The aim of this study was to document receptive and expressive language levels and reading skills achieved by Mandarin-speaking children who had received cochlear implants (CIs) and used them for 4.75–7.42 years. The effects of possible associated factors were also analyzed. Standardized Mandarin language and reading tests were administered to 39 prelingually deaf children with Nucleus 24 devices. The Mandarin Chinese version of the Peabody Picture Vocabulary Test was used to assess their receptive vocabulary knowledge and the Revised Primary School Language Assessment Test for their receptive and expressive language skills. The Graded Chinese Character Recognition Test was used to test their written word recognition ability and the Reading Comprehension Test for their reading comprehension ability. Raw scores from both language and reading measurements were compared to normative data of nor- mal-hearing children to obtain standard scores. The results showed that the mean standard score for receptive vocabulary measurement and the mean T scores for the receptive language, expressive language and total language measurement were all in the low-average range in comparison to the normative sample. In contrast, the mean T scores for word and text reading comprehension were almost the same as for their age-matched hearing counterparts. Among all children with CIs, 75.7% scored within or above the normal range of their age-matched hearing peers on receptive vocabulary measurement. For total language, Chinese word recognition and reading scores, 71.8, 77 and 82% of children with CIs were age appropriate, respectively. A strong correlation was found between language and reading skills. Age at implantation and sentence perception scores account for 37% of variance for total language outcome. Sentence perception scores and preimplantation residual hearing were revealed to be associated with the outcome of reading comprehension. We concluded that by using standard tests, the language development and reading skill of Mandarin-speaking children who use CIs from a young age appear to fall within the normal range of their hearing age mates, at least after 4.8–7.4 years of experience. However, to fully evaluate the fine linguistic skills of these subjects, a more detailed study and longer follow-up period are needed.

1.
Archbold S, Harris M, O’Donoghue GM, Nikolopoulos T, White A, Richmond HL: Reading abilities after cochlear implantation: the effect of age at implantation on outcomes at 5 and 7 years after implantation. Int J Pediatr Otorhinolaryngol 2008;72:1471–1478.
2.
Blamey PJ, Sarant JZ, Paatsch LE, et al: Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing. J Speech Lang Hear Res 2001;44:264–285.
3.
Chen JS, Lin YS: Comparison of Nucleus-22TM and MED-EL C40TM cochlear implant performances in the postlingual deaf. J Taiwan Otolaryngol Head Neck Surg 2000;35:318–325.
4.
Cheung H, Ng LK-H: Chinese reading development in some major Chinese societies: an introduction; in McBride-Chang C, Chen H-C (eds): Chinese Children’s Reading Development. London, Praeger, 2003, pp 3–17.
5.
Connor CM, Craig HK, Raudenbush SW, Heavner K, Zwolan TA: The age at which young deaf children receive cochlear implants and their vocabulary and speech production growth: is there an added value for early implantation? Ear Hear 2006;27:628–644.
6.
Connor CM, Hieber S, Arts HA, et al: Speech, vocabulary and the education of children using cochlear implants: oral or total communication? J Speech Lang Hear Res 2000;43:1185–1204.
7.
Connor CM, Zwolan T: Examining multiple sources of influence on the reading comprehension skills of children who use cochlear implants. J Speech Lang Hear Res 2004;47:509–