![]() The following recommendations were developed based on published research and experience of clinicians managing children and adults with SSD + CI. The aim of this review is to summarize the current literature regarding CI outcomes for children with SSD and provide guidance for candidacy, outcome measures, and mapping of children with SSD + CI. Candidacy considerations, counseling, habilitation, and evaluation postactivation must look beyond simple speech perception and move toward evaluation that encompasses tasks associated with binaural hearing. Children who seek cochlear implantation for unilateral hearing loss (UHL) or single-sided deafness (SSD) are seeking implantation not solely for better speech understanding, but in the hopes of achieving binaural hearing. This is a considerable challenge as so much of the groundwork for evaluation of CI patients has been laid by working with patients who have bilateral hearing loss. ![]() Now children with hearing loss in only one ear are receiving CIs and clinicians are challenged with programming, testing, and evaluating performance in children who have hearing thresholds within the normal range on the contralateral side. ![]() With bilateral cochlear implantation becoming standard of care for children in the US with bilateral severe to profound hearing loss, clinicians began to describe outcomes in terms of individual ear word recognition and bilateral performance on speech perception tasks ( Uhler et al. Outcome measures moved from detection of speech to closed set word recognition, to open-set word recognition, to sentences in quiet, and ultimately sentence perception in noise. With multichannel CIs, speech perception became an achievable and expected goal. When cochlear implants (CIs) were first approved for children, the initial goal was unilateral sound awareness.
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