Example of Comments of a Deaf Students Reading Ability

Ear Hear. Author manuscript; available in PMC 2012 Feb ten.

Published in concluding edited form as:

PMCID: PMC3023978

NIHMSID: NIHMS261182

Reading, Writing, and Phonological Processing Skills of Adolescents with 10 or More Years of Cochlear Implant Experience

Ann Eastward. Geers

¹Dallas Cochlear Implant Program, Callier Advanced Hearing Research Eye, Academy of Texas at Dallas, 1966 Inwood Road, Dallas, TX 75235

ⁱⁱDallas Cochlear Implant Programme, Department of Otorhinolaryngology—Head and Neck Surgery, University of Texas Southwestern Medical Eye, Dallas, TX 75235

Heather Hayes

³Washington University School of Medicine, Program in Audiology and Communication Sciences, 660 South. Euclid, Campus Box 8042, St. Louis, MO, 63110

INTRODUCTION

Children with prelingual deafness typically demonstrate average delays of four to five years in reading evolution past the fourth dimension they enter high school. Many of these children experience what teachers refer to as the "quaternary grade problem," significant that they fail to brand progress across identification of a limited number of words (Scarborough, 2001). Normative information indicate approximately half of deaf students read below the fourth form level at the finish of high school (Traxler, 2000). Nearly hearing children are competent linguistic communication users when they brainstorm to map reading onto existing phonological, syntactic, and semantic skills. The ofttimes reported low literacy levels among deaf students are, in part, due to the discrepancy between their incomplete voice communication arrangement and the demands of reading a speech-based organisation (Perfetti & Sandak, 2000). Nevertheless, the advent of the cochlear implant (CI) as a handling for prelingual profound deafness is associated with a reduction in the achievement gap relative to age-mates with normal hearing (Connor & Zwolan, 2004). A contempo comprehensive review of the literature on reading skills in students with CIs concluded that children with implants frequently read better than deafened peers who employ hearing aids, fifty-fifty if they lag behind hearing age mates (Marschark, Rhoten, & Fabich, 2007). Some of the factors that bear on reading in CI users also are of import for reading development in hearing children (e.m., general intelligence, parent education, family unit income). However, it is possible other contributors to literacy are unique to children with hearing loss (Geers, 2002). Both kinds of predictors are examined in the current investigation. Get-go, nosotros describe several factors that are necessary for deaf children to larn to read and write, and how these factors are affected past cochlear implantation. Nosotros then describe the current study, which investigates reading and writing skills in a group of adolescents who received CIs as preschoolers.

Factors Necessary for Successful Literacy Development

Phonological Processing Skills

The early reader or speller must learn noesis of letter–sound or audio–letter correspondences based on an internal phonological system. Non surprisingly, hearing children who have expert phonological skills are expert readers (run across Rayner, Foorman, Perfetti, Pesetsky, & Seidenberg for a review, 2001). Although deaf children's phonological development is delayed compared to hearing peers, some research has found that deaf children develop phonological sensation in a similar sequence as hearing children (e.g., Sterne & Goswami, 2000). Children who vesture CIs may be at a greater advantage than profoundly deaf peers without CIs in terms of developing phonological awareness. Early access to sound assists young CI users to amend encode the speech indicate and accurately produce the sounds of language (Blamey, Sarant, Paatsch, Barry, Bow, Wales, et al., 2001; Connor, Craig, Raudenbush, Heavner, & Zwolan, 2006). A review of the relevant literature suggests that children who utilise CIs develop phonological systems that are stronger than those of their deaf peers without CIs, only are weaker than those of their hearing peers (Spencer & Tomblin, 2008).

As might exist expected, deaf children with CIs who demonstrate strong phonics skills are proficient readers. A written report of 181 children with CIs who were 8-ix years old reveals a high correspondence (r = 0.85) between phonics skills and reading comprehension scores (Geers, 2003). Reading levels were associated with students' functioning on a rhyme decision and a homophony lexical decision task, both of which assess utilise of a phonological strategy. A written report by Johnson and Goswami (2010) also establish that phonological awareness measures correlated with reading outcomes. Thus, just equally is the case for hearing children, strong phonological processing skills are essential for successful reading evolution in deaf children and the CI appears to provide children an opportunity to larn these crucial skills (Spencer & Oleson, 2008). It is important to notation, however, that variation in phonological processing skills is quite large in children with CIs (James, Rajput, Dark-brown, Sirimanna, Brinton, & Goswami, 2005). The successful acquisition of phonological processing skills may also depend on demographic factors, such as age at implantation, duration of CI use, and communication manner (Johnson & Goswami, 2010). It is possible that the longer the auditory deprivation or the poorer the signal from the CI, the less well-specified are a kid'due south phonological representations of speech sounds (Pisoni, Kronenberger, Conway, Horn, Karpicke, & Henning, 2008).

Vocabulary

As phonological processing is essential for decoding letter of the alphabet–sound and sound–alphabetic character correspondences, vocabulary noesis is essential for reading comprehension and expository writing. Vocabulary noesis refers to word meanings that the child acquires through exposure and formal instruction to store in long-term memory. Children with prelingual deafness approach reading and writing with more than limited vocabularies than their hearing historic period-mates practice (Boothroyd, Geers, & Moog, 1991). Moreover, the greater the hearing loss, the larger the filibuster (Boothroyd et al., 1991). Vocabulary development gain more than rapidly following cochlear implantation, specially when implant surgery occurs during preschool ages (Connor et al., 2006; Connor, Hieber, Arts, & Zwolan, 2000; Dawson, Blamey, Dettman, Barker, & Clark, 1995; Hayes, Geers, Treiman, & Moog, 2009). Unlike grammar, which is fairly complete in hearing children by 4-five years of age (Ingram, 1989; Hirsh-Pasek & Golinkoff, 1996), meanings of words represent concepts that must be learned individually, contributing to the continuing refinement of vocabulary throughout development. The vocabulary advantage associated with cochlear implantation at an early age, combined with improved phonological decoding, facilitates reading and comprehension, resulting in more age-appropriate literacy skills (Connor & Zwolan, 2004; Johnson & Goswami, 2010).

Language/Discourse Skills

In the U.s., electric current technological and societal demands necessitate a 10th- or 11th-grade reading ability for functional participation in social club (Marschark et al., 2007). This relatively high level of literacy requires knowledge of cohesive devices (e.g., conjunctions, pronouns) too every bit world cognition and knowledge of texts in full general (Stanovich, 1980). Syntax, soapbox, and metacognitive skills are especially of import for achieving avant-garde reading and writing competence (Geers & Moog, 1989). Such skills contribute to the child's prior knowledge near the world and the ability to describe inferences and embrace figurative language. A reduced ability to overhear conversation and narrative discourse may interfere with a deaf kid'southward ability to comprehend connected language structure, master ideas, and associative relationships betwixt events (Schopmeyer, 2009).

An effective reader and writer must understand how to use patterns of linguistic communication and discourse factors that are specially difficult for deafened students to acquire. For example, deaf students use fewer cohesive markers in their writing (DeVilliers, 1991) and elaborate the content of written composition less often than hearing historic period-mates (Yoshinaga-Itano, Snyder, & Mayberry, 1996). Difficulties with grammar are evident in the written expression of deaf students (Antia, Reed, & Kreimeyer, 2005; Moores & Sugariness, 1990; Yoshinaga-Itano et al., 1996). Interestingly, if the written cloth consists of less formal material, such as stories or personal narratives, and the focus is on the structure and arrangement of discourse, deaf students' writing more than closely resembles that of hearing peers (Marschark, Mouradian, & Halas, 1994). Thus, grammatical correctness is certainly important for effective written communication just assessment also should have into business relationship dimensions such equally content and organization when judging writing competence.

