Background: The majority of research on the effects of cochlear implants has been on clinical evaluations of efficacy (hearing and speech skills, and auditory thresholds). But it's unclear how much clinical efficacy metrics (speech, hearing, and language tests) actually demonstrate how beneficial cochlear implants (CI) are in everyday circumstances.

Objective: this study aimd to assess the performance of a child's current CI with both subjective and functional outcomes measures. Also, we aimed to assess factors affecting these outcomes after CI.

 Patients and Methods: The study group included 45 cochlear implanted children, their chronological age range between 4 to 12 years. Children were divided according to their language age into three groups, group 1(G1) includes15 children with a language age of less than two years, group 2(G2) includes 15 children with a language age of two to less than four years, and Group 3(G3) includes 15 children with language age four to six years. Assessment was done in two sessions, one for phoniatric evaluation and another for audiological evaluation.

Results: CI enabled children to develop speech perception in a closed manner evidenced by the early speech perception (ESP) test with pattern perception being the easiest and monosyllabic words being the most difficult and the least to develop. Most children with CI were able to control their voice, to a lesser extent to use speech in meaningful use in social situations and to develop communication strategies in oral situations which were the least to develop, this was evident by Meaningful use of speech Scale. Children with CI were able to acquire language and their chronological age.

Conclusion: The cochlear implant is an effective rehabilitative tool for the treatment of prelingually deafened children and this was evident by our results. A hierarchal approach of speech assessment according to the language age of the child and selection of age-appropriate speech perception test is very important to assess cochlear implanted children Speech recognition had a high degree of variability. Early implantation age and increased duration of implant experience were the most important factors associated with good performance with CI, better speech perception, and better language outcomes.