Sentence recognition in quiet and amidst single-talker babble in Chinese kindergarten-aged children with cochlear implants

This study aimed to investigate open-set sentence recognition in quiet and amidst single-talker babble among Mandarin-speaking children with cochlear implants (CIs) to elucidate key contributing cognitive and linguistic factors influencing performance. Open-set sentence recognition was assessed in both conditions, alongside measurement of cognitive skills (operational efficiency and auditory short-term memory) and linguistic skills (oral vocabulary and syntactic competence) in kindergarten-aged children with CIs (n = 22; age = 59.8 ± 10.6 months; age at implantation = 31.9 ± 15.1 months; primary communication mode: auditory-oral) compared to peers with typical hearing (TH) (n = 21; age = 67.9 ± 7.9 months). Results showed that children with CIs exhibited poorer performance than TH peers across measures (p < 0.001) except for operational efficiency. Notably, in children with CIs, oral vocabulary significantly contributed to sentence recognition in quiet (β = 0.39, p = 0.029), while auditory short-term memory significantly influenced sentence recognition in both quiet (β = 0.51, p = 0.006) and noise conditions (β = 0.44, p = 0.04). These findings suggest that kindergarten-aged children with CIs face significant challenges in sentence recognition, particularly in the interference condition despite relatively early implantation. Auditory short-term memory emerges as a crucial factor affecting sentence recognition in children with CIs, underscoring its importance for clinical and educational consideration.