The relationship between language production and early literacy in children with cochlear implants: a study on the transition between preschool and primary school

Introduction. The transition to primary school could be a complex developmental challenge for children with developmental difficulties/disorders. Children with cochlear implants (CIs), although benefiting from the access to sound, may have expressive language difficulties and early literacy problems, that could delay the acquisition of literacy skills in primary school. The present study focuses on (1) expressive language skills (with a specific focus on phonetic-phonological features) and early literacy in children with CIs and in age matched normal hearing (NH) peers and assesses (2) the relationship between developmental skills considered at the end of infant school, before the formal acquisition of literacy. Method. Sixteen children with CIs (mean chronological age=61.0 months; DS=6.50) and 20 NH peers (mean chronological age=64.0 months, DS=4.30) participated in the study. Standardized tests to assess phonetic and phonological skills evaluation and early literacy (syllable segmentation and blending) were administered. Syllable and vowel recognition was assessed using multimedia tasks. Results. Data analysis showed significant differences between the groups in phonetic-phonological skills and early literacy. Specifically, children with CIs show a lower number of correctly produced words (U=56.5, p=.039) and lower syllable segmentation scores (U=48.5, p=.014) compared to NH peers. Furthermore, NH children show significant correlations between the number of vowels recognized and: 1) simplified words produced (r(19)=-.49); 2) number of phonological processes produced (r(19)=-.52). In contrast, no significant correlations emerged in children with CIs. Discussion. The present study confirms difficulties in phonetic-phonological skills and early literacy in children with CIs. However, correlational analysis suggests different approaches to accessing literacy between the two groups. The findings could provide important indications for early literacy support in the transition to primary school for children with CIs, adopting an inclusive perspective.