Spatial Hearing Rehabilitation in Noise for Bilateral Cochlear Implant Children

NCT ID: NCT06040892

Last Updated: 2026-02-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-27

Study Completion Date

2027-11-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

In recent decades, there was a great expansion for bilateral cochlear implantation (bCI) in children, leading to an improvement of their quality of life. However, spatial hearing skills of bCI children remain limited, even for children with the best speech understanding outcomes. Recent studies have brought new insights in spatial hearing by using virtual reality to record spatial hearing performance in 3D and the impact of active listening (i.e. free head exploration during sound emission): all bCI children showed spatial hearing difficulties related to front-back confusions and distance perception, which partly resulted from the reduction in auditory cues by the CI settings. However, bCI children notably improved under conditions of active listening, suggesting that interaction with environment could represent a rehabilitation entry strategy to help bCI users when faced with complex auditory scenes in daily life.

The ability to localize sounds in space (spatial hearing) and the ability to understand speech in noise are both auditory skills essential in daily interactions with our physical and social environment and, when deficient, limit the quality of life. However, there is no specific rehabilitation program devoted to spatial hearing which could help children face their daily difficulties in noisy environments. Even though technological advances are crucial to improve the restoration of hearing functions, these improvements are also highly dependent on rehabilitation strategies to train our auditory brain to face the restoration of binaural processing or to decode the impoverished spectral information delivered by the CI.

The investigators recently performed a pilot study in bCI adults who attended 8 training sessions of spatial hearing, involving a sensorial and interactive immersive environment (i.e. virtual reality with auditory and visual environment during an active listening task). All participants benefitted of the training, in terms of spatial hearing performance, speech understanding in noise, and quality of life. All early benefits were maintained 1 month after the end of training.

The investigators aim to propose a spatial hearing rehabilitation program (KidTrain) adapted to bCI children from 8 to 17 years old, based on their previous pilot study on bCI adults. Their tool makes it possible to propose rehabilitation programs adapted to the performance and expectations of each child. This program will manipulate both the ambient sound with varying background noise to simulate daily life environments (i.e. making auditory detection more or less complex), and also manipulate virtual immersive environment (i.e. giving more or less relevant visual cues related to real sound location). The KidTrain's effects will be measured with different auditory tests performed in noisy environments. The investigators will also include Normal Hearing (NH) children as age-matched control groups to perform the auditory tests in noise. These NH groups will also bring new insights of spatial hearing maturation in complex auditory environments. Based on our preliminary data in bCI adults, this 'KidTrain program' should improve spatial hearing skills of bCI children, speech comprehension in noise and quality of life in many daily situations.

Virtual reality (VR) has recently proven its effectiveness in rehabilitation in many domains and recent studies have shown that this technology has its place in the auditory evaluation and adaptation of spatial hearing. This VR approach takes advantage of the control of multisensory cues of our environment (audio and visual) during a spatial hearing task, and allows the subject to interact with his environment according to his hearing abilities and needs (i.e. active listening).

Based on their previous study conducted in bCI and NH children and on their spatial training study conducted with bCI adults, the investigators wish to respond to the growing need of spatial hearing rehabilitation for bCI children. To achieve this goal, the investigators will improve the spatial training program by adding different immersive environment in VR with various background noise to simulate daily life environments. This approach will also be a great opportunity to characterize the developmental stages of spatial hearing maturation in NH children. Thus, this project will propose new axes of speech therapy on the Orthophonie \& Surdité platform, combining spatial hearing and speech understanding in noise. This innovative and adapted rehabilitation program will lead the speech therapist to propose more adapted and effective rehabilitations for the daily life of deaf children.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Cochlear Implantation

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Group A

bilateral cochlear implant children with rehabilitation including 8 sessions with a spatialized sensory index

Group Type EXPERIMENTAL

spatial hearing rehabilitation program

Intervention Type OTHER

The tool makes it possible to propose rehabilitation programs adapted to the performance and expectations of each child. This program will manipulate both the ambient sound with varying background noise to simulate daily life environments (i.e. making auditory detection more or less complex), and also manipulate virtual immersive environment (i.e. giving more or less relevant visual cues related to real sound location).

SPHERE protocol : Spatial hearing performances test

Intervention Type DIAGNOSTIC_TEST

Participants will be instructed to localize a sound emitted in their environment using a virtual reality setup (SPHERE protocol).

FRASIMAT Test : audiology test of speech in noise perception

Intervention Type DIAGNOSTIC_TEST

Intelligibility threshold is the signal-to-noise ratio (in decibels) for which the subject can repeat 50% of the words heard in a dichotic listening.

Kid SSQ questionnaire of life : The Speech, Spatial and Other Qualities of Hearing Scale

Intervention Type DIAGNOSTIC_TEST

The SSQ questionnaire is a clinical subjective scale that allows evaluating of hearing performances in daily life. The questionnaire is divided into 3 main items (A: speech; B: spatial hearing; C: other qualities of hearing) comprising questions with rating scores out of ten.

Group B

bilateral cochlear implant children with rehabilitation including initially 4 sessions without spatialized sensory cue followed by 4 sessions with spatialized sensory cue

Group Type EXPERIMENTAL

spatial hearing rehabilitation program

Intervention Type OTHER

The tool makes it possible to propose rehabilitation programs adapted to the performance and expectations of each child. This program will manipulate both the ambient sound with varying background noise to simulate daily life environments (i.e. making auditory detection more or less complex), and also manipulate virtual immersive environment (i.e. giving more or less relevant visual cues related to real sound location).

SPHERE protocol : Spatial hearing performances test

Intervention Type DIAGNOSTIC_TEST

Participants will be instructed to localize a sound emitted in their environment using a virtual reality setup (SPHERE protocol).

