Beyond speech perception: contemporary landscape of language agnostic hearing assessment

Speech perception testing remains the dominant framework for cochlear implant (CI) outcomes assessment, yet its reliance on language introduces two fundamental limitations. Mechanistically, speech recognition performance reflects a composite of peripheral auditory encoding, cognitive processing, and linguistic knowledge, obscuring the contribution of each....

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Audiologists assessing cochlear implant outcomes should consider supplementing standard speech-perception tests with language-agnostic measures, particularly for non-English-speaking or multilingual patients — this review provides a conceptual framework but not yet a validated clinical protocol.

Shifting cochlear implant outcome measurement beyond speech perception could improve equity in assessment across diverse linguistic populations and reveal dimensions of hearing benefit currently invisible to standard test batteries.

1. 01Current cochlear implant (CI) outcome assessment relies heavily on speech-perception tests, which are language- and culture-dependent.
2. 02The review identifies fundamental limitations: existing tests disadvantage non-native speakers and multilingual patients.
3. 03Language-agnostic alternatives (e.g., non-speech auditory tasks, electrophysiological measures) are proposed as broader outcome metrics.
4. 04Published in Frontiers in Neuroscience (DOI: 10.3389/fnins.2026.1887850).
5. 05No new empirical data presented — this is a conceptual/narrative review.

PMID

42656458

DOI

10.3389/fnins.2026.1887850.

Journal

Frontiers in Neuroscience

Publication type

review

Evidence level

5

Population

Cochlear implant recipients across diverse linguistic backgrounds (literature review — no direct study population)

Intervention

Language-agnostic hearing assessment approaches

Comparator

Standard speech-perception-based cochlear implant outcome measures