Semantic and syntactic reading comprehension strategies used by deaf children with early and late cochlear implantation

Children with Auditory Brainstem Implants: Language Proficiency and Reading Comprehension Process

INTRODUCTION

Auditory performance and language proficiency in young children who utilize auditory brainstem implants (ABIs) throughout the first 3 years of life are difficult to predict. ABI users have challenges as a result of delays in language proficiency and the acquisition of reading comprehension, even if ABI technology offers auditory experiences that enhance spoken language development. The aim of this study was to evaluate about the impact of language proficiency on reading comprehension skills in children with ABI.

METHOD

In this study, 20 children with ABI were evaluated for their reading comprehension abilities and language proficiency using an Informal Reading Inventory, Test of Early Language Development-Third Edition (TELD-3), Categories of Auditory Performance-II (CAP-II), and Speech Intelligibility Rating (SIR). Three distinct aspects of reading comprehension were assessed and analyzed to provide a composite score for reading comprehension abilities. TELD-3, which measures receptive and expressive language proficiency, was presented through spoken language.

RESULTS

Studies have shown that there was a relationship between language proficiency and reading comprehension in children with ABI. In the present study, it was determined that the total scores of reading comprehension skills of the children who had poor language proficiency and enrolled in the school for the deaf were also low. The children use short, basic sentences, often repeat words and phrases, and have a restricted vocabulary. In addition, the children had difficulty reading characters and detailed paragraphs and could not remember events in a logical order.

CONCLUSION

Children with ABI may potentially have complicated reading comprehension abilities due to lack of access to all the speech formants needed to develop spoken language. In addition, variables affecting the reading levels of children with ABI include factors such as age at implantation, duration of implant use, presence of additional disability, communication model, and access to auditory rehabilitation. The reading comprehension skills of ABI users were evaluated in this study for the first time in the literature and may constitute a starting point for the examination of variables affecting reading comprehension in this area.

Correlates of Korean Hangul Reading in Children With Hearing Loss

This study examined the associations of vocabulary and phonological and orthographic awareness with Hangul word reading in Korean children, aged between 7 and 10 years, who were deaf and hard of hearing (DHH) and children with typical hearing (TH). The participants were 24 children with hearing aids (HAs), 24 children with cochlear implants (CIs), and 24 TH children in Korea. The three groups were matched for chronological age, vocabulary age, and nonverbal intelligence. Results showed that there were no differences between children with CIs and those with HAs in reading fluency and cognitive skills, except word-reading accuracy, whereas children with CIs and HAs were delayed in all measures compared with their TH peers. Regression analyses showed that syllable and phoneme awareness uniquely explained word-reading accuracy in children with DHH and those with TH. However, word-reading fluency was uniquely explained by syllable awareness in the DHH children and by vocabulary and orthographic awareness in the TH children. These results suggest that DHH and TH children in Korea rely on phonological awareness for Korean word recognition. However, DHH and TH Korean children tend to use different strategies based on sublexical versus lexical information, respectively, to read Korean words fluently.

Meta-Analytic Findings on Reading in Children With Cochlear Implants

This meta-analysis study aims to quantify the group differences in reading skills between children with cochlear implants and their hearing peers and between children with cochlear implants and children with hearing aids (aged between 3 and 18 years old). Of the 5,642 articles screened, 47 articles met predetermined inclusion criteria (published between 2002 and 2019). The robust variance estimation based meta-analysis models were used to synthesize all the effect sizes. Children with cochlear implants scored significantly lower than their hearing peers in phonological awareness (g = -1.62, p < 0.001), vocabulary (g = -1.50, p < 0.001), decoding (g = -1.24, p < 0.001), and reading comprehension (g = -1.39, p < 0.001), but not for fluency (g = -0.67, p = 0.054). Compared to children with hearing aids, children with cochlear implants scored significantly lower in phonological awareness (g = -0.30, p = 0.028). The percentage of unilateral cochlear implant negatively impacts the group difference between children with cochlear implants and their hearing peers. Findings from this study confirm a positive shift in reading outcomes for profoundly deaf children due to cochlear implantation. Some children with cochlear implants may need additional supports in educational settings.

Did the three little pigs frighten the wolf? How deaf readers use lexical and syntactic cues to comprehend sentences

BACKGROUND

The ways in which students with deafness process syntactic and semantic cues while reading sentences are unclear. While some studies have supported the preference for semantic cues, others have not.

AIM

To examine differences in the processing of syntactic versus semantic cues during sentence reading among students who are deaf or hard of hearing (DHH).

METHOD

Twenty DHH students (mean age = 12.48 years) and 20 chronologically age-matched students with typical hearing (TH) were asked to read sentences written in Spanish with different grammatical structures and to choose the picture that best matched the sentences' meaning while their eye movements were being registered. The picture options were manipulated so that, in addition to the correct ones, there were lexical distractors and syntactic distractors.

