title: Written Language Ability in Mandarin-Speaking Children with Cochlear Implants.
abstract: Objectives. To examine narrative writing in cochlear implant (CI) children and understand the factors associated with unfavorable outcomes. Materials and Methods. Forty-five CI children in grades 2-6 participated in this study. They received CIs at 4.1 ± 2.1 years of age and had used them for 6.5 ± 2.7 years. A story-writing test was conducted and scored on 4 subscales: Total Number of Words, Words per Sentence, Morphosyntax, and Semantics. Scores more than 1.5 SD lower than the mean of the normal-hearing normative sample were considered problematic. Language and speech skills were examined. Results. Significantly more implanted students were problematic on "Total Number of Words" (p < 0.001), "Words per Sentence" (p = 0.049), and "Semantics" (p < 0.001). Poorer receptive language and auditory performance were independently associated with problematic "Total Number of Words" (R (2) = 0.489) and "Semantics" (R (2) = 0.213), respectively. "Semantics" problem was more common in lower graders (grades 2-4) than in higher graders (grades 5-6; p = 0.016). Conclusion. Implanted children tend to write stories that are shorter, worse-organized, and without a plot, while formulating morphosyntactically correct sentences. Special attention is required on their auditory and language performances, which could lead to written language problems.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou Branch, Taoyuan 333, Taiwan.
authors.forename: Che-Ming
authors.initials: CM
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou Branch, Taoyuan 333, Taiwan.
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Ko
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou Branch, Taoyuan 333, Taiwan.
authors.forename: Yen-An
authors.initials: YA
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou Branch, Taoyuan 333, Taiwan.
authors.forename: Yung-Ting
authors.initials: YT
authors.lastname: Tsou
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou Branch, Taoyuan 333, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Chao
mesh_terms: D000293:Adolescent; D002648:Child; D003054:Cochlear Implants; D003710:Demography; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D010775:Photic Stimulation; D012660:Semantics; D013060:Speech; D014956:Writing