Hearing loss during the first 3 years of life can hinder speech and language acquisition. Speech performance deteriorates rapidly with increased levels of background noise in cochlear implant users compared with normal-hearing (NH) listeners, especially when the noise is dynamic e.g., competing speaker or modulated noise. Studying CI users' susceptibility to noise remains a major challenge for researchers and is an important step toward improving CI users' performance in the adverse noisy

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... ions. Aim of the work: To evaluate speech perception in noise of a group of cochlear implanted (CI) children using different types of noise, at different signal to noise ratios (SNR) and explore the effect of age at surgery on speech understanding in noisy situations. Patient and Methods: Forty subjects divided into 2 groups were included in the present study. Group I: Ten normal hearing children (NH) with mean age of 95.5 months. Group II: Thirty CI users with mean age of 100.2 months. They were tested using the newly developed low-verbal sentences in noise test (LV-SIN) using white, multi-talker babble and story noise. Language and speech evaluation were done. Scoring was done by measuring the SNR 50 which is the level at which the child repeated 50% of the number of words per list. Results: Significant difference in LV-SIN test scores was obtained between NH children and CI users using the 3 types of noise. White noise showed the least challenging situation. Age at CI implantation was significantly correlated to the LV-SIN test scores. Conclusions: Children with CI need much higher signal to noise ratios (SNRs) than their NH peers and age at CI surgery highly affects their speech perception in noise.