-reduction algorithms over a period of one year.
Methods: Twelve pediatric CI recipients (7 to 16 years) upgraded to the Marvel CI sound processors and were evaluated for the SLV skills compared to their previous processor. Besides audiological measures (aided audiometry, SRT, WRS in noise, SSQ-12), measures of ‘maximum phonation duration’ (Voice – GRBASI), articulation, phonology, fluency, speech intelligibility were obtained. Developmental-milestone scales for attention, cognition and a validated 30-point questionnaire were also used.
Results & Discussion: To date, a 5-10 dB improvement is noted in CI assisted free-field audiometry (0.25-6 KHz), a 11.6% improvement in WRS scores in noise, and a 5 dB improvement in SRT. On the developmental scale, a lag of three years in language and cognition categories in children was noted at baseline. By the end of month three, vocabulary and expressive language increased significantly in 10/12 children along with improvements in speech-intelligibility, articulation and reduction in nasality. There was refinement in emphasis, phrasing skills and controlled rate of speech. Low-context questions were comprehended with greater accuracy with discourse and sentence level being improved to level 8 towards conversing and recalling elements for undisclosed topics. There were improvements in substitution errors of stops (p-b contrast) and nasal-oral consonant contrasts. Attention improved from stage 3 (single-channeled) to stage 4 (early integrated). Wireless streaming via Bluetooth and remote microphones augmented comprehension of audio input for phone calls and online education which enhanced their confidence.
Conclusion: Automatic front-end noise reduction systems and wireless streaming can provide measurable and clinically relevant improvements in speech-language-voice skills in the real world amongst CI users.

**Introduction & Objectives:** Achieving age-appropriate speech, language, and voice (SLV) skills is the foremost goal for any young cochlear implant (CI) recipient. Amidst several other factors, sound processing technology can significantly impact CI individuals’ SLV outcomes. In this study, objective and subjective measures of speech perception, speech–language, voice, fluency, and articulation-phonological skills were obtained in CI recipients not undertaking formal speech language therapy. The objective is to assess if these skills are impacted by the introduction of new automatic noise-reduction algorithms over a period of one year.
**Methods:** Twelve pediatric CI recipients (7 to 16 years) upgraded to the Marvel CI sound processors and were evaluated for the SLV skills compared to their previous processor. Besides audiological measures (aided audiometry, SRT, WRS in noise, SSQ-12), measures of ‘maximum phonation duration’ (Voice – GRBASI), articulation, phonology, fluency, speech intelligibility were obtained. Developmental-milestone scales for attention, cognition and a validated 30-point questionnaire were also used.
**Results & Discussion:** To date, a 5-10 dB improvement is noted in CI assisted free-field audiometry (0.25-6 KHz), a 11.6% improvement in WRS scores in noise, and a 5 dB improvement in SRT. On the developmental scale, a lag of three years in language and cognition categories in children was noted at baseline. By the end of month three, vocabulary and expressive language increased significantly in 10/12 children along with improvements in speech-intelligibility, articulation and reduction in nasality. There was refinement in emphasis, phrasing skills and controlled rate of speech. Low-context questions were comprehended with greater accuracy with discourse and sentence level being improved to level 8 towards conversing and recalling elements for undisclosed topics. There were improvements in substitution errors of stops (p-b contrast) and nasal-oral consonant contrasts. Attention improved from stage 3 (single-channeled) to stage 4 (early integrated). Wireless streaming via Bluetooth and remote microphones augmented comprehension of audio input for phone calls and online education which enhanced their confidence.
**Conclusion:** Automatic front-end noise reduction systems and wireless streaming can provide measurable and clinically relevant improvements in speech-language-voice skills in the real world amongst CI users.

Influence of Automatic Noise Reduction Algorithms and Wireless Streaming on Speech, Language and Voice in Pediatric CI Users

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,