Classification performance of Spanish and English word recognition testing to identify cochlear implant candidates

Objective: To explore the effects of language on word recognition ability and associated access to cochlear implants in Spanish- and English-speakers with hearing loss.

Design: Retrospective chart review.

Study sample: The study included 1411 English and Spanish-speaking adults with sensorineural hearing loss. Word recognition as a function of pure-tone average was evaluated by test language. Sensitivity and specificity of word recognition testing performed using the NU-6 and Spanish Bisyllables in discriminating between cochlear implant and non-cochlear implant candidates were analysed.

Results: Spanish-speakers had significantly poorer thresholds compared to English-speakers, yet significantly better word recognition, t(2763) = 1.86, p < 0.05. The effect of test language on word recognition increased with increasing hearing loss severity, F(3, 2762) = 6.03, p < 0.001, partial η² = .007. The sensitivity and specificity of word recognition testing were 93% and 74% respectively for Spanish, and 95% and 75%, respectively, for English word recognition tests in meeting referral criteria for cochlear implant evaluation.

Conclusions: Based on classification performance analysis, Spanish and English word recognition measures exhibit comparable effectiveness in referring patients for cochlear implant evaluation. While Spanish-language measures yielded better performance, this does not result in a significant difference in referral rates for Spanish versus English speakers for unaided word recognition scores of 60% or less.