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Abstract

Background: Hearing loss in children can significantly delay speech and language development, affecting communication skills, educational performance, and overall quality of life. While both devices aim to provide access to sound, their effectiveness on speech recognition outcomes may vary depending on the degree of hearing loss and aided hearing thresholds. Objective: To compare the effects of hearing aid versus cochlear implant on hearing and speech recognition in children. Methodology: A comparative cross-sectional study was conducted at Superior University, and data were collected from the Audiology and Speech Clinic of the Society for Audiological and Developmental Ailments. The duration of the study was 10 months after approval of the synopsis from the Departmental Research Committee. A total of 26 participants, comprising both genders and aged between 6 and 18 years, were included. Hearing aid users with moderate to severe degree sensorineural hearing loss and cochlear implant users with severe to profound degree sensorineural hearing loss were included in the study. Data was collected through a structured questionnaire/proforma, aided audiometry and speech audiometry, measuring word recognition score by using a phonetically balanced word list in Urdu. The normality of the data was assessed using the Kolmogorov-Smirnov test. According to the data distribution, independent sample t-tests and repeated measures ANOVA were used to analyse the parametric differences between and within each group, respectively. Correlation between different variables was found using Pearson’s correlation. Results: Children with cochlear implants demonstrated a higher average word recognition score than those using hearing aids, although this difference was not statistically significant (p>0.05). Aided hearing thresholds were positively associated with word recognition score performance; children with mild or normal aided thresholds had better speech recognition compared to those with moderate thresholds.  Conclusion: There is no significant differences in speech recognition outcomes between hearing aid and cochlear implant users. However, a positive trend was observed, suggesting that better aided hearing thresholds are associated with improved word recognition performance. These findings emphasise the importance of achieving optimal aided thresholds in pediatric audiological management, regardless of the amplification device used.