Early predictors of phonological and morphosyntactic skills in second graders with cochlear implants

• Hearing loss and cochlear implantation have different effects on the acquisition of phonological and morphosyntactic skills.
• Preschool measures of morphosyntactic abilities predict later skills in both of these domains.
• Early treatment factors affect language acquisition at school age for children with cochlear implants.
• Language functions are acquired more independently for children with normal hearing than for children with hearing loss.

PurposeNewborn hearing screening has made it possible to provide early treatment of hearing loss to more children than ever before, raising expectations these children will be able to attend regular schools. But continuing deficits in spoken language skills have led to challenges in meeting those expectations. This study was conducted to (1) examine two kinds of language skills (phonological and morphosyntactic) at school age (second grade) for children with cochlear implants (CIs); (2) see which measures from earlier in life best predicted performance at second grade; (3) explore how well these skills supported other cognitive and language functions; and (4) examine how treatment factors affected measured outcomes.MethodsData were analyzed from 100 second-grade, monolingual English-speaking children: 51 with CIs and 49 with normal hearing (NH). Ten measures of spoken language and related functions were collected: three each of phonological and morphosyntactic skills; and four of other cognitive and language functions. Six measures from preschool and seven from kindergarten served as predictor variables. The effects of treatment variables were examined.ResultsChildren with CIs were more delayed acquiring phonological than morphosyntactic skills. Mean length of utterance at earlier ages was the most consistent predictor of both phonological and morphosyntactic skills at second grade. Early bimodal stimulation had a weak, but positive effect on phonological skills at second grade; sign language experience during preschool had a negative effect on morphosyntactic structures in spoken language.ConclusionsChildren with CIs are delayed in language acquisition, and especially so in phonological skills. Appropriate testing and treatments can help ameliorate these delays.

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