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There were four sound conditions (natural speech, instrumental music, multi\u2010speaker babble noise, and speech\u2010in\u2010noise). Post\u2010CI auditory and verbal communication performance was evaluated using clinical questionnaires with caretakers. Both classification and individualized regression models were constructed to predict post\u2010CI behavioral improvement from fNIRS data using support vector machine (SVM) learning algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Auditory cortical responses shortly after CI hearing onset yielded highly accurate prediction of behavioral development in young CI children. For classification models, optimal prediction was achieved using cortical responses to two or more sound conditions, with the highest accuracy of 98.20% (precision\u2009=\u200998.17%, sensitivity\u2009=\u200998.96%, area under the curve of the receiver operating characteristic curve\u2009=\u200999.61%) obtained with the combination of speech, noise, and music stimuli. Similarly, for regression models, best prediction of individual development was achieved using three (highest <jats:italic>r<\/jats:italic>\u2009=\u20090.919) or four (<jats:italic>r<\/jats:italic>\u2009=\u20090.966) sound conditions. The predictability of cortical responses far outperformed (Cohen's <jats:italic>d<\/jats:italic>: 18.56) that of the collection of audiological and demographic parameters (classification accuracy: 0.62) under the same SVM algorithms and could not benefit from the inclusion of the latter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Machine learning models using auditory cortical hemodynamic responses shortly after CI activation were able to predict individualized post\u2010CI behavioral improvement in children with prelingual deafness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level 5.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.70035","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T13:39:22Z","timestamp":1731505162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Individualized post\u2010operative 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