Spelling

Spelling is an often neglected component of general literacy skills. Notwithstanding, spelling is non to be overlooked, equally recent studies suggest that poor spelling leads to poor perceptions of a person'due south overall writing abilities (Figueredo & Varnhagen, 2005; Kreiner, Schnakenberg, Green, Costello, & McClin, 2002). Contrary to traditional views, spelling involves more than memorizing letter sequences. In English, spelling draws on noesis of many aspects of language, including the cognition of relationships among words, root words, and words' historical origins. An accurate comprehension of the phonological structure of spoken words, together with an ability to represent this structure in writing, is a foundation of spelling skill. Studies of spelling in deaf children have shown that, not surprisingly, deaf children are poorer spellers on average than hearing children of the same age (Burden & Campbell, 1994; Harris & Moreno, 2004; Sutcliffe, Dowker, & Campbell, 1999). However, these studies were conducted primarily on deaf children without CIs. Deaf people using CIs accept better access to spoken linguistic communication phonology than previously possible through hearing aids or other means. Increased access to sound provided past CIs, combined with an accent on speech and phonological skills, may facilitate spelling in children using these devices.

Child and family unit characteristics

Characteristics such equally performance intelligence caliber (PIQ), family socioeconomic status (SES), parent didactics, age at onset of deafness, and gender were important factors associated with reading outcomes in 8-9 twelvemonth old children with CIs (Geers, 2003). Female children with higher PIQs from college SES families who had onset of deafness after birth (only before 36 months of age) scored best on a measure of reading comprehension. These child and family characteristics accounted for 25% of the variance in reading scores. CI characteristics were important as well, accounting for an boosted 12% of variance in reading level after controlling for child and family characteristics. Better readers used the newest CI speech processing strategies available for longer time periods than poorer readers. They also used a larger dynamic range. One might expect that communication style used in the child'southward educational setting following cochlear implantation would be of import for reading; all the same, whether a kid's educational plan used sign and speech (simultaneous communication or SC) or but speech (oral communication or OC) did not account for pregnant variance in reading consequence after variance due to child, family and implant characteristics was removed. Kid and family characteristics as well are of import factors for writing success in deaf children (Antia et al., 2005), with SES, historic period, gender, and caste of hearing loss accounting for variance in written expression abilities.

Literacy Skills of Children with Cochlear Implants

Given that the above factors are crucial components of successful literacy development, and that cochlear implantation facilitates evolution in these areas, how do deaf children with CIs perform on reading and writing tasks compared with hearing peers? In tests of reading, 70% of children enrolled in a private oral teaching setting post-obit cochlear implantation scored within the boilerplate range on standardized reading tests in elementary school (Moog, 2002). Geers (2003) reported 61% of CI children in Due north America scored inside or to a higher place the boilerplate range for hearing historic period-mates and the mean standardized score for all children (89) was within the low-boilerplate range. Like findings were reported for a group of 39 CI users in the United Kingdom (Johnson & Goswami, 2010). However, non all children with CIs achieve literacy levels expected for their age. An cess of reading comprehension levels in 91 CI users (average age of 11 years) revealed they were not reading besides as their peers with normal hearing (Connor & Zwolan, 2004). A recent written report of 12-xvi year olds in the Uk found that 48% of the students with hearing aids read within i year of hearing age-mates while only 19% of CI users achieved age-advisable reading levels (Harris & Terleksi, 2010). The differences in reading achievement reported across studies may be associated with the age of the participants. Lags in reading development in children with hearing loss tend to widen with historic period (Kroese, Lotz, Puffer, & Osberger, 1986; Marschark & Harris, 1996). The current study compares reading levels of children with CIs in early unproblematic grades (age 8-9 years) with those aforementioned children in high schoolhouse (age 15-xviii years) to see whether they maintain their reading levels or whether the gap widens equally they get older.

How do deafened children with CIs compare to hearing children on written language tasks? To our cognition, only ane study has quantitatively examined spelling skills in this specific population (Hayes, Kessler, & Treiman, in press) as compared to hearing peers. These children, ages 6 to 12 years, spelled as well equally hearing children matched for reading, but poorer than hearing children of the same age. Information technology is non known how well adolescents with CIs spell in comparison with hearing peers. However, a study of spelling errors in 12-xvi year olds with hearing losses >85 dB, reported no difference between CI users and HA users in either number of correct spellings or percentage of phonetic errors (Harris & Terleksi, 2010).

The study of expository writing in deaf children with CIs has not received much attention in the literature. Previous research documents that 17-18 twelvemonth old deaf students' written language resembles that of hearing students who are 9-10 years old (Paul, 2001). Does this gap in performance exist subsequently in development or do the children with CIs catch upwardly over time? Given the importance of literacy skills for academic and futurity career success (Kutner, Greenberg, Jin, Boyle, Hsu, & Dunleavy, 2007), further investigation into their development in deaf students is warranted.

Goals of the Electric current Investigation

The electric current written report examines literacy skills of a grouping of early-implanted children when they were in loftier school (CI-HS). This population was examined first when they were in early on unproblematic grades (CI-Due east) every bit part of a previous study on the effects of early cochlear implantation on speech, language, auditory, and reading skills (Tobey, Geers, Brenner, Altuna, & Gabbert, 2003; Geers, Nicholas, & Sedey, 2003; Geers, 2003). The CI-Due east children'south reading skills were not directly associated with auditory speech perception skills achieved with the CI, but rather were associated with speech product skills and English language competence. Considerable variability was evident in the CI-E children's ability to use auditory skills to reach language and academic parity. Although some CI-Due east children achieved in a higher place-average reading scores, other children exhibited barely-developed reading skills. The current report has three goals: one) to certificate reading, spelling, expository writing, and phonological processing skills of CI-HS students, ii) to determine the extent to which age-advisable readers kept footstep with their hearing historic period-mates throughout elementary and high school grades in social club to make up one's mind whether the below-average CI-E readers caught up over time, and 3) to assess the predictive contributions of phonological processing and child/family unit characteristics to literacy skills.

METHOD

Participants

Participants included 112 students who were administered a bombardment of voice communication, auditory, cognitive, language, and literacy assessments at CI-E and CI-HS test sessions. This report focuses on literacy skills at the CI-HS exam session. Information virtually results from the speech, auditory, cerebral and linguistic communication assessments are described in this book (Davidson, Geers, Blamey, & Tobey, submitted; Geers, Brenner, & Tobey, submitted; Geers & Sedey, submitted; Moog, Gustus, Geers, & Brenner, submitted; Pisoni, Kronenberger, Roman, & Geers, submitted; Tobey, Geers, Sundarrajan, & Lane, submitted). Characteristics of CI-HS students are as well described in detail in this volume (Geers et al., submitted). The CI-HS students were 15;0 (fifteen years 0 months) to eighteen;5 years old, with a mean age of 16;7 at the time of assessment. Class placement ranged from 9^th to 12^thursday grades, with the majority of the participants enrolled in 10^th and xi^thursday grades. All participants were implanted past age 5;four years with a mean age at implantation of 3;5 years. The adolescents reported using either spoken language (Northward = 83) or sign and speech (Northward = 29) equally their primary methods of communication.

Data were likewise collected from a control group of hearing teenagers (NHC-HS) (North = 46), who ranged in age from 15;three to 18;four years. Boosted details about these participants can be institute in this monograph (Geers et al., submitted). All participants and their families signed consent and assent forms canonical past the Institutional Review Board of the University of Texas at Dallas.

Measures

Literacy skills assessed in the CI-HS students included reading vocabulary and comprehension, syntactic and text comprehension, spelling accuracy, expository writing, and phonological processing. Tests were administered in both individual and group sessions. The CI-HS participants were assessed on all of the measures described below. The NHC-HS participants were assessed only on written expression tasks and one phonological processing job, the Children's Test of Nonword Repetition (CNRep) (Gathercole & Baddeley, 1996). For the reading and other phonological processing tasks, hearing norms provided by the assessment developers were used for comparisons.

Reading

Peabody Individual Achievement Examination (PIAT) – Revised (Dunn & Markwardt, 1989)

Both reading subtests—Reading Recognition and Reading Comprehension—were individually administered at both exam sessions. Total correct scores were converted to standard scores in relation to a normative sample of typically-developing hearing age-mates (mean = 100; SD = 15).

