Emergent Literacy in Kindergartners With Cochlear Implants

Abstract

Problem A key ingredient to academic success is being able to read. Deaf individuals have historically failed to develop literacy skills comparable to those of their normal-hearing peers, but early identification and cochlear implants have improved prospects that these children can learn to read at the levels of their peers. The goal of this study was to examine early, or emergent, literacy in these children. Method 27 deaf children with cochlear implants (CIs) who had just completed kindergarten were tested on emergent literacy, as well as on cognitive and linguistic skills that support emergent literacy, specifically ones involving phonological awareness, executive functioning, and oral language. 17 kindergartners with normal hearing (NH) and 8 with hearing loss, but who used hearing aids (HAs) served as controls. Outcomes were compared for these three groups of children, regression analyses were performed to see if predictor variables for emergent literacy differed for children with NH and those with CIs, and factors related to the early treatment of hearing loss and prosthesis configuration were examined for children with CIs. Results Performance of children with CIs was roughly one or more standard deviations below the mean performance of children with NH on all tasks, except for syllable counting, reading fluency, and rapid serial naming. Oral language skills explained more variance in emergent literacy for children with CIs than for children with NH. Age of first implant explained moderate amounts of variance for several measures. Having one or two CIs had no effect, but children who had some amount of bimodal experience outperformed children who had none on several measures. Conclusions Even deaf children who have benefitted from early identification, intervention, and implantation are still at risk for problems with emergent literacy that could affect their academic success. This finding means that intensive language support needs to continue through at least the early elementary grades. Also a period of bimodal stimulation during the preschool years can help boost emergent literacy skills to some extent.

Rethinking Sound : Computer-assisted reading intervention with a phonics approach for deaf and hard of hearing children using cochlear implants or hearing aids

“…A CI delivers auditory stimulation but it does not restore the auditory perception to a normal level. Additionally, it does not deliver the entire speech spectrum in terms of the same fine acoustic-phonetic details or the rich spectral and temporal resolution as in acoustical hearing (Moore, 2008;Nittrouer, Caldwell, Lowenstein et al, 2012). Consequently, certain aspects of the speech signal are more difficult to incorporate in the child's language, for example consonant clusters and fragments with weaker amplitude.…”

“…A challenge for DHH using HA or CI is that the HL itself prevents them to perceive the phonemes clearly which would have negative consequences for reaching fine-grained levels of phonological processing skills (Nittrouer et al, 2012) and consequently, for developing efficient phonological decoding strategies. Wass et al (2009) andPark, Lombardino andRitter (2013) speculate that this qualitatively different phonological sensitivity may lead to changed reading strategies, in favour of visually based decoding.…”

“…First, fluctuating and impoverished speech perception through childhood makes the encoding into the phonological lexicon difficult. This may be considered an effect of the HL itself in combination with restrictions of the technical devices that do not deliver rich enough temporal and spectral information of the speech signal (Nittrouer et al, 2012. Second, small vocabularies might affect the neighbourhood density (ND) of words in the phonological lexicon (that is the number of words that can be generated by replacing a single phoneme in a target word in a single position, see Chen, Vaid, Boas et al, 2011). As a consequence of reduced ND, the perception of a word's phonemes is decreased.…”

The Phonics Approach in Swedish Children using Cochlear Implants or Hearing Aids: Inspecting Phonological Gain

“…Another aspect worth considering when studying DHH children's cognitive development is how reduced spectral resolution [31] and less cues of temporal fine structure [32,33] affect how they develop PhPS in different situations, i.e., speech recognition in noise [21,34], and in reaching fine-grained levels of phonological sensitivity [2]. Thus, as Nittrouer et al reasoned [2] finegrained levels of phonological processing might be difficult to acquire both due to the hearing loss itself, and due to the signal transmitted through their technical device. This in turn might alter cognitive strategies, e.g., redirecting attention to other important visual clues in the environment, i.e., written symbols, to compensate for coarsegrained perception.…”

“…Phonological Processing Skills (PhPS) are thus a set of abilities that we use in many different contexts in everyday life. Due to their intimate connection to the sound structure of spoken language, there are many Deaf and Hard of Hearing children (DHH) who struggle to develop them [2][3][4]. PhPS is further related to the acquisition and use of lexical items as well as to the building and organization of the mental lexicon [5,6], which is especially difficult for DHH children who experience periods of auditory deprivation or distortion [7][8][9][10][11][12].…”