Background:Cochlear implants (Cls) can improve speech recognition for children with severe congenital hearing loss,and open-set word recognition is an important efficacy measure.This study examined Mandarin open-set word recognition development among Chinese children with CIs and normal hearing (NH).Methods:This study included 457 children with CIs and 131 children with NH,who completed the Mandarin lexical neighborhood test.The results for children at 1-8 years after receiving their Cls were compared to those from the children with NH using linear regression analysis and analysis of variance.Results:Recognition of disyllabic easy words,disyllabic hard words,monosyllabic easy words,and monosyllabic hard words increased with time after CI implantation.Scores for cases with implantation before 3 years old were significantly better than those for implantation after 3 years old.There were significant differences in open-set word recognition between the CI and NH groups.For implantation before 2 years,there was no significant difference in recognition at the ages of 6-7 years,compared to 3-year-old children with NH,or at the age of 10 years,compared to 6-year-old children with NH.For implantation before 3 years,there was no significant difference in recognition at the ages of 8-9 years,compared to 3-year-old children with NH,or at the age of l0 years,compared to 6-year-old children with NH.For implantation after 3 years,there was a significant difference in recognition at the age of 13 years,compared to 3-year-old children with NH.Conclusions:Mandarin open-set word recognition increased with time after CI implantation,and the age at implantation had a significant effect on long-term speech recognition.Chinese children with Cls had delayed but similar development of recognition,compared to normal children.Early CI implantation can shorten the gap between children with CIs and normal children.