Reliability of a rating scale for measuring speech intelligibility after pediatric cochlear implantation

Objective: To evaluate the reliability of the Speech Intelligibility Rating scale to monitor the speech intelligibility of deaf children who have received cochlear implants. Study Design: A prospective study assessing the speech intelligibility of deaf children with cochlear implants by local and cochlear implant program speech and language therapists. Setting: Pediatric tertiary referral center for cochlear implantation. Setting: Pediatric tertiary referral center for cochlear implantation. Patients and Methods: Fifty-four children were each rated by two speech and language therapists, one working With the child locally and the other working with the child at the cochlear implant program. All children were between 1.2 and 10.9 years of age at the time of implantation (median, 4.0 years). The follow-up intervals ranged from before implantation to 9 years after implantation. Main Outcome Measure: Correlation coefficient, intraclass correlation coefficient, and kappa statistics were used to assess the interobserver reliability of the Speech Intelligibility Rating scale. Results: Spearman rank correlation coefficient and intraclass correlation coefficient were 0.82 with high statistical significance (p < 0.00001). Kappa statistical analysis revealed a moderate to substantial agreement between the ratings. This agreement also reached a high statistical significance (overall kappa = 0.53, p < 0.000001). The Speech Intelligibility Rating scale was found to be able to discriminate speech intelligibility among subjects, and the ratings covaried with high consistency. Conclusion: The study found a high rate of agreement between observers when they used the Speech Intelligibility Rating scale to assess the speech intelligibility of deaf children after cochlear implantation. Because the scale presents information in a format that is understood by parents, local professionals, and health care purchasers, it will be useful to provide them with accessible information on speech intelligibility outcomes of deaf children who have received cochlear implants.