title: Emergent literacy in kindergartners with cochlear implants.
abstract: OBJECTIVE
  A key ingredient to academic success is being able to read. Deaf individuals have historically failed to develop literacy skills comparable with those of their normal-hearing (NH) peers, but early identification and cochlear implants (CIs) have improved prospects such that these children can learn to read at the levels of their peers. The goal of this study was to examine early, or emergent, literacy in these children.
  
  
  METHODS
  Twenty-seven deaf children with CIs, who had just completed kindergarten were tested on emergent literacy, and on cognitive and linguistic skills that support emergent literacy, specifically ones involving phonological awareness, executive functioning, and oral language. Seventeen kindergartners with NH and eight with hearing loss, but who used hearing aids served as controls. Outcomes were compared for these three groups of children, regression analyses were performed to see whether predictor variables for emergent literacy differed for children with NH and those with CIs, and factors related to the early treatment of hearing loss and prosthesis configuration were examined for children with CIs.
  
  
  RESULTS
  The performance of children with CIs was roughly 1 SD or more below the mean performance of children with NH on all tasks, except for syllable counting, reading fluency, and rapid serial naming. Oral language skills explained more variance in emergent literacy for children with CIs than for children with NH. Age of first implant explained moderate amounts of variance for several measures. Having one or two CIs had no effect, but children who had some amount of bimodal experience outperformed children who had none on several measures.
  
  
  CONCLUSIONS
  Even deaf children who have benefitted from early identification, intervention, and implantation are still at risk for problems with emergent literacy that could affect their academic success. This finding means that intensive language support needs to continue through at least the early elementary grades. Also, a period of bimodal stimulation during the preschool years can help boost emergent literacy skills to some extent.
authors.affiliation: Department of Otolaryngology, The Ohio State University, Columbus, Ohio 43212, USA. nittrouer.1@osu.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Nittrouer
authors.forename: Amanda
authors.initials: A
authors.lastname: Caldwell
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Lowenstein
authors.forename: Eric
authors.initials: E
authors.lastname: Tarr
authors.forename: Christopher
authors.initials: C
authors.lastname: Holloman
mesh_terms: D001301:Audiometry, Pure-Tone; D001364:Awareness; D002648:Child; D003054:Cochlear Implants; D003638:Deafness / Q000534:rehabilitation*; D056344:Executive Function; D005260:Female; D006310:Hearing Aids; D006801:Humans; D007805:Language Development Disorders / Q000534:rehabilitation; D008297:Male; D010700:Phonetics; D011932:Reading; D012016:Reference Values; D014705:Verbal Behavior