• Reading Recognition. Items consist of single words that the educatee reads aloud. Testing continues until a ceiling is obtained at the lowest 7 sequent responses containing v errors. Either a signed or spoken production recognizable every bit the target word is scored as a correct response.

• Reading Comprehension. The student is presented with a page containing one sentence to be read silently. The page is removed and the student is presented with 4 illustrations, i of which best represents the sentence provided. No speech is required for this task, as the student'due south response is to select ane of the iv pictures. The starting point is determined by the educatee'south raw score on the reading recognition subtest and continues to a ceiling of 7 consecutive responses containing v errors.

Test of Reading Comprehension (TORC) (Brown, Hammill, & Wiederholt, 1995)

The TORC assesses silent reading comprehension. Each student responds to all items. Number correct scores were converted to standard scores for each subtest in relation to a normative sample of hearing historic period-mates (mean = ten, SD = 3). The post-obit subtests were administered in small groups of 5-6 students:

• General Vocabulary. The student reads 3 stimulus words that are related in some manner (xanthous, red, blue) and selects two words from a group of four (black, grass, green, yes) that are related to the stimulus words. Both answers must be correct to receive credit for the item.

• Syntactic Similarities. The student reads five sentences and selects the two that are most most alike in meaning (It was her railroad vehicle. It was non her wagon. It was his wagon. The railroad vehicle was non hers. It was not his wagon.)

• Paragraph Reading. The student reads a paragraph and five questions. A multiple-choice format is used for all five questions. The student selects the "all-time" championship, recalls story details, draws an inference, and draws a negative inference (Which sentence could not go in the story?)

• Sentence Sequencing. Each item includes five randomly ordered sentences that, when ordered properly, create a meaningful paragraph. The educatee orders the sentences. Scoring is based on relational order rather than specific sequence. (Before long information technology will be noon. Adjacent it will be nighttime. Information technology is morning. Then, it volition be morning again. Then, it will be this afternoon.)

Written Expression

Flick Spelling Test

Traditional spelling tasks, in which the experimenter says a word and the student writes the word, are problematic for deaf children because information technology is difficult to know whether the word was accurately perceived. Thus, a film spelling task was designed. One-hundred words were selected from familiar vocabulary to adolescents, picturable, and with varied orthographic length and complexity. Each item was presented every bit a photograph, a line drawing, or a cartoon image. Participants were asked to name each item (presented one-at-a-time) and spell the name on a worksheet. The participants were encouraged to approximate at any particular that they did not know; if needed, the experimenter named the particular. See the appendix for a list of the spelling items.

Expository Writing with NTID Scoring (Schley & Albertini, 2005)

Each teenager wrote a descriptive essay. The post-obit instructions were provided:

"Everybody knows of something that is worth talking virtually. Possibly yous know about a famous building like the Empire Land Building in New York City or something similar the Golden Gate Bridge in San Francisco. Or you might know a lot nearly the Mormon Tabernacle in Salt Lake City or the sports stadium in your home town. Or you might be familiar with something from nature, like Niagara Falls, a gigantic wheat field, a grove of orange trees, or a part of a wide dingy river like the Mississippi.

There is probably something you tin can describe. Choose something yous know about. It may be something from around where you alive or something you have seen while traveling, or something you have studied in school. Think virtually information technology for awhile then write a description of what information technology looks like and then that it could be recognized by someone who has read your description. Name what you are describing and effort to use your best writing."

Students were tested in small groups and given unlimited time to compose their essay. They were encouraged to review their work and make changes subsequently completion. Students wrote the essays by hand in pencil and later they were typed by someone else with punctuation, spelling and grammar maintained. Both the original written version and the typed version were sent to experienced raters who were faculty members in the English department at the National Technical Establish for the Deafened (NTID) for scoring. The scoring process was adult for assessing the writing power of postsecondary deaf students (Schley & Albertini, 2005). Each essay was evaluated by three raters. Scores were found to be reliable betwixt multiple raters (Albertini, Bochner, Dowaliby, & Henderson, 1996). Each rater assigned between one and 100 points, every bit divided among the post-obit four scoring categories:

• Organization. Points are awarded for a clear argument of the topic and intent of the essay, presence of a unified and coherent theme, and application of appropriate transitions.

• Content. Higher scoring essays address the assigned topic with persistent and noteworthy ideas. Inclusion of extraneous material is avoided and generalizations are supported by examples.

• Language Utilise. Points are awarded for correct employ of grammatical structures and punctuation, correct use of complex structures, intelligible spelling, clarity of style and expression and clarity of reference.

• Vocabulary Use. Points are awarded for appropriate semantic utilise of vocabulary, consistent register, sophisticated option of vocabulary and appropriate use of figurative and idiomatic expressions.

Scores were averaged for the three raters and a full score was obtained by summing across the four subscales. Reliability was assessed for triads of raters who evaluated 236 essays from students at the National Technical Institute for the Deaf (Schley & Albertini, 2005). Pearson correlations amidst pairs of raters were all above .81. Intra-course correlation coefficients amidst groups of 3 raters (Shrout & Fleiss, 1997) ranged from .70 to .90. In add-on, difference scores were calculated amongst pairs of raters and the absolute values of these difference scores were examined. Hateful difference scores ranged from 5.33 to 9.48 points on the score range of ane-100 (SDs iv.2 to vii.58). Raters did not differ past more x points for the vast bulk of essays evaluated.

Phonological Processing

A group of measures was included in the battery that required phonological knowledge, sensation and/or decoding. Skills sampled include letter-audio correspondence, phonetic spelling and manipulation of sounds in words and phonological retentiveness and production. These tasks were called to correspond a range of abilities associated with the child'due south phonological representations of linguistic communication.

Woodcock Reading Mastery Test (WRMT)– Revised (Woodcock, 1987)

• Word Attack. This 45-detail subtest of the WRMT bombardment assesses the student'south power to pronounce nonsense words (e.g., raff, chad, yeng, cigbet, bafmotben) using phonic and structural assay skills. Students are tested beginning at item one and go along to a ceiling level of six consecutive incorrect responses. Correct articulation of each phoneme is required for a correct response.

Phonological Plausibility Score

A scoring procedure was adult to assess misspellings on the Picture Spelling Exam. Unlike the spelling accurateness (pct correct) score, included as part of the written expression battery, the plausibility score quantified whether the children were making errors based on the sounds in the target words. The scoring technique is similar to a recent study of hearing children's spelling errors (Ellefson, Treiman, & Kessler, 2009; Hayes et al., in press). For each of the 100 spelling words, a list was generated reflecting all the letters used to spell each phoneme. The reference for whether a letter of the alphabet is a plausible one given a certain phoneme was an "aligned" corpus: a subset of a word frequency database (Zeno, Ivenez, Millard, & Duvvari, 1995) aligned with pronunciations from the Carnegie Mellon Pronouncing Lexicon (Carnegie Mellon Academy, 1998). The children's misspellings were scored for whether they used plausible letters for the particular phonemes in the word, moving from left to right. Students received a 1 if all of the letters in the misspelling were phonologically plausible choices only received a 0 if whatsoever of the messages were implausible choices for a particular phoneme. The mean proportion of plausible misspellings was calculated for each participant.

Comprehensive Test of Phonological Processing (CTOPP) (Wagner, Torgesen, & Rashotte, 1999)

• Elision subtest. This individually-administered subtest taps the student's phonological awareness and admission to the phonological structure of oral language. The examiner presents a word orally and asks the student to say the word with a syllable or phoneme deleted (eastward.k., "Say airplane. At present say airplane without saying plane." "Say farm. At present say farm without saying /f/.") Raw scores are converted to scaled score equivalents based on age-appropriate norms for hearing children.

