Background: Although sound localization and speech-in-noise perception are better for people with bilateral Cochlear Implants (CIs) compared to those with a unilateral implant, these skills remain far below those of normally-hearing children (Sarant et al., 2014; Sparreboom et al., 2015). A large body of research demonstrates that sound localisation can improve with training, underpinned by plasticity-driven changes in the auditory pathways for children and adults (Firszt et al., 2015; Yu et al., 2018). The use of audio-visual stimuli helps with task familiarisation, and the gamification approach contributes to improving engagement and attainment, which is crucial for children and teenagers. However, there is currently a lack of engaging, remote, multimodal training programmes for young people with bilateral CIs.

The BEARS approach: The BEARS project (NIHR201608) was established: (1) To develop the Both Ears (BEARS) training package, a set of virtual-reality games to train spatial hearing in young people with bilateral CIs through a series of PPIE workshops. (2) To develop the outcome measures needed to evaluate the effectiveness of the BEARS training package. (3) To conduct a large-scale confirmatory clinical trial to assess whether BEARS substantially improves hearing with two implants. (4) To understand the learning mechanism and process evaluation.

Results and conclusions: Over the last 2 years, the outcome measures and intervention have been developed and the clinical trial launched in June 2023. Here, we summarise the BEARS logic model, approach and next steps.

Funding: Supported by the National Institute for Health and Care Research (NIHR, grant number NIHR201608). MSC was supported by a travel bursary from Oticon Medical.

References:

• Firszt J.B., Reeder R.M., Dwyer N.Y., Burton H., Holden L.K. (2015) Localization training results in individuals with unilateral severe to profound hearing loss. Hearing Research 319: 48–55. doi:10.1016/j.heares.2014.11.005.
• Sarant J., Harris D., Bennet L., Bant S. (2014). Bilateral versus unilateral cochlear implants in children: A study of spoken language outcomes. Ear Hear. 35(4):396–409.
• Sparreboom M.A., Langereis M.C., Snik F.M., Mylanus A.M. (2015). Long-term outcomes on spatial hearing, speech recognition and receptive vocabulary after sequential bilateral cochlear implantation in children. Research in Developm Disabil. 36:328–337.
• Yu F., Li H., Zhou X., Tang X., Galvin J. J. III, Fu Q. J., Yuan W. (2018) Effects of training on lateralization for simulations of cochlear implants and single-sided deafness. Frontiers in Human Neuroscience 12: 287, doi:10.3389/fnhum.2018.00287.