Effects of auditory training via direct streaming to the AudioLink in SSD CI-children on speech recognition

Stefanie Muck, BSc

Master Digital Healthcare, St. Pölten University of Applied Sciences 2022

Aim and Research Question(s)

The aim of this pilot study was to test whether SSD-children, aged 5-12 years, accept this training method and whether this method improves the speech recognition after Tiptoi training streamed directly via the AudioLink.


The rehabilitation training of SSD-children requires regular, daily, at home training to ensure a successful outcome [1]. Training materials for auditory training with children are scarce. In case of SSD, the normal hearing ear is covered manually only, consequently the implanted ear is not trained properly [2]. The newest generations of implant system offers an external universal connectivity device, the AudioLink [3]. This can be used to connect the externally worn audio processor with media devices and the auditory stimuli is directly streamed to the implanted ear. In our study, the Tiptoi [4] game was linked to the AudioLink for therapeutic purposes.

Figure 1: Performance of the Tiptoi training


10 implanted SSD patients received Tiptoi training via AudioLink as an additional voluntary therapy intervention. The children were asked for a daily to 10 minutes practice over 1 month and record the tasks and duration. Baseline and Follow-Up measurements include: Göttinger Children's Language Test WRS (65dB, 80dB, Streaming via AudioLink), Tiptoi tasks (10 sounds, 10 sentences), SSQ P questionnaire.

Results and Discussion

Out of the 10 included subjects, each of them finished the four weeks of training method described. Based on the diary a daily training time of 9.9 minutes was reported. The WRS at 65dB, 80dB and streamed via AudioLink was significantly improved (p=0.0195, p=0.0078, p=0.002). The SSQ P Questionnaire showed a significant improvement in the Dimension of Quality of Hearing and Overall gain (p=0.0078 and p=0.0488). The outcomes of the Tiptoi tasks resulted in a significant benefit in both categories “recognition of sounds” and “understanding of sentences” (p=0.002 and p=0.0156).

Figure 2: WRS results


The results are very encouraging and showing not only the positive uptake and acceptable compliance of daily training at home but also resulted in significant improvements in subjective as well as objective measures for this rather short training period of only 1 month.


[1] Speck, T., et al. (2021). [2] Távora-Vieira, D., & Marino, R. (2019). [3] MED-EL GmbH, Innsbruck, Austria. [4] Ravensburger AG, Ravensburg, Germany.