Children'south Test of Nonword Repetition- CNRep (Gathercole & Baddeley, 1996)

In order to accurately repeat a nonsense word, the student must immediately construct a phonological representation, based on a unmarried exposure to the novel auditory stimulus, and then "translate" or "reassemble" that newly-formed representation into an articulatory output in speech production. We used a shortened, adjusted version of the CNRep list (Dillon, Burkholder, Cleary, & Pisoni, 2004). The stimuli were recorded by a female speaker of American English. The CNRep nonwords were presented auditorily via a desktop speaker (Cyber Acoustics MMS-1) at approximately lxx dB SPL. Each student heard the nonword stimuli played aloud one at a time, in random society. The students were told that they would hear a funny give-and-take and were instructed to repeat it dorsum equally well equally they could. Their fake responses were recorded via a head-mounted microphone (Audio-Technica ATM75) onto digital audio tape using a TEAC DA-P20 tape deck. The DAT tapes were subsequently digitized and segmented into private sound files. The children'due south nonword productions were transcribed past graduate students/clinicians in spoken communication-linguistic communication pathology using the International Phonetic Alphabet (International Phonetic Clan, 1999). The transcribed productions were entered into the Estimator Assisted Voice communication and Language Cess (CASALA) software for assay (Serry, Blamey, & Grogan, 1997; Serry & Blamey, 1999). Each production was transcribed past two different people and and then a third listened to the words that the other two did not concur on for a terminal determination. Using CASALA, reports were generated to obtain a percentage of phonemes correct.

Child and Family Characteristics

Predictor variables summarizing child characteristics included gender, historic period at first hearing assistance fitting (roughly corresponding to historic period at which educational intervention was initiated), duration of deafness (age at implant minus age at onset of deafness), historic period at the CI-HS test session, WISC- PIQ, and a CI-HS mensurate of sign enhancement. Sign enhancement was estimated by the departure in standard scores on Form A of the Peabody Motion-picture show Vocabulary Test (PPVT) (Dunn & Dunn, 1981) administered in simultaneous communication (SC) and Form B of the PPVT administered using spoken communication (OC). Values greater than 0 point college receptive vocabulary standard scores in the SC than in the OC test status. Family characteristics included family size and socioeconomic status (SES) at the CI-HS test session. The SES value was a combination of the number of years of education completed by the most highly educated parent and a ranking of total family income.

Cochlear Implant Characteristics

Aided sound-field detection thresholds were obtained at the CI-HS evaluation using frequency modulated (FM) tones at octave frequencies from 250-4000 Hz. The CI-HS participants were seated approximately 1 to 1.five k from the loudspeaker at 0° azimuth using their CI every bit typically worn. Spoken language processor technology from Cochlear Corporation (Cochlear Americas, 13059 E. Peakview, Centennial, CO 80111) was rank ordered from 1 to 4 with i representing the oldest technology (i.e., Spectra) and four the most contempo (i.e., Freedom). A complete clarification of methods are contained in this book (Davidson et al., submitted).

RESULTS

Table 1 summarizes the means and standard deviations of reading, written expression and phonological processing scores obtained from the CI-HS students and a normally hearing reference grouping. Scores of the reference group were derived either from the normative sample of typically-developing loftier school students (NS-TDS) published in the examination manual or from the 46 hearing control high school students (NHC-HS) tested as function of this report. The percentage of CI-HS students scoring within normal limits (i.e., at or higher up one standard difference of the mean for the specified reference group) is as well provided. The post-obit results section is presented according to the three goals of the report outlined in the introduction.

Table 1

Mean Literacy Outcomes for Deaf Adolescents with Cochlear Implants equally compared with Hearing Peers

Measures	Groups
	CI			Normal Hearing
	Mean	SD	Percent WNL	Mean	SD
READING
Peabody Private Achievement Examination (PIAT): Standard Score
TOTAL	83	17	47	100a	fifteen
Reading Recognition	82	16.8		100a	15
Reading Comprehension	88.9	twenty.1		100a	15
Test of Reading Comprehension (TORC): Standard Score
TOTAL	90	15	66	100a	xv
Sentence Sequencing	9.2	iii		10a	3
Syntactic Similarities	viii.3	3		10a	3
Paragraph Comprehension	vii.6	two.6		10a	three
General Vocabulary	ix	2.v		10a	3
WRITTEN EXPRESSION
Picture Spelling Test (PST): Pct Correct Score
Spelling Accurateness	67	22	55	eightyb	ten
NTID Written Essay (Rating Points)
Full (out of 100)	53.v	16.8	38	69.2b	9.6
Organization (out of 25)	12.1	4.2	36	16.ib	3.0
Content (out of 25)	thirteen.3	iv.5	44	17.oneb	ii.9
Language Use (out of 25)	14.viii	4.7	39	18.3b	ii.1
Vocabulary (out of 25)	14	4.8	38	17.7b	2.iii
PHONOLOGICAL PROCESSING
Woodcock Reading Mastery Examination: Caliber Score
Word Set on (WRMT-WA)	seventy	27.eight	30	100a	xv
Comprehensive Exam of Phonological Processing (C-TOPP): Standard Score
Elision	half dozen.9	3.ane	46	10a	3
Picture Spelling Test (PST): Per centum of Spelling Errors
Phonological Plausibility	62	25.nine	30	89b	viii
Children's Examination of Non-Word Repetition (ChNWR): Per centum Correct
% Phonemes Correct	41.7	eighteen.3	0	95.8b	3.0

Literacy and related skills of CI-HS students Reading

Reading

Scores of CI-HS students on the PIAT-R were compared to the NS-TDS, The average standard score for the CI-HS students was 83, which falls just below the cutoff representing the lower terminate of the average range for hearing age-mates. Almost half of the CI-HS students (47%) scored within or in a higher place one standard divergence of the mean for hearing high school students in comparable grades. Somewhat lower scores were obtained on the recognition subtest than on the comprehension subtest. Performance on the recognition subtest requires more facility with phonological processing and speech production than the comprehension subtest, which places greater demands on vocabulary and language skills (although see Keenan, Betjemann, & Olson, 2008, which argues that the comprehension subtest of the PIAT mainly assesses decoding skills, peculiarly in young readers).

Scores of CI-HS students on the TORC were compared to the NS-TDS. The boilerplate total score on the TORC was higher (SS = 90) than for the PIAT-R and within 1 SD of hearing age-mates (Mean = 100; SD = 15). Over half of the sample (66%) scored within the expected range (≥ 85) based on hearing norms. The relatively loftier scores were due primarily to strong performance on the Sentence Sequencing and Vocabulary subtests. Paragraph Comprehension was specially hard for this group.

Written Expression

Spelling

Percent correct scores on the PST were compared to the NHC-HS sample. On average, the CI-HS participants were significantly poorer spellers than the hearing control group, spelling 67% of items correctly compared to 80% (Mann-Whitney U = 3480, z = 3.46, p = .001). All the same, more than than half of the CI-HS students (55%) spelled inside 1 standard deviation of the NHC-HS group. The remaining 45% of CI-HS spellers scored 2 or more standard deviations below their hearing peers. This is in abrupt contrast to the NHC-HS group, in which only 15% scored in that depression range. Spelling accurateness did non differ significantly between the CI-HS students who used speech (68% accurate) or those students who used sign and speech (65% authentic).

Expository writing

Ratings on the NTID Essay were compared to the NHC-HS sample. Fewer than half of the CI-HS students scored within 1 SD of the hearing command grouping in each of the four rating categories. Mean ratings were highest for Language Use (14.viii) and lowest for Organization (12.ane) out of 25 possible points. When compared to the NHC-HS group, 44% of the CI-HS students scored within 1 SD of the mean on Content ratings, their highest-performing area.

Phonological processing

Word Set on

Scores of CI-HS students on The WRMT-WA subtest were compared to the NS-TDS. This measure of reading decoding skill was difficult for the CI-HS students, whose average quotient score (70) was two SD beneath the hateful for the NS-TDS. Just 30% of the CI-HS sample scored within the average range. The WRMT-WA also was administered to these adolescents at the CI-E test session where operation was essentially higher than their CI-HS scores in relation to hearing norms (mean = 88.7; SD fifteen.5). At CI-E, 53% of the students scored inside the average range. Thus, the development of decoding skills failed to go on step with hearing peers between elementary and loftier schoolhouse grades.

