Examining Multiple Sources of Influence on the Reading Comprehension Skills of Children Who Use Cochlear Implants

Abstract

Children with profound deafness are at risk for serious reading difficulties. Multiple factors affect their development of reading skills, including use of cochlear implants. Further, multiple factors influence the overall success that children experience with their cochlear implants. These factors include the age at which they receive an implant, method of communication, vocabulary skills, preoperative residual hearing, and socioeconomic status. Ninety-one children with prelingual and profound hearing impairments who received cochlear implants at varying ages participated in the study. Structural equation modeling confirmed that multiple factors affected young cochlear implant users' reading comprehension skills and that there were significant associations between the predictors of reading comprehension. Pre-implant vocabulary had an indirect positive effect on reading through postimplant vocabulary, which had a direct positive effect on reading. Overall, children with stronger language skills demonstrated stronger reading outcomes. Age at implantation both directly and indirectly, through postimplant vocabulary, affected reading outcomes, and the total effect was large. Children who were younger when they received their implants tended to have higher reading comprehension scores. Socioeconomic status negatively affected reading. Children who used total communication prior to implantation tended to have stronger pre-implant vocabulary scores, but the total effect of pre-implant communication method on children's reading skills was negligible. Research and educational implications are discussed. KEY WORDS: deafness, literacy, language development, communication, sign language, socioeconomic status (SES)C hildren with profound hearing losses are at particular risk for serious reading difficulties. On average, these children graduate from high school with reading skills at a third-grade level (Allen, 1986;Holt, 1994). This gap in reading achievement between children with hearing impairment and children with normal hearing sensitivity widens as severity of hearing loss increases (Karchmer, Milone, & Wolk, 1979). In recent and separate studies, use of cochlear implants (L. Spencer, Tomblin, & Gantz, 1998;Svirsky, Stallings, Lento, Ying, & Leonard, 2002;Szagun, 2001;Tomblin, Spencer, Flock, Tyler, & Ganz, 1999) and early exposure to sign language (Padden & Ramsey, 1998 have been positively associated with vocabulary and literacy skills. Further, multiple factors affect the reading skills of children with cochlear implants (Geers, 2002(Geers, ,2003Geers et al., 2002;Rayner, Foorman, Perfetti, Pesetsky, & Seidenberg, 2001), just as multiple factors affect the reading skills of children with normal hearing sensitivity (Geers, 2002;Geers et al., 2002;Rayner et al., 2001). Although there is research that has explored the multiples sources that affect reading skills among children with profound hearing losses, there is little research that has used multilevel modeling. The chief advantage of multilevel models is that they ...

Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review

“…The late-identified group consisted of 12 children exposed to sign and 26 with no sign exposure (oral). One US cochlear implant study, 45 whose primary goal was to investigate reading comprehension, also reported pre-and postimplant expressive vocabulary scores. The authors reported that sign + oral intervention was significantly associated with better vocabulary outcomes preimplant.…”

“…Studies [39][40][41][42][43]45 report duration of cochlear implant use and age at assessment (details in Table 1). …”

“…signed and spoken responses accepted, 45 or instructions given nonverbally and certain vocabulary considered less likely to be known by children using sign was removed. 32 h Calculated based on information provided in article.…”

“…As noted in Table 1, tests were administered in the child's preferred modality (sign or spoken language) in 4 studies 39,40,42,43 or with adaptations (for 1 test) in 1 study, 32 and responses were accepted in sign and/or spoken language in another. 45 These adjustments in test procedures can potentially affect the psychometric properties of the tests, which were standardized on children with normal hearing, and hence interpretation of the results. No study reported any adverse effects of the intervention.…”

Neuroscience and education: prime time to build the bridge

“…Notably, early intervention made possible by newborn screenings has been related to significant improvement in the academic performance of deaf people 33,34 . Children receiving cochlear implants before 3 years of age show faster rates of speech and vocabulary production when compared with age-matched peers who had received their implants at later ages 35 ; earlier implantations also lead to improved reading comprehension 36 .…”