The programming of CIs is essential for good performance. However, no Good Clinical Practice guidelines exist. This paper reports on the results of an inventory of the current practice worldwide. A questionnaire was distributed to 47 CI centers. They follow 47600 recipients in 17 countries and 5 continents. The results were discussed during a debate. Sixty-two percent of the results were verified through individual interviews during the following months. Most centers (72%) participated in a cross-sectional study logging 5 consecutive fitting sessions in 5 different recipients. Data indicate that general practice starts with a single switch-on session, followed by three monthly sessions, three quarterly sessions, and then annual sessions, all containing one hour of programming and testing. The main focus lies on setting maximum and, to a lesser extent, minimum current levels per electrode. These levels are often determined on a few electrodes and then extrapolated. They are mainly based on subjective loudness perception by the CI user and, to a lesser extent, on pure tone and speech audiometry. Objective measures play a small role as indication of the global MAP profile. Other MAP parameters are rarely modified. Measurable targets are only defined for pure tone audiometry. Huge variation exists between centers on all aspects of the fitting practice.

This paper describes the outcomes in six children with hypoplastic cochlear nerves, demonstrated on magnetic resonance imaging who were selected for implantation because they had clear responses to sound, with hearing aids. In four of the six children the internal auditory canals were abnormally narrow; however in the remaining two the internal auditory canals were of normal width. After activation of their devices, all six children had auditory thresholds within the normal range for implanted congenitally deaf children. However the progress of all these children after 2 to 6 years of implant use turned out to be disappointing. Five of the children developed only the ability to detect the presence of sound, and were unable to discriminate accurately between speech sounds. They remain at Category of Auditory Performance (CAP) level 2: sign is their primary mode of communication. All five children also remain at Speech Intelligibility Rating (SIR) level 2, with unintelligible connected speech. The sixth child was able to develop some understanding of common phrases through listening alone, however he remains at CAP level 4 and his SIR level also remains at 2. The benefit of cochlear implantation in this group of children is likely to be considerably restricted. In specific cases it may be appropriate to offer a cochlear implant to a child with hypoplastic auditory nerves but careful counselling of the family about likely outcomes is essential.

Our purpose is to examine statistical methods, particularly field plot technique, hypothesis testing, and inference suggesting, from a seed corn (Zea mays L.) company viewpoint. Company managers must look beyond traditional statistical methods to develop systems that identify superior new products. These systems should mimic the processes used by farmers in selecting new hybrids that provide superior performance in the broad range of environments where they will be grown. This paper shows the evolution of seed company strategy to identify superior hybrids in product development and testing systems. Test resource allocation has changed to fewer replicates per location, to more locations per year, to more years per hybrid comparison, and to more data integration across test types. Experimental design has changed from sophisticated to simple designs, from experiment summaries to head‐to‐head comparisons (two hybrids compared in all tests in which both were grown) then to head‐to‐group comparisons (series of head‐to‐head comparisons for a hybrid with appropriate elite hybrids within a maturity group), and from analyses of variance to t‐test analyses. Stability regressions have become more popular. As improved statistical methods have been used, more genetic progress per unit of time has resulted; hybrids have become more stress tolerant, thus more widely adapted.

This paper describes the outcomes in six children with hypoplastic cochlear nerves, demonstrated on magnetic resonance imaging who were selected for implantation because they had clear responses to sound, with hearing aids. In four of the six children the internal auditory canals were abnormally narrow; however in the remaining two the internal auditory canals were of normal width. After activation of their devices, all six children had auditory thresholds within the normal range for implanted congenitally deaf children. However the progress of all these children after 2 to 6 years of implant use turned out to be disappointing. Five of the children developed only the ability to detect the presence of sound, and were unable to discriminate accurately between speech sounds. They remain at Category of Auditory Performance (CAP) level 2: sign is their primary mode of communication. All fi ve children also remain at Speech Intelligibility Rating (SIR) level 2, with unintelligible connected speech. The sixth child was able to develop some understanding of common phrases through listening alone, however he remains at CAP level 4 and his SIR level also remains at 2. The benefi t of cochlear implantation in this group of children is likely to be considerably restricted. In specifi c cases it may be appropriate to offer a cochlear implant to a child with hypoplastic auditory nerves but careful counselling of the family about likely outcomes is essential.

The aim of this retrospective study was to investigate the use of the frequency transposition Transonic FT 40 system in a group of 36 children with profound sensorineural hearing loss. The group comprised 36 children (11 boys, 25 girls) aged between 2.8 and 15.6 years (mean 7.6 years) at fitting of the FT 40 device. At 48 months post-FT 40 fitting, only 11 children (30%) were still wearing the device. The children discontinued wearing the FT 40 for the following reasons: ergonomic (11%); no perceived benefit from the system (11%); cosmetic (17%); and subsequent cochlear implantation (30%). The performance of the long-term FT 40 users was investigated using the following outcome measures: aided soundfield hearing thresholds: closed set speech tests (the E2L toy test and the Manchester Picture Test discrimination test) and a speech intelligibility rating score. The 11 long-term FT 40 users (three boys, eight girls) were aged from 5.3 to 12.9 years (mean 7.2 years) at the time of initial fitting of the FT 40 device. At time of fitting, the aided soundfield thresholds with the FT 40 were significantly better at 500 Hz (p<0.04), 1 kHz (p<0.019), 2 kHz (p<0.001) and 4 kHz (p <0.001) compared to thresholds with conventional hearing aids. Six of 11 children did not show any change in performance on the closed set speech tests and two children had intelligible speech at 48 months' follow-up. A small subgroup of good performers was identified. These children were younger at age of fitting (mean 6.2 years compared to a mean of 7.7 years for the remainder of the group), were predominantly oral communicators and had identified aetiologies for their deafness. The present study suggests that there is a small subgroup of hearing-impaired children who benefit from frequency transposition hearing systems, and future suggested fitting criteria and outcome measures are listed.