Paragraph-reading comprehension ability in Mandarin-speaking children with cochlear implants

Objectives1) 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. Study DesignCross-sectional, case-controlled study. MethodsFifty-three students with CIs (aged 11.01.4 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. ResultsThe 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). ConclusionsSpecialists 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. Level of Evidence3b. Laryngoscope, 125:1449-1455, 2015