title: Paragraph-reading comprehension ability in Mandarin-speaking children with cochlear implants.
abstract: OBJECTIVE
  1) To investigate different aspects of paragraph reading in Mandarin-speaking students with cochlear implants (CIs) and the factors associated with unfavorable outcomes, and 2) to understand the replaceability of a paragraph-reading test with a sentence-reading test.
  
  
  METHODS
  Cross-sectional, case-controlled study.
  
  
  METHODS
  Fifty-three students with CIs (aged 11.0 ± 1.4 years) and 53 grade- and gender-matched children with normal hearing (NH) participated in the study. A paragraph-reading comprehension test was conducted. Sentence and word reading, speech perception, language skills, and child/family characteristics were examined. An unfavorable paragraph-reading outcome was defined as a score lower than one standard deviation below the NH mean.
  
  
  RESULTS
  The CI subjects had significantly worse paragraph-reading comprehension than did the NH controls (P = 0.017, d = 0.54). Their performance in grades 5 to 6 was not significantly higher than of those with NH in grades 2 to 4. The CI children's abilities to understand semantics (P = 0.012) and syntax (P = 0.020) significantly fell behind the NH controls in grades 2 to 4, and the lag continued in grades 5 to 6 (P = 0.039, P = 0.002, respectively). Grade and sentence reading were independently associated with unfavorable paragraph-reading outcomes (R(2)  = 0.453). The optimal sensitivity and specificity of the sentence-reading test in identifying unfavorable paragraph-reading outcomes were 90.9% and 90.0%, respectively (area under the curve = 0.923).
  
  
  CONCLUSIONS
  Specialists should pay attention to CI students' development of different reading skills. Paragraph-reading tests enable a multidimensional evaluation of reading competence. Use of sentence-reading tests is suggested only as a tool for preliminary screening for basic reading capacities.
  
  
  METHODS
  3b.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Che-Ming
authors.initials: CM
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Li-Ang
authors.initials: LA
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Chao
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Yung-Ting
authors.initials: YT
authors.lastname: Tsou
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Yen-An
authors.initials: YA
authors.lastname: Chen
mesh_terms: D002648:Child; D003054:Cochlear Implants; D032882:Comprehension; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D019986:Persons with Hearing Disabilities / Q000534:rehabilitation*; D012680:Sensitivity and Specificity
keywords: Mandarin Chinese; Paragraph-reading comprehension; cochlear implant; deafness