In high levels of noise, the adaptive digital system provides superior performance when compared to adaptive analog FM and fixed-gain FM systems.

Young children exhibit significantly poorer speech recognition than do older children and adults in a classroom, especially when speech and noise are presented from the same location. Given the poor acoustics of typical classrooms, and the earlier age at which many children are educated, special modifications to classrooms may be necessary to improve listening through acoustic modifications or classroom amplification. A combination of a parent or teacher questionnaire and the PINT may be helpful in identifying children who are at risk for educational delays and listening difficulties in classrooms with typically poor acoustics.

Use of a remote-microphone accessory designed for a CI sound processor provides superior speech recognition in quiet and in noise when compared with performance obtained with the CI sound processor alone.

ClearVoice and Roger technology each improves speech recognition in noise, particularly when used at the same time. Because ClearVoice does not degrade performance in quiet settings, clinicians should consider recommending ClearVoice for routine, full-time use for AB implant recipients. Roger should be used in all instances in which remote microphone technology may assist the user in understanding speech in the presence of noise.

A wireless HAT for the mobile telephone provides bimodal users with significant improvement in word recognition in quiet and in noise over the mobile telephone.