Speech discrimination testing was carried out under clinical trial conditions for eight profoundly postlingually deaf adults to assess the efficacy of a newly developed 22-channel cochlear prosthesis and speech processor. Three months postoperatively, these patients showed significantly better results with the cochlear prosthesis than for preoperative testing with a conventional hearing aid or vibrotactile aid (following a 6-month trial with the aid) on each of a series of tests from the Minimal Auditory Capabilities battery. Assessment of lipreading enhancement using standard speech tests, consonant recognition studies, and speech tracking showed significant improvements for each patient when using the cochlear prosthesis. Six patients showed a significant amount of open set speech discrimination without lipreading at levels which have not been reported for single electrode cochlear prostheses. The two patients who performed poorly on these tests both had restricted multiple channel systems due to their disease, one patient being restricted to virtually a single channel system and the other to only ten of the 22 electrodes. These results indicate that this multiple channel cochlear prosthesis has potential as a treatment for profound postlingual deafness over a wide range of etiologies and ages.