[Model oriented assessment of literacy performance in children with cochlear implants].
BACKGROUND
Although most hearing-impaired children lag behind normally hearing children in literacy acquisition, this aspect has hardly been addressed in the evaluation of language acquisition after cochlear implantation. The present study investigated written language abilities in 8 school-age children with cochlear implants. Neurolinguistic dual-route-models of written language processing indicate that literacy acquisition leads to the establishment of two distinct reading and writing strategies: a lexical one for the quick processing of known words and a sublexical one for decoding unfamiliar words or nonwords letter by letter.


METHODS
8 school-aged children were investigated, a very heterogeneous group concerning age of onset of hearing impairment, educational placement, and competences in sign language. However, this range is typical of the group of CI-children.


METHODS
The aim was to investigate if children with cochlear implants are able to establish both strategies or if they need to find a differential and individual access to written language. Performance within the Salzburger Lese-Rechtschreib-Test was evaluated. Individual performance of each subject was analysed.


RESULTS
Performance varied substantially ranging from only rudimentary spoken and written language abilities in two children to age-equivalent performance in three of them. Severe qualitative differences in written language processing were shown in the remaining three subjects. Suggestions for remediation were made and a re-test was carried out after 12 months. Their individual profiles of performance are described in detail.


CONCLUSIONS
The present study stresses the importance of a thorough investigation of written language performance in the evaluation of language acquisition after cochlear implantation. The results draw a very heterogeneous picture of performance. Model-oriented testing and analysis of performance prove to be sensible in at least a subpopulation of children with cochlear implants. Based on a better understanding of their acquired word-processing strategies, remediation programs meeting the needs of each individual child can be derived.
Klinik und Poliklinik für Phoniatrie und Pädaudiologie des Universitätsklinikums Münster. fiori@uni-muenster.de
A
A
Fiori
K
K
Reichmuth
P
P
Matulat
C M
CM
Schmidt
A G
AG
Dinnesen
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D003638:Deafness / Q000534:rehabilitation*; D004522:Educational Status; D005260:Female; D006801:Humans; D007802:Language; D007804:Language Development; D007807:Language Tests; D008297:Male; D010865:Pilot Projects; D011932:Reading; D012813:Sign Language; D013060:Speech; D014956:Writing