**4. Factors affecting speech perception, production and language outcomes**

Despite the significant improvements made in cochlear implant technology, and the large body of clinical knowledge gained over time regarding likely benefits for children with cochlear implants, one of the remaining significant challenges is to identify predictors of post-implant outcomes, as there is great variation in benefits between individuals. Several factors have currently been identified as influential in children's speech perception, speech production, language and academic development after implantation, and the most important of these are discussed below.
