BackgroundAuditory neuropathy (AN) is a recently recognized hearing disorder characterized by intactouter hair cell function, disrupted auditory nerve synchronization and poor speech perception and recognition. Cochlear implants (CIs) are currently the most promising interventionfor improving hearing and speech in individuals with AN. Although previous studies haveshown optimistic results, there was large variability concerning benefits of CIs among individuals with AN. The data indicate that different criteria are needed to evaluate the benefit ofCIs in these children compared to those with sensorineural hearing loss. We hypothesizedthat a hierarchic assessment would be more appropriate to evaluate the benefits of cochlearimplantation in AN individuals