title: Computer-assisted training of phoneme-grapheme correspondence for children who are deaf and hard of hearing: effects on phonological processing skills.
abstract: OBJECTIVE
  Examine deaf and hard of hearing (DHH) children's phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme-grapheme correspondence training in the children. Specifically analyze possible effects on DHH children's phonological processing skills.
  
  
  METHODS
  The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme-grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents.
  
  
  RESULTS
  NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme-grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme-grapheme correspondence.
  
  
  CONCLUSIONS
  For some DHH children phonological processing skills are boosted relatively more by phoneme-grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.
authors.affiliation: Department of Behavioral Sciences and Learning, Swedish Institute for Disability Research, Linköping University, 581 83 Linköping, Sweden. Electronic address: cecilia.von.mentzer@liu.se.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Nakeva von Mentzer
authors.forename: Björn
authors.initials: B
authors.lastname: Lyxell
authors.forename: Birgitta
authors.initials: B
authors.lastname: Sahlén
authors.forename: Malin
authors.initials: M
authors.lastname: Wass
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindgren
authors.forename: Marianne
authors.initials: M
authors.lastname: Ors
authors.forename: Petter
authors.initials: P
authors.lastname: Kallioinen
authors.forename: Inger
authors.initials: I
authors.lastname: Uhlén
mesh_terms: D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods / Q000534:rehabilitation*; D003054:Cochlear Implants; D003194:Computer-Assisted Instruction; D015709:Correspondence as Topic; D003638:Deafness / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D060345:Education of Persons with Hearing Disabilities / Q000379:methods; D005260:Female; D006310:Hearing Aids; D006311:Hearing Disorders / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007804:Language Development; D008297:Male; D015588:Observer Variation; D010700:Phonetics; D011932:Reading; D012016:Reference Values; D013067:Speech Perception; D013068:Speech Production Measurement
keywords: Children; Cochlear implants; Computer-assisted intervention; Deaf and hard of hearing; Hearing aids; Phonological processing skills