Spelling Errors

Another measure of phonological processing—the percent of phonologically plausible spelling errors— was compared to the NHC-HS sample. More than than half of the spelling errors made by the CI-HS students were phonologically plausible (62%). However, the NHC-HS students made proportionally more than plausible errors than the CI-HS group (89%), and this difference was significant (Isle of mann-Whitney U = 4230, z = half dozen.473, p < .001). The NHC-HS students' primary strategy when encountering difficult words was to use a phonological arroyo to spelling, compared to the CI-HS students who did non use phonological knowledge in spelling to every bit peachy a degree. Interestingly, the CI-HS students who were primarily oral communicators fabricated proportionately more plausible errors than those students who used sign and speech (66% vs. 51%) and this difference was significant (Isle of man-Whitney U = 786, z = -2.71, p = .007).

Elision

Elision scores of the CI-HS students were compared to the NS-TDS on the C-TOPP. The mean scaled score on the Elision task (half-dozen.9) was simply below i SD of the mean for the NS-TDS. Almost half of CI-HS students (46%) scored within the expected range (seven to 13), indicating facility with manipulating the sounds of language.

Nonword repetition (CNRep)

Per centum phonemes correct scores of the CI-HS students were compared to those obtained from the NHC-HS sample. The CI-HS students had the most difficulty with this chore and none accurately imitated phonemes within one SD of the NHC-HS group. Boilerplate per centum of right phonemes for the CI-HS grouping was only about half (42%) of that observed for NHC-HS group (96%).

Development of reading skills in CI students

Because the PIAT-R as well was administered at the CI-Due east test session (Geers, 2003), we examined alter in reading skills over time. The boilerplate standard score at CI-E was 89, inside the low-boilerplate range for hearing peers; 61% of the CI-E students scored within or above the average range. We expected that the hateful standard score might decrease over time because deaf students experience a gap in reading achievement that increases equally they get older (Kroese et al., 1986). The average standard score of the CI-HS students was indeed slightly lower at 83. As a grouping, CI students did not quite go on pace with normal evolution of reading skills. All the same, about of the sample maintained their standing relative to hearing norms over fourth dimension: 40% of the students (N = 45) scored within 1 SD of the normative boilerplate at both sessions while 32% (Northward = 36) scored more than 1 SD below hearing age mates at both test sessions. The remaining 28% of students' continuing relative to the hearing norms inverse over time. The majority of these (Due north = 23) scored within the average range in uncomplicated grades, but savage beneath-average in high schoolhouse. The remaining 8 students showed delayed reading in elementary grades just caught upwards by loftier schoolhouse.

Reading improvement between elementary grades and loftier school is possibly ameliorate reflected in form equivalent scores, which are plotted by historic period at test in Figure 1. At CI-Due east, most students scored between second and fourth grades. CI-HS scores ranged from 2d course to post high school. In Figure 1, these outcomes are grouped according to three categories of performers identified among children with hearing impairment (Nevins & Chute, 2009).

Grade equivalent scores on the Peabody Individual Achievement Test are plotted by historic period for 112 students at the CI-Eastward (triangles) and CI-HS (diamonds) test sessions. Performance at each test session is indicated for three sample students from each of three accomplishment groups: Commensurate performers (solid line) exhibited reading progress within the range of typically developing peers. Capable performers (dot-and-nuance line) demonstrated reading progress, but did non catch up to typically-developing peers. Challenged performers (dashed line) scored beneath the 4^th grade reading level, at both examination sessions, indicating barely-developed reading comprehension.

Challenged Performers

These students are characterized by slow and laborious bookish progress. This category is exemplified in the electric current study by the 17% of CI-HS students who scored below the 4^th grade reading level, indicating barely-developed reading comprehension.

Capable Performers

Although these students do not catch up to their typically developing peers linguistically or academically, capable performers demonstrate academic progress. This category is exemplified past 46% of the CI-HS students who scored betwixt 4^th and 8^th grade levels, reflecting moderate and consistent reading growth, simply with some delay.

Commensurate Performers

These students perform inside the range of typically developing peers. In our sample, 36% of the CI-HS group scored at ix^th class or higher and appeared to have successfully overcome the reading deficits expected from profound deafness.

Forming Composite Variables using Principal Components Analysis

Examination scores that are highly related to one another may exist combined, using principal components analysis (PCA) to form composite factor scores that are more robust and representative of the underlying construct than any single component measure (Strube, 2003; submitted). Correlation matrices summarizing relations amongst literacy and amongst phonological processing measures are presented in Table 2 to demonstrate how these measures could be combined to form composite factors. Both sets of measures were significantly correlated, and PCA determined that the reading/written expression measures could exist combined into a Literacy gene score and the phonological processing measures into a Phonological Processing cistron score. The principal component loadings for literacy and phonological processing measures are listed in Table 3. For the literacy measures, an eigenvalue of 3.195 indicated that 80% of the original score variance was accounted for by the combined factor score. For the phonological processing measures, an eigenvalue of 2.596 was obtained, indicating that a linear combination of individual measures into a single score accounted for 65% of the original score variance.

Table 2

Intercorrelation matrices for literacy and phonological processing measures

	Literacy Measures
	PIAT	TORC	NTID-WL
Film Spelling Test (PST)	.702	.669	.680
Peabody Individual Achievement Test (PIAT)	ane	.794	.780
Test of Reading Comprehension (TORC)		1	.771
Written Language (NTID-WL)			i
Note. All coefficients pregnant at p < .001.

	Phonological Processing Measures
	ChNWR	PST-PL	WRMT-WA
Children'south Test of Phonological Processing: Elision (C-TOPP-E)	.316	.505	.663
Children's Nonword Repetition (ChNWR)	1	.504	.490
Movie Spelling Test: Plausibility Score (PST-PL)		i	.677
Woodcock Reading Mastery Test: Word Assail (WRMT-WA)			1
Note. All coefficients significant at p < .01.

Tabular array three

Principal Components Loadings for Literacy and Phonological Awareness Factors

Literacy Factor	Loadings
Peabody Individual Accomplishment Exam (PIAT)	.919
Written Language (NTID-WL)	.906
Examination of Reading Comprehension (TORC)	.904
Flick Spelling Test (PST): Pct Right	.846
Note. Full variance explained = lxxx%

Phonological Processing Factor	Loadings
Woodcock Reading Mastery Test: Word Attack (WRMT-WA)	.894
Flick Spelling Test: Plausibility Score (PST-PL)	.844
Children's Test of Phonological Processing: Elision (C-TOPP-Due east)	.776
Children's Nonword Repetition (ChNWR)	.695
Note. Full variance explained = 65%

Factors contributing to literacy skills in CI students

Multiple linear regression analysis was used to predict the amount of variance in the literacy cistron score accounted for past the phonological processing cistron score afterwards removing variance acquaintance with kid, family and implant characteristics. Results are shown in Tabular array 4. The assay was conducted in four steps and so that groups of variables were considered and then controlled in subsequent stages in the analysis. First, the child characteristics of gender, elapsing of deafness, and age at get-go hearing assist fitting were entered in the regression and deemed for viii.6% of the variance in literacy effect. Elapsing of deafness was the only significant predictor from this group of variables, and the influence was negative. This ways that a shorter duration between the onset of profound deafness (birth in most cases) and CI surgery was associated with a college level of literacy. This result suggests that there are long-term literacy benefits of early cochlear implantation.

