SPPI is begun after implant activation and continued until the child says words on a regular basis. This approach is intended to supplement other intervention practices that focus on speech perception, meaningful speech, and the normal communicative interactions between children and their parents (e.g., Moog, Biedenstein, & Davison, 1995; Robbins, 2000). To use SPPI, parents model developmentally appropriate, speech-like vocalizations during 1-minute stimulation periods at least 5 times per day.

The SPPI is an initial, research-based attempt to provide developmentally appropriate stimulation for toddlers who are learning to talk after receiving a cochlear implant. As such, it is anticipated that refinements to the procedures described here will be necessary in the future.


Prelinguistic vocalizations have several advantages for developing auditory and speech skills in young children with cochlear implants.

1) The acoustic characteristics of individual speech sounds are highlighted when they are presented in isolation or in simple combinations (e.g., /i/, /i/, /i/ or /babababa/). Repeating a small set of vocalizations may make it easier to associate speech sounds with the speech movements needed to produce them.

2) Simple prelinguistic vocalizations are likely to be easier to imitate than words or phases. The ability to produce a speech pattern may also enhance speech perception (Osberger, 1983).

3) Modeling of prelinguistic vocalizations provides opportunities for the child to produce speech without the cognitive load associated with understanding and producing words. Such “vocal play” opportunities are important for discovering the “auditory-motor linkages” that lead to a mature phonological system in typically developing children (Stark, Ansel, & Bond, 1988, p. 17).

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