Phonological processing, oral language abilities, and reading comprehension in children with cochlear implants

Acquiring literacy (i.e., the ability to read with comprehension) involves language and phonological processing skills and can be challenging for deaf children. Deficits in phonological processing, which are often more pronounced in hearing impaired children, increase risk for language and reading disorders. Advances in hearing technology, including cochlear implants (CIs), have yielded promising improvements in language and reading. In this study, norm-referenced assessments of phonological processing, oral language abilities, and reading comprehension were administered to 47 prelingually deaf children with CIs (mean age = 8.33 years). As previously reported, phonological processing abilities in children with CIs fell significantly below age-expected levels and were strongly associated with language and reading comprehension. However, language and reading comprehension abilities were often within the typical range and significantly above phonological processing levels. This is intriguing because hearing children with similar deficits in phonological processing would be likely to display deficits in language and in reading comprehension. It is noteworthy that spectral differences inherent to CI signal processing did not prevent many of these children from acquiring typical language and reading comprehension levels, suggesting alternate pathways of skill acquisition. Future research should focus on how language and reading are acquired in pediatric CI users despite limitations in spectral resolution and phonological processing.