Table 4

Hierarchical Multiple Regression Predicting CI-HS Literacy

Predictor	Step 1			Step 2			Step 3			Pace iv
	β	t	p	β	t	p	β	t	p	β	t	p
Gender	0.157	1.701	0.089	0.207	2.317	0.020	0.076	one.214	0.225	0.074	1.400	0.162
Age 1st HA	-0.142	1.511	0.131	-0.024	ii.256	0.798	0.031	0.486	0.627	0.034	0.643	0.520
Duration of Deafness	-0.244	2.590	0.010	-0.179	1.889	0.058	-0.040	0.615	0.538	-0.023	0.406	0.685
Age				0.080	0.876	0.381	0.092	1.468	0.142	0.079	ane.489	0.137
PIQ				0.250	2.744	0.006	0.150	ii.389	0.017	0.152	2.850	0.004
Sign Enhancement				-0.329	iii.488	<0.001	-0.052	0.746	0.455	-0.043	0.740	0.460
Family Size				-0.40	0.426	0.670	-0.018	0.289	0.772	-0.033	0.619	0.536
Family unit SES				0.081	0.830	0.407	0.206	0.389	0.697	0.011	0.187	0.851
Aided Threshold		0.110	ane.131	0.258	0.115	1.726	0.084	0.113	2.000	0.045
Device		0.015	0.157	0.875	0.027	0.416	0.677	0.033	0.603	0.546
Phonological Processing					0.733	10.753	<0.001	0.391	iv.944	<0 .001
CI-Eastward Reading Level								0.475	6.376	<0.001
Δ R2	0.086	0.198			0.383			0.100
Rii	0.086	0.284			0.667			0.767

Adjacent, a number of kid, family unit, and implant characteristics were entered in Step 2 of the analysis: Age at examination, PIQ, sign enhancement (OC-SC difference score on the PPVT), family size, family SES, aided CI threshold and device technology rating. Together, these variables accounted for xix.8% of additional variance in high school literacy outcomes of CI participants. Meaning predictors in this group of variables included gender (girls did better than boys), PIQ and the sign enhancement metric that describes how much benefit a student receives by the improver of sign linguistic communication to spoken language during the PPVT receptive vocabulary assessments. Students with higher PIQ scores and those whose receptive vocabulary was not enhanced by addition of sign language obtained the highest literacy levels in high school.

The 3rd step in the assay examined the degree of importance of phonological processing skills to literacy outcomes in CI-HS students. Phonological processing accounted for 38.3% of added variance in literacy level. Thus, not only were phonological processing skills highly related to one another (i.east., the ability to imitate nonwords from an auditory model, to pronounce nonwords presented in print, to dispense the phonological structure of oral language past deleting sounds and syllables, and to create phonologically plausible misspellings of words) but they also played a major part in successful reading and written expression. Furthermore, the contribution of phonological processing skills to literacy was independent of the influence of functioning intelligence.

In a final stride, we examined the amount of residue variance in literacy that was accounted for by reading scores obtained at the CI-E test session. This step accounted for an boosted 10% of variance in high school literacy level. This result indicates that those with the highest literacy levels at CI-HS were those with the best reading skills at CI-East. The predictor variables examined accounted for 76.7% of the variance in CI-HS literacy. The connected significance of PIQ in step 4 indicates that those with college PIQs fabricated even greater reading gains than would be anticipated from their CI-East reading levels alone.

Give-and-take

The goals of the current study were threefold: document the literacy skills of early-implanted deaf adolescents, determine whether students who demonstrated age-advisable reading skills in unproblematic school were able to keep up with their hearing peers in high school, and make up one's mind the caste to which phonological processing skills and demographic characteristics play a role in literacy achievement amidst deaf high school students with cochlear implants. To our knowledge, no other study in the literature has addressed reading and writing skills in this particular population using such a broad array of measures. Using a wide battery of literacy and phonological processing measures, we documented the achievements of CI-HS students who had received CIs as preschoolers and used their implants for many years. Many CI-HS students had stiff literacy skills commensurate with hearing peers. Between 47% and 66% of the CI-HS students scored within or higher up the average range for hearing age-mates on two tests of reading (the PIAT-R and TORC, respectfully). 30-six pct of the students read at 9^thursday grade level or above on the PIAT-R, compared to only 17% reading below the iv^th class barrier that characterized deaf students' performance before the appearance of the CI. Written expression, however, posed greater difficulty for CI-HS students. CI-HS students were poorer spellers on average than hearing peers. They also were rated as having poorer expository writing skills on boilerplate than hearing peers. Despite increased access to spoken language via the CI, CI-HS students struggled with phonological processing tasks as compared to hearing peers. On measures of discussion set on, plausibility of spelling errors, elision, and nonword repetition, the CI-HS students performed below the levels achieved by their hearing peers. Learning to read is a chore typically mastered in the early years of elementary school; children then must "read to learn" in mid- to afterward-elementary grades. Information technology is this transition that seems to pose great difficulty to children who are deaf. Yet their relatively better performance on literacy measures than on phonological processing tasks suggests that other strategies (e.yard. visual processing) may provide an alternate road to successful reading acquisition. In other words, phonological processing is only one correspondent to literacy competence.

Considering this population of children had been assessed for reading abilities at ages viii-ix years (Geers, 2003), we were able to document reading development in children with cochlear implants from elementary through high school. We institute many CI-HS students who were good readers at ages viii-9 years were good readers in high schoolhouse. In fact, 36% of the CI-HS students scored at nine^th grade levels or higher. The majority of the CI-HS students showed reading growth over fourth dimension, fifty-fifty if some CI-HS students were delayed compared to hearing peers.

The third goal of the study was to investigate how well sure factors predicted literacy success. We were primarily interested in the contributions of phonological processing measures and kid/family characteristics to overall skills in reading, spelling, and written expression. Using step-wise regression, important contributors to literacy success included elapsing of deafness (shorter was better, indicating early on implantation), PIQ, sign enhancement (students with strong OC skills did better) and phonological processing skills. After controlling for these variables, early reading skills at CI-East deemed for an boosted 10% of remaining variance in literacy skills in high schoolhouse.

It is not entirely surprising that phonological processing skills accounted for 38% of variance in literacy abilities for students with CIs, or that early reading success was important for later reading success. What is striking are the numbers of students (72% of sample) who retained their reading standing compared to hearing peers over a relatively long academic period of time. That is, 72% of the sample made age-appropriate growth over fourth dimension. For these students, the gap that often exists between deaf and hearing peers in reading did non widen with time. The current CI-HS sample may not represent the entire population of children receiving CIs in the Us and Canada in the early 1990s and the 112 CI-HS students recruited from the original sample of 181 CI-E students may be advantaged in some respects (Geers, Brenner, & Tobey, submitted).

Academic success relies heavily on reading and writing skills; skills reported equally seriously deficient in deaf students. With early cochlear implantation, deaf children accept the opportunity to strengthen phonological awareness skills influencing reading and spelling development. The current written report documented a broad array of reading, writing, and phonological processing skills in a relatively large group of adolescents with CIs. Although these students received their implants at relatively young ages (preschool), current practices in combination with universal newborn hearing screening dictate that many children receive implants at 12 months (and younger), or receive a second CI either meantime or presently after the starting time one. Thus, future studies must document the effects of cochlear implantation on academic skills, specially in populations of children who receive their implants at 12 months or younger, and those children who employ bilateral cochlear implants from very immature ages.

Acknowledgments

This study was supported by grant # DC008335 from the National Institutes of Health to the University of Texas at Dallas. Statistical analysis was provided by Dr. Michael J. Strube at Washington University in St. Louis. We would like to give thanks the students with cochlear implants and their families who traveled to St. Louis to participate in a data collection summertime camp.

These studies were supported by the National Institute of Deafness and Other Communication Disorders (R01DC 000581). Michael J. Strube, PhD provided statistical assay and interpretation. We wish to acknowledge the participating teenagers and their families who made this piece of work possible.

