Background: Speech perception in noise remains a significant challenge for cochlear implant (CI) users in everyday life. It has been argued that training to use the information provided by the CI is as important as technological advances. So far, however, only few studies have trained speech perception in noise, most (if not all) included postlingually deafened CI adult users using non-sentence training material. Objective: To assess the effect of training on a speech perception in noise task in prelingually hearing-impaired CI users with years of CI experience, as compared with normal-hearing (NH) young adults, following single- and multi-session training using the same training protocol. Methods: Participants included 22 CI users with prelingual hearing loss and 30 NH. The Hebrew version of the Matrix sentence-in-noise test was used for training. All participants took part in a single training session. Six NH and seven CI continued training for four additional training sessions. All seven CI users trained for additional 5 days, totaling 10 training sessions. Generalization and retention of learning gains were assessed. Results: Following single-session training, CI users showed speech reception thresholds in noise (SRTn) that were 9 to 10 dB higher than NH. After 5 first days of training, five of seven CI users reduced this disadvantage by half. After 10 days of training the CI improved performance by 4.1 dB SNR. No generalization and partial retention of learning were demonstrated. Conclusions: The present study is the first to demonstrate the course of learning and improvements in SRTn following training speech perception in noise in CI users with prelingual hearing loss.

Cochlear implants (CIs) are the state-of-the-art therapy for individuals with severe to profound hearing loss, providing them with good functional hearing. Nevertheless, speech understanding in background noise remains a significant challenge. The purposes of this study were to: (1) conduct a novel within-study comparison of speech-in-noise performance across ages in different populations of CI and normal hearing (NH) listeners using an adaptive sentence-in-noise test, and (2) examine the relative contribution of sensory information and cognitive–linguistic factors to performance. Forty CI users (mean age 20 years) were divided into “early-implanted” <4 years (n = 16) and “late-implanted” >6 years (n = 11), all prelingually deafened, and “progressively deafened” (n = 13). The control group comprised 136 NH subjects (80 children, 56 adults). Testing included the Hebrew Matrix test, word recognition in quiet, and linguistic and cognitive tests. Results show poorer performance in noise for CI users across populations and ages compared to NH peers, and age at implantation and word recognition in quiet were found to be contributing factors. For those recognizing 50% or more of the words in quiet (n = 27), non-verbal intelligence and receptive vocabulary explained 63% of the variance in noise. This information helps delineate the relative contribution of top-down and bottom-up skills for speech recognition in noise and can help set expectations in CI counseling.