FRASIMAT Test : audiology test of speech in noise perception

Intervention Type DIAGNOSTIC_TEST

Intelligibility threshold is the signal-to-noise ratio (in decibels) for which the subject can repeat 50% of the words heard in a dichotic listening.

Kid SSQ questionnaire of life : The Speech, Spatial and Other Qualities of Hearing Scale

Intervention Type DIAGNOSTIC_TEST

The SSQ questionnaire is a clinical subjective scale that allows evaluating of hearing performances in daily life. The questionnaire is divided into 3 main items (A: speech; B: spatial hearing; C: other qualities of hearing) comprising questions with rating scores out of ten.

Normal hearing volunteers

Children without known hearing loss

Group Type ACTIVE_COMPARATOR

SPHERE protocol : Spatial hearing performances test

Intervention Type DIAGNOSTIC_TEST

Participants will be instructed to localize a sound emitted in their environment using a virtual reality setup (SPHERE protocol).

FRASIMAT Test : audiology test of speech in noise perception

Intervention Type DIAGNOSTIC_TEST

Intelligibility threshold is the signal-to-noise ratio (in decibels) for which the subject can repeat 50% of the words heard in a dichotic listening.

Kid SSQ questionnaire of life : The Speech, Spatial and Other Qualities of Hearing Scale

Intervention Type DIAGNOSTIC_TEST

The SSQ questionnaire is a clinical subjective scale that allows evaluating of hearing performances in daily life. The questionnaire is divided into 3 main items (A: speech; B: spatial hearing; C: other qualities of hearing) comprising questions with rating scores out of ten.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

spatial hearing rehabilitation program

The tool makes it possible to propose rehabilitation programs adapted to the performance and expectations of each child. This program will manipulate both the ambient sound with varying background noise to simulate daily life environments (i.e. making auditory detection more or less complex), and also manipulate virtual immersive environment (i.e. giving more or less relevant visual cues related to real sound location).

Intervention Type OTHER

SPHERE protocol : Spatial hearing performances test

Participants will be instructed to localize a sound emitted in their environment using a virtual reality setup (SPHERE protocol).

Intervention Type DIAGNOSTIC_TEST

FRASIMAT Test : audiology test of speech in noise perception

Intelligibility threshold is the signal-to-noise ratio (in decibels) for which the subject can repeat 50% of the words heard in a dichotic listening.

Intervention Type DIAGNOSTIC_TEST

Kid SSQ questionnaire of life : The Speech, Spatial and Other Qualities of Hearing Scale

The SSQ questionnaire is a clinical subjective scale that allows evaluating of hearing performances in daily life. The questionnaire is divided into 3 main items (A: speech; B: spatial hearing; C: other qualities of hearing) comprising questions with rating scores out of ten.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Child aged between 7 and 17 years
* Normal vision (including correction),
* Able to understand the experimental instructions,
* Parents or guardians informed of the study and having signed the consent form,

Specific for NH:

* Normal tone audiometry (mean threshold ≤ 30 dB). Specific for bIC
* Minimum 2 years of binaural experience,
* Average speech recognition ≥ 80% with both cochlear implants

Exclusion Criteria

* Bilateral vestibular areflexia,
* Attention deficit disorder,
* Known neurological or psychiatric disorders,
* Oculomotor disorders,
* Parents not affiliated to a social security scheme or beneficiaries of a similar scheme who sign the consent for the child's participation,
* Subject participating in other interventional research with an exclusion period still ongoing at inclusion.
Minimum Eligible Age

7 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hospices Civils de Lyon

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Aurélie Coudert, MD

Role: STUDY_CHAIR

Hospices Civils de Lyon

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Service d'Oto-Rhino-Laryngologie et Chirurgie cervico-faciale Hôpital Edouard Herriot, Groupement Hospitalier Centre

Lyon, , France

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

France

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Aurélie Coudert, MD

Role: CONTACT

0427855506 ext. +33

Valérie GAVEAU, MCU

Role: CONTACT

04 72 91 34 10 ext. +33

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Eric TRUY, Pr

Role: primary

04 72 11 04 92 ext. +33

Aurélie Coudert, MD

Role: backup

0427855506 ext. +33

References

Explore related publications, articles, or registry entries linked to this study.

Yuzefovsky AI, Lonardo RF, Michel RG. Spatial discrimination against background with different optical systems for collection of fluorescence in laser-excited atomic fluorescence spectrometry with a graphite tube electrothermal atomizer. Anal Chem. 1995 Jul 1;67(13):2246-55. doi: 10.1021/ac00109a052.

Reference Type BACKGROUND
PMID: 8694251 (View on PubMed)

Valzolgher C, Gatel J, Bouzaid S, Grenouillet S, Todeschini M, Verdelet G, Salemme R, Gaveau V, Truy E, Farne A, Pavani F. Reaching to Sounds Improves Spatial Hearing in Bilateral Cochlear Implant Users. Ear Hear. 2023 Jan-Feb 01;44(1):189-198. doi: 10.1097/AUD.0000000000001267. Epub 2022 Aug 19.

Reference Type BACKGROUND
PMID: 35982520 (View on PubMed)

Coudert A, Verdelet G, Reilly KT, Truy E, Gaveau V. Intensive Training of Spatial Hearing Promotes Auditory Abilities of Bilateral Cochlear Implant Adults: A Pilot Study. Ear Hear. 2023 Jan-Feb 01;44(1):61-76. doi: 10.1097/AUD.0000000000001256. Epub 2022 Aug 9.

Reference Type BACKGROUND
PMID: 35943235 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

69HCL22_0893

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

fNIRS in Pediatric Hearing Aids
NCT04696835 RECRUITING NA