Appendix

Stimuli for Picture Spelling Task

Cucumber, embarrassed, thumb, leopard, cafeteria, atomic number 26, scissors, refrigerator, ambulance, squirrel, mirror, camouflage, biscuit, giraffe, potato, diamond, astronaut, bristles, chimney, cigarette, mosquito, chocolate, dinosaur, license, sorcerer, oven, whale, cookie, hockey, cauliflower, thermometer, 8th, broccoli, ballerina, shoulder, bracelet, sandwich, convertible, soup, alligator, piano, caterpillar, statue, restaurant, camera, mount, mustache, faucet, building, trampoline, spaghetti, vanilla, pyramid, soccer, razor, castle, purple, scuba, orchestra, lizard, tornado, neighbor, ceiling, tractor, umbrella, garage, island, 12th, watermelon, tongue, licorice, agenda, pall, turtle, mustard, breakfast, vacuum, calculator, antenna, lightning, muscle, submarine, forty, balloon, scarf, motorcycle, kangaroo, sword, referee, orange, satellite, telescope, guitar, stadium, ghost, secretary, asparagus, reindeer, witch, fountain

References

• Albertini J, Bochner J, Dowaliby F, Henderson J. Valid assessment of writing and access to academic discourse. Journal of Deaf Studies and Deaf Education. 1996;2:71–77. [PubMed] [Google Scholar]
• Antia SD, Reed S, Kreimeyer KH. Written language of deaf and hard-of-hearing students in public schools. Journal of Deaf Studies and Deaf Education. 2005;10:244–255. [PubMed] [Google Scholar]
• Blamey PJ, Sarant JZ, Paatsch LE, Barry JG, Bow CP, Wales RJ, et al. Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing. Journal of Oral communication, Language, and Hearing Inquiry. 2001;44:264–285. [PubMed] [Google Scholar]
• Boothroyd A, Geers A, Moog J. Practical implications of cochlear implants in children. Ear and Hearing. 1991;12:81–89. [PubMed] [Google Scholar]
• Dark-brown VL, Hammill DD, Wiederholt JL. Test of Reading Comprehension. 3. Austin, TX: Pro-Ed; 1995. [Google Scholar]
• Burden Five, Campbell R. The evolution of discussion-coding skills in the born deaf. British Journal of Developmental Psychology. 1994;12:331–349. [Google Scholar]
• Carnegie Mellon Academy. Carnegie Mellon pronouncing lexicon [information file] 1998. Retrieved 2007, from ftp://ftp.cs.cmu.edu/project/speech/dict/cmudict.0.6.
• Connor CM, Craig HK, Raudenbush SW, Heavner K, Zwolan T. The age at which young deaf children receive cochlear implants and their vocabulary and speech communication product growth: Is there an added value for early implantation? Ear and Hearing. 2006;27:628–644. [PubMed] [Google Scholar]
• Connor CM, Zwolan T. Examining multiple sources of influence on the reading comprehension skills of children who employ cochlear implants. Journal of Speech and Hearing Research. 2004;43:1185–1204. [PubMed] [Google Scholar]
• Connor CM, Hieber S, Arts HA, Zwolan TA. Speech communication, vocabulary, and the education of children using cochlear implants: oral or total communication? Journal of Speech, Language and Hearing Research. 2000;43:1185–1204. [PubMed] [Google Scholar]
• Davidson L, Geers A, Blamey P, Tobey E. Factors contributing to speech perception scores in long-term pediatric CI users. Ear and Hearing. submitted. [PMC costless commodity] [PubMed] [Google Scholar]
• Dawson PW, Blamey PJ, Dettman SJ, Barker EJ, Clark GM. A clinical report on receptive vocabulary skills in cochlear implant users. Ear and Hearing. 1995;xvi:287–294. [PubMed] [Google Scholar]
• DeVilliers PA. English literacy development in deafened children: directions for research and intervention. In: Miller J, editor. Enquiry on Kid Linguistic communication Disorders: A Decade of Progress. Austin, TX: Pro-Ed; 1991. [Google Scholar]
• Dillon C, Burkholder R, Cleary Grand, Pisoni D. Nonword Repetition by Children with Cochlear Implants: Accuracy Ratings from Normal-Hearing Listeners. Periodical of Speech, Language, and Hearing Research. 2004;47:1103–1116. [PMC free article] [PubMed] [Google Scholar]
• Dunn L, Dunn L. Peabody Picture Vocabulary Test-Revised. Circumvolve Pines, MN: American Guidance; 1981. [Google Scholar]
• Dunn L, Markwardt FC. Peabody Private Accomplishment Exam-Revised. Circle Pines, MN: American Guidance; 1989. [Google Scholar]
• Ellefson MR, Treiman R, Kessler B. Learning to label letters by sounds or names: A comparing of England and the The states. Journal of Experimental Child Psychology. 2009;102:323–341. [PMC gratuitous article] [PubMed] [Google Scholar]
• Figueredo L, Varnhagen CK. Didn't you lot run the spell checker? Effects of type of spelling error and use of a spell checker on perceptions of the author. Reading Psychology. 2005;26:441–458. [Google Scholar]
• Gathercole SE, Baddeley A. The Children's Test of Non-Word Repetition. London: Psychological Corporation Europe; 1996. [Google Scholar]
• Geers A. Factors affecting the evolution of speech,language and literacy in children with early cochlear implantation. Language, Oral communication and Hearing Services in Schools. 2002;33:172–183. [PubMed] [Google Scholar]
• Geers A. Predictors of reading skill development in children with early cochlear implantation. Ear and Hearing. 2003;24:59S–68S. [PubMed] [Google Scholar]
• Geers A, Brenner C, Tobey E. Long-term outcomes of cochlear implantation in early childhood: Sample characteristics and data collection methods. Ear and Hearing. submitted. [PMC free article] [PubMed] [Google Scholar]
• Geers A, Moog JS. Factors predictive of the development of literacy in hearing-impaired adolescents. Volta Review. 1989;91:69–86. [Google Scholar]
• Geers AE, Nicholas JG, Sedey AL. Language skills of children with early on cochlear implantation. Ear and Hearing. 2003;24:46–58. [PubMed] [Google Scholar]
• Geers A, Sedey A. Linguistic communication and verbal reasoning skills in sdolescents with 10 or more than years of cochlear implant experience. Ear and Hearing. submitted. [PMC free article] [PubMed] [Google Scholar]
• Harris Grand, Moreno C. Deaf children'southward use of phonological coding: Bear witness from reading,spelling and working retentiveness. Periodical of Deaf Studies and Deaf Didactics. 2004;iv:111–123. [PubMed] [Google Scholar]
• Harris M, Terlektsi E. Reading and spelling abilities of deaf adolescents with cochlear implants and hearing aids. Periodical of Deaf Studies and Deafened Education. 2010 [July 5, 2010]; doi: 10.1093/deafed/enq031. [PubMed] [CrossRef] [Google Scholar]
• Hayes H, Geers AE, Treiman R, Moog JS. Receptive vocabulary development in deaf children with cochlear implants: Achievement in an intensive auditory-oral educational setting. Ear and Hearing. 2009;30:128–135. [PubMed] [Google Scholar]
• Hirsh-Pasek K, Golinkoff RM. The origins of grammar: Prove from comprehension. Cambridge, MA: MIT Press; 1996. [Google Scholar]
• Ingram D. First linguistic communication acquisition: Method, clarification,explanation. Cambridge: Cambridge Academy Press; 1989. [Google Scholar]
• International Phonetic Clan. Handbook of the International Phonetic Association: A guide to the utilise of the International Phonetic Alphabet. Cambridge, England: Cambridge University Press; 1999. [Google Scholar]
• James D, Rajput Grand, Brownish T, Sirimanna T, Brinton J, Goswami U. Phonological awareness in deafened children who apply cochlear implants. Periodical of Speech, Language and Hearing Research. 2005;48:1511–1528. [PubMed] [Google Scholar]
• Johnson C, Goswami U. Phonological awareness, vocabulary, and reading in deafened children with cochlear implants. Journal of Speech, Language, and Hearing Research. 2010;53:237–261. [PubMed] [Google Scholar]