RESULTS

The TH participants outperformed the DHH participants in reading complex sentences but not simple sentences in the active voice. In the correctly answered trials, both groups fixated longer and made more fixations on the target than on the syntactic distractor than on the lexical distractor. DHH participants made significantly longer fixations on the lexical distractions.

CONCLUSIONS

Our results did not support a strict preference for either lexical or semantic cues in the DHH participants.

"Textual Prosody" Can Change Impressions of Reading in People With Normal Hearing and Hearing Loss

Recently, dynamic text presentation, such as scrolling text, has been widely used. Texts are often presented at constant timing and speed in conventional dynamic text presentation. However, dynamic text presentation enables visually presented texts to indicate timing information, such as prosody, and the texts might influence the impression of reading. In this paper, we examined this possibility by focusing on the temporal features of digital text in which texts are represented sequentially and with varying speed, duration, and timing. We call this "textual prosody." We used three types of textual prosody: "Recorded," "Shuffled," and "Constant." Recorded prosody is the reproduction of a reader's reading with pauses and varying speed that simulates talking. Shuffled prosody randomly shuffles the time course of speed and pauses in the recorded type. Constant prosody has a constant presentation speed and provides no timing information. Experiment 1 examined the effect of textual prosody on people with normal hearing. Participants read dynamic text with textual prosody silently and rated their impressions of texts. The results showed that readers with normal hearing preferred recorded textual prosody and constant prosody at the optimum speed (6 letters/second). Recorded prosody was also preferred at a low presentation speed. Experiment 2 examined the characteristics of textual prosody using an articulatory suppression paradigm. The results showed that some textual prosody was stored in the articulatory loop despite it being presented visually. In Experiment 3, we examined the effect of textual prosody with readers with hearing loss. The results demonstrated that readers with hearing loss had positive impressions at relatively low presentation speeds when the recorded prosody was presented. The results of this study indicate that the temporal structure is processed regardless of whether the input is visual or auditory. Moreover, these results suggest that textual prosody can enrich reading not only in people with normal hearing but also in those with hearing loss, regardless of acoustic experiences.

Time-Course of Grammatical Processing in Deaf Readers: An Eye-Movement Study

Twenty participants who were deaf and 20 chronological age-matched participants with typical hearing (TH) (mean age: 12 years) were asked to judge the correctness of written sentences with or without a grammatically incongruent word while their eye movements were registered. TH participants outperformed deaf participants in grammaticality judgment accuracy. For both groups, First Pass and Total Fixation Times of target words in correct trials were significantly longer in the incongruent condition than in the congruent one. However, whereas TH students showed longer First Pass in the target area than deaf students across congruity conditions, deaf students made more fixations than their TH controls. Syntactic skills, vocabulary, and word reading speeds (measured with additional tests) were significantly lower in deaf students but only syntactic skills were systematically associated to the time-course of congruity processing. These results suggest that syntactic skills could have a cascading effect in sentence processing for deaf readers.

Reading and Theory of Mind in Adolescents with Cochlear Implant

Previous research has shown a possible link between reading comprehension and theory of mind (ToM), but these findings are unclear in adolescents with cochlear implants (CI). In the present study, reading comprehension and ToM were assessed in adolescents with CI and the relation between both skills was also studied. Two sessions were performed on two groups of adolescents aged between 12 and 16 years of age (36 adolescents with CI and 54 participants with typical hearing, TH). They were evaluated by means of a standardized reading battery, a false belief task, and Faux Pas stories. The results indicated that reading and cognitive ToM were more developed in the TH group than in adolescents with CI. However, early-CI and binaural group performance were close to the TH group in narrative and expository comprehension and cognitive ToM. The results also indicated that cognitive ToM and reading comprehension appear to be related in deaf adolescents.

Effects of Age at Cochlear Implantation on Learning and Cognition: A Critical Assessment

Purpose Age at cochlear implantation frequently is assumed to be a key predictor of pediatric implantation benefits, but outcomes related to learning and cognition appear inconsistent. This critical assessment examines relevant literature in an effort to evaluate the impact of age at implantation in those domains for individuals who received their devices as children. Method We examined 44 peer-reviewed articles from 2003 to 2018 considering age at implantation and conducted statistical analyses regarding its impact on several domains, including literacy, academic achievement, memory, and theory of mind. Results Across 167 assessments in various experiments and conditions, only 21% of the analyses related to age at implantation yielded evidence in favor of earlier implantation, providing greater benefits to academic achievement, learning, or cognition compared to implantation later in childhood. Among studies that considered cognitive processing (e.g., executive function, memory, visual-spatial functioning), over twice as many analyses indicated significant benefits of earlier implantation when it was considered as a discrete rather than a continuous variable. Conclusion Findings raise methodological, practical, and theoretical questions concerning how "early" is defined in studies concerning early cochlear implantation, the impact of confounding factors, and the use of nonstandard outcome measures. The present results and convergent findings from other studies are discussed in terms of the larger range of variables that need to be considered in evaluating the benefits of cochlear implantation and question the utility of considering age at implantation as a "gold standard" with regard to evaluating long-term outcomes of the procedure as a medical treatment/intervention for hearing loss. Supplemental Material https://doi.org/10.23641/asha.8323625.

