Phonological Awareness Development of Preschool Children with Cochlear Implants

Abstract

Purpose: 1) To assess whether very early access to speech sounds provided by the cochlear implant (CI) enabled children with severe to profound hearing loss to develop age-appropriate phonological awareness abilities during their preschool years. 2) To examine whether preschool-age children with CIs develop age-appropriate skills in speech perception, speech production, general language, receptive vocabulary, and print knowledge; skills that are assumed to provide the foundation for or, minimally, to covary with phonological awareness. 3) To examine which of these factors contribute uniquely to the variance in the phonological awareness abilities of these preschoolers. Method: 24 children ages 36 to 60 months who had been utilizing their CI(s) for a minimum of 18 months (CI group) and 26 normal hearing peers (NH group) were enrolled in this study. Children's phonological awareness, speech perception, speech production, general language, receptive vocabulary, and print knowledge abilities were assessed. Results: Despite mean scores within the typical range, the CI group was outperformed by their NH peers in phonological awareness, speech production, general language, and receptive vocabulary, but not print knowledge. For speech perception, the CI group included significantly more children who demonstrated limited ability on the speech perception measure than did the NH group. These "non-perceiving" children evidenced significantly delayed skills in each area except print knowledge as compared to the perceiving subgroup. In contrast, some of the "perceivers" in the CI group demonstrated skills above the mean of the NH group in each of the skill areas assessed. Regression analyses indicated that for the CI group, speech production did not uniquely predict any significant variance in phonological awareness scores after accounting for general language abilities. The opposite was also true; general language abilities did not uniquely account for any significant variance in phonological awareness scores after consideration of speech production abilities. That is, the variance was shared. For the NH group, speech production abilities did not account for any significant variance in phonological awareness scores. However, general language scores accounted for significant variance in phonological awareness abilities for the NH group.