• Keenan JM, Betjemann RS, Olson RK. Reading comprehension tests vary in the skills they appraise: Differential dependence on decoding and oral comprehension. Scientific Studies of Reading. 2008;12(iii):281–300. [Google Scholar]
• Kreiner DS, Schnakenberg SD, Green AG, Costello MJ, McClin AF. Furnishings of spelling errors on the perception of writers. Journal of General Psychology. 2002;129:v–17. [PubMed] [Google Scholar]
• Kroese J, Lotz W, Puffer C, Osberger MJ. Language and learning skills of hearing-impaired students: Academic skills. ASHA Monograph. 1986:66–76. [PubMed] [Google Scholar]
• Kutner North, Greenberg E, Jin Y, Boyle B, Hsu J, Dunleavy East. Literacy in everyday life: Results from the 2003 National Assessment of Adult Literacy (NCES 2007-480) Washington, DC: U.Due south. Department of Pedagogy National Center for Educational Statistics; 2007. [Google Scholar]
• Marschark M, Harris K. Success and failure in learning to read: The special example (?) for deaf children. In: Cornoldi C, Oakhill J, editors. Reading comprehension difficulties: Processes and intervention. Mahwah, NJ: Erlbaum; 1996. pp. 279–300. [Google Scholar]
• Marschark M, Mouradian V, Halas K. Discourse rules in the language productions of deaf and hearing children. Journal of Experimental Child Psychology. 1994;57:89–107. [PubMed] [Google Scholar]
• Marschark M, Rhoten C, Fabich M. Furnishings of cochlear implants on children's reading and academic achievement. Periodical of Deaf Studies and Deafened Education. 2007;12:269–282. [PubMed] [Google Scholar]
• Moog J. Changing expectations for children with cochlear implants. Register of Otology, Rhinology & Laryngology. 2002;111:138–142. [PubMed] [Google Scholar]
• Moog J, Gustus C, Geers A, Brenner C. Psychosocial adjustment in adolescents who use cochlear implants since preschool. Ear and Hearing. submitted. [PMC gratuitous article] [PubMed] [Google Scholar]
• Moores DF, Sugariness C. Factors predictive of school achievement. In: Moores DF, Meadow-Orlans KP, editors. Educational and Developmental Aspects of Deafness. Washington DC: Gallaudet University Press; 1990. pp. 154–201. [Google Scholar]
• Nevins Thousand, Chute P. Educational considerations: From listening to literacy. In: Eisenberg L, editor. Clinical Management of Children with Cochlear Implants. San Diego: Plural Publishing; 2009. pp. 459–512. [Google Scholar]
• Paul PV. Linguistic communication and Deafness. San Diego: Singular; 2001. [Google Scholar]
• Perfetti CA, Sandak R. Reading optimally builds on spoken linguistic communication: implications for deaf readers. Periodical of Deaf Studies and Deafened Education. 2000;5:32–l. [PubMed] [Google Scholar]
• Pisoni D, Kronenberger W, Conway CM, Horn DL, Karpicke J, Henning South. Efficacy and effectiveness of cochlear implants in deaf children. In: Marschark One thousand, Hauser P, editors. Deaf Cognition: Foundations and Outcomes. New York: Oxford University Press; 2008. pp. 52–101. [Google Scholar]
• Pisoni DB, Kronenberger W, Roman A, Geers A. Measures in digit span and verbal rehearsal speed in deafened children following more than than ten years of cochlear implant use. Ear and Hearing. submitted. [PMC gratis article] [PubMed] [Google Scholar]
• Rayner Yard, Foorman BR, Perfetti CA, Pesetsky D, Seidenberg MS. How psychological science informs the teaching of reading. Psychological Science in the Public Interest. 2001;2:31–74. [PubMed] [Google Scholar]
• Scarborough H. Connecting early linguistic communication and literacy to later reading (dis)abilites: Prove, theory and practise. In: Neuman S, Dickenson D, editors. Handbook of Early Literacy Research. Vol. one. New York: The Guilford Press; 2001. pp. 97–110. [Google Scholar]
• Schley S, Albertini J. Assessing the writing of deafened college students: Reevaluating a direct assessment of writing. Journal of Deaf Studies and Deaf Education. 2005;10:96–104. [PubMed] [Google Scholar]
• Schopmeyer B. Reading and Deafness. In: Niparko J, editor. Cochlear Implants: Principles and Practices. 2. Baltimore: Lippincott, Williams, & Wilkins; 2009. pp. 263–266. [Google Scholar]
• Serry T, Blamey P, Grogan M. Phoneme acquisition in the first four years of implant use. Otology & Neurotology. 1997;18:S122–S124. [PubMed] [Google Scholar]
• Serry TA, Blamey PJ. A four-yr investigation into phonetic inventory development in young cochlear implant users. Periodical of Speech, Language, and Hearing Research. 1999;42:141–154. [PubMed] [Google Scholar]
• Shrout PE, Fleiss JI. Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin. 1997;86:420–428. [PubMed] [Google Scholar]
• Spencer Fifty, Oleson JJ. Early Listening and speaking skills predict later on reading profieiency in pediatric cochlear implant users. Ear and Hearing. 2008;29:270–280. [PMC free article] [PubMed] [Google Scholar]
• Spencer L, Tomblin B. Evaluating phonological processiing skills in children with prelingual deafness who use cochlear implants. Periodical of Deafened Studies and Deaf Education. 2008;xiv:1–20. [PMC free article] [PubMed] [Google Scholar]
• Stanovich KE. Toward an interactive-compensatory model of individual differences in the evolution of reading fluency. Reading Enquiry Quarterly. 1980;i:32–71. [Google Scholar]
• Sterne A, Goswami U. Phonological awareness of syllables, rhymes and phonemes in deafened children. Journal of Child Psychology and Psychiatry. 2000;41:609–625. [PubMed] [Google Scholar]
• Sutcliffe A, Dowker A, Campbell R. Deafened children'due south spelling: Does information technology show sensitivity to phonology. Journal of Deaf Studies and Deafened Education. 1999;iv:111–123. [PubMed] [Google Scholar]
• Tobey East, Geers A, Sundarrajan M, Lane J. Factors Influencing Unproblematic and High-Schoolhouse Anile Cochlear Implant Users. Ear and Hearing. submitted. [PMC gratis article] [PubMed] [Google Scholar]
• Tobey EA, Geers AE, Brenner C, Altuna D, Gabbert G. Factors associated with evolution of speech production skills in children implanted past age five. Ear and Hearing. 2003;24:36S–45S. [PubMed] [Google Scholar]
• Traxler CB. Measuring up to functioning standards in reading and mathematics: Accomplishment of selected deaf and hard-of-hearing students in the national norming of the 9th Edition Stanford Achievement Examination. Journal of Deaf Studies and Deaf Education. 2000;5:337–348. [PubMed] [Google Scholar]
• Treiman R, Hirsh-Pasek K. Silent reading: insights from second-generation deaf readers. Cognitive Psychology. 1983;fifteen:39–65. [PubMed] [Google Scholar]
• Wagner R, Torgesen J, Rashotte C. Comprehensive Test of Phonological Processing. Austin, TX: Pro-Ed; 1999. [Google Scholar]
• Wechsler D. Wechsler Intelligence Scale for Children. iii. San Antonio, TX: Psychological Corporation Harcourt Brace; 1991. [Google Scholar]
• Woodcock RW. Woodcock Reading Mastery Test. Allen, TX: Didactics Resources; 1987. Revised ed. [Google Scholar]
• Yoshinaga-Itano C, Snyder 50, Mayberry R. Examining written-language assessment and intervention links to literacy: Tin lexical/semantic skills differentiate deafened or difficult-of-hearing readers and nonreaders? Volta Review. 1996;98:39–61. [Google Scholar]
• Zeno SM, Ivenez SH, Millard RT, Duvvari R. The educator's discussion frequency guide. Brewster, NY: Touchstone Applied Science Associates; 1995. [Google Scholar]

singletonvagind.blogspot.com

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023978/

Share this post