Objective: This study aimed to evaluate the change in performance when the Speak processing strategy replaced the Mpeak strategy.

Subjects: Twenty-one veterans who participated in the original Department of Veterans Affairs Multicenter Cochlear Implant Study, received the Nucleus FOF1F2 processor (Cochlear Corp., Englewood, CO, USA)(WSP) and were subsequently upgraded to the Mpeak (MSP) processing strategy.

Methods: Closed-and open-set speech recognition in quiet and in noise in auditory only conditions at the phoneme, word, and sentence levels were evaluated.

Results: Changes in audiologic parameters were evaluated using a paired t-test for related samples. Statistically significant improvements in mean scores were found for all tests and were greatest for the speech-in-noise conditions. An examintion of individual data revealed that 61% of the subjects improved for tests administered in quiet, whereas up to 69% the subjects had improved performance in noise. Subjec with no open set speech discrimination using the Mpeak strategy showed no improvement with the Speak strategy.

Conclusions: Cochlear implants can provide improved performance using modifications to external speech process hardware and software without changing the internal implant.