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Evaluating Phonological Processing Skills in Children With Prelingual Deafness Who Use Cochlear Implants

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  • Dr. Linda J. Spencer/SUNY Geneseo, NY was available from 1/12/09 until 2/01/09 to answer questions and share ideas concerning her research and its implications for parents of children who are deaf/hard of hearing, their teachers and other professionals who work with them.
  • You are encouraged to read the research summary below and review the attached discussion

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Abstract
  • This study investigated the phonological processing skills of 29 children with prelingual, profound hearing loss with 4 years of cochlear implant experience. Results were group matched with regard to word-reading ability and mother’s educational level with the performance of 29 hearing children. Results revealed that it is possible to obtain a valid measure of phonological processing (PP) skills in children using CIs. They could complete rhyming tasks and were able to complete sound-based tasks using standard test materials provided by a commercial test distributor. The CI children completed tasks measuring PP, but there were performance differences between the CI users and the hearing children. The process of learning phonological awareness (PA) for the children with CIs was characterized by a longer, more protracted learning phase than their counterparts with hearing. Tests of phonological memory skills indicated that when the tasks were controlled for presentation method and response modality, there were no differences between the performance of children with CIs and their counterparts with hearing. Tests of rapid naming revealed that there were no differences between rapid letter and number naming between the two groups. Results yielded a possible PP test battery for children with CI experience.
  • Article Summary
  • Parents and educator of children who are Deaf and Hard of Hearing have long been concerned about how well these children learn to read. There is no shortage of research that documents the presence of reading difficulties in this group, but there is a shortage of information and knowledge about how to address these difficulties. Recently research on children with prelingual, profound deafness who receive a cochlear implant (CI) has begun to document that these children tend to read at levels that are higher than did their predecessors who used hearing aids or no amplification. This article explores how the access to sound via the cochlear implant signal relates to using sound-based strategies (phonological skills) during reading. Research on children who have hearing suggests that those who are better at phonological processing are also better readers, so logic would follow that access to sound via a cochlear implant may be related to better reading skills in CI users.
  • What are phonological skills? These are a set of skills that begin with phonological awareness, which is defined as the ability to “pull apart” and manipulate segments of spoken language. There are several abilities involved in phonological awareness with three main skills that are proposed. One is the ability to break individual words into smaller units. Thus words are broken into syllables, then into the first sound and the final “cluster of sounds” which is the onset and the rime as in the example “t/ime”. Finally the word can be broken down into the individual sound level or “phoneme” level. Phonological awareness is also part of a broader construct called Phonological Processing which involves a memory component.
  • One of the first issues in learning about how CI users are able to incorporate phonological learning strategies into how they read is the problem of assessment. Valid assessment of phonological abilities for children with profound hearing loss has been challenging because most assessment tasks require the child to listen to a word that is spoken and then to perform some manipulation on the sounds of the word. Thus the tasks involve listening and speaking and it is often assumed that children who are deaf will not be able to reliably perform these tasks. In fact one of the criticisms of literacy educational methods for deaf and hard of hearing children is that teachers do not incorporate enough of the sound-based learning strategies into their teaching. There is indirect support for using these methods. We know that reading skills in children who are deaf are predicted by their knowledge of print-to-sound correspondence, their speech intelligibility and their speech reading skills.
  • Thus one goal of this article was to establish a series of tasks that could reliably measure the phonological skills of CI users, a second goal was to document the range of phonological skills in these children and to see how their skills compared with their peers who read at the same level. The third goal was to look at the relationship between phonological skills and reading in children who use CIs.
  • To that end, the study was able to identify several tasks that were “best bets” to use to assess phonological skills in children who use Cis. These tasks include: 1. a rhyme task in which the child has a target word then chooses from a choice of three photos to find a rhyming word. 2. An elesion or sound deletion task in which the child is presented with a word, e,g, “say pink”, the child says the word “pink”. Then the child is directed to say the word again but to delete one sound. (e.g. say “pink” without saying the “p”3. An adapted audio-visual digit span task. 4. A rapid-letter naming task.
  • Regarding the second goal of assessing the range of phonological skills in children using CIs as compared with their peers with hearing who read at the same level, revealed that in general, childen with CIs have similar performance levels as their reading-matched hearing peers for rhyming, elesion, rapid-letter naming, and an adapted audio-visual digit span task. Childre with CIs had lower overall performance tasks that had a sound and memory component such as blending sounds to form words or repeating nonsense words.. One factor that influenced performance included modality of presentation of stimuli. Children with CIs did better if the stimuli was presented in an audititon plus vision modality rather than an audiotry only modality.
  • Finally the study wanted to know if the performance on phonological tasks was related to reading proficiency in children with CIs, given the foundation that performance on phonologial tasks is realted to reading proficiency in chidlren with hearing. The study did find that there was a correlation between phonological skills and reading skills in children with CIs. Furthermore the study provided evidence that phonologic skills in CI children are an important part of reading assessment in this group of children, and that it may be possible to identify chilren early on who are at more risk for experiencing reading difficulties. Alternatively, this type of testing can be an important part of assessing the phonological skills of a child in relatinship to his or her peers, and to pick out particular areas of strength or weakness. This information can then be used in a proactive manner to support the develoment of reading skills.

  • Reference:
  • Spencer, L.J. and Tomblin, J.B. (2008). Evaluating Phonological Processing Skills in Children With Prelingual Deafness Who Use Cochlear Implants. The Journal of Deaf Studies and Deaf Education 2008; Volume 14 (1) Winter 2009 pp1-21.