BEARS (both ears) - virtual reality training to improve binaural hearing in children

Background and aims: although people with bilateral cochlear implants typically have better sound localisation and speech-in-noise perception than those with one implant, these skills are far below people with normal hearing. There is evidence to show that computer-based training improves speech-in-noise perception for people with bilateral cochlear implants. We used participatory design to develop virtual reality (VR) games to help children and young people with bilateral cochlear implants hear better in noise. The stakeholders involved were children and young people using bilateral implants, family and friends, teachers, engineers and developers, speech and language therapists, music therapists, and audiologists. Method: we are running an eleven-centre trial of the games for children aged 8 to 16. The games involve speech-in-noise perception, music listening, and sound-source localisation. Recruitment target is 384. Participants are randomised to either use the VR games at home for 3 months or follow their usual care pathway. Results: the primary outcome measure is the difference between baseline and 3 month score on the spatial speech in noise (SSiN-VA) test, with secondary outcomes of scores at three and 12 months on other measures of spatial hearing, language, and quality of life. We are also assessing health economic outcomes. Recruitment began in May 2023 and continues until September 2024; we will present early results.Conclusion: if using the BEARS games significantly improves spatial hearing and/or quality of life in children and young people with cochlear implants, we will be scaling up the intervention across all UK centres offering bilateral cochlear implants to children