The relationship between comprehension of syntax and reading comprehension in cochlear implanted and hearing children

OBJECTIVES

There is a large variation in the function of cochlear implanted children in language assessments. However, they usually have poorer performance in language abilities compared with their normal hearing peers. The purpose of the present study was to determine the relationship between syntax comprehension and reading comprehension in cochlear implanted and hearing children in the third to fifth grades of the elementary school and to identify the relationship between their reading comprehension and the age of receiving a cochlear implant as well as the duration of receiving speech therapy in cochlear implanted children.

METHODS

A total of 15 cochlear implanted children and 15 hearing children studying in the third to fifth grades of the elementary school participated in the present descriptive-analytic and cross-sectional study. Two skills of reading comprehension and syntax comprehension were evaluated in these two groups of children.

RESULTS

The results showed that there was a significant relationship between reading comprehension and comprehension of syntax in cochlear implanted children (P < 0.001). According to the linear regression, the score of reading comprehension increases with the increase in the score of syntax comprehension. No significant relationship was observed between reading comprehension and the age of receiving a cochlear implant (p = 0.337) and the duration of receiving speech therapy (p = 0.227).

CONCLUSION

Based on the findings of the present study, it can be concluded that focusing on comprehension of syntax for intervention can improve reading comprehension. Particularly, it seems that working on structures which are complicated for the children helps to improve their reading comprehension.

Development of Phonological, Lexical, and Syntactic Abilities in Children With Cochlear Implants Across the Elementary Grades

PURPOSE

This study assessed phonological, lexical, and morphosyntactic abilities at 6th grade for a group of children previously tested at 2nd grade to address 4 questions: (a) Do children with cochlear implants (CIs) demonstrate deficits at 6th grade? (b) Are those deficits greater, the same, or lesser in magnitude than those observed at 2nd grade? (c) How do the measured skills relate to each other? and (d) How do treatment variables affect outcome measures?

PARTICIPANTS

Sixty-two 6th graders (29 with normal hearing, 33 with CIs) participated, all of whom had their language assessed at 2nd grade.

METHOD

Data are reported for 12 measures obtained at 6th grade, assessing phonological, lexical, and morphosyntactic abilities. Between-groups analyses were conducted on 6th-grade measures and the magnitude of observed effects compared with those observed at 2nd grade. Correlational analyses were performed among the measures at 6th grade. Cross-lagged analyses were performed on specific 2nd- and 6th-grade measures of phonological awareness, vocabulary, and literacy to assess factors promoting phonological and lexical development. Treatment effects of age of 1st CI, preimplant thresholds, and bimodal experience were evaluated.

RESULTS

Deficits remained fairly consistent in type and magnitude across elementary school. The largest deficits were found for phonological skills and the least for morphosyntactic skills, with lexical skills intermediate. Phonological and morphosyntactic skills were largely independent of each other; lexical skills were moderately related to phonological skills but not morphosyntactic skills. Literacy acquisition strongly promoted both phonological and lexical development. Of the treatment variables, only bimodal experience affected outcomes and did so positively.

CONCLUSIONS

Congenital hearing loss puts children at continued risk of language deficits, especially for phonologically based skills. Two interventions that appear to ameliorate that risk are providing a period of bimodal stimulation and strong literacy instruction.

Effect of age at cochlear implantation and at exposure to Cued Speech on literacy skills in deaf children

The aim of this study was to investigate how age at cochlear implantation (CI) and age at exposure to Cued Speech (CS, Manual system that resolves the ambiguity inherent lipreading) could impact literacy skills in deaf children. Ninety deaf children fitted with CI (early vs late) and exposed to CS (early vs late) from primary schools (from Grade 2 to Grade 5) took part in this study. Five literacy skills were assessed: phonological skills through phoneme deletion, reading (decoding and sentence comprehension), word spelling and vocabulary. The results showed that both age at CI and age at first exposure to CS had some influence on literacy skills but there was no interaction between these factors. This implies that the positive effects of age at CI, especially on all literacy skills in the younger children, were not strengthened by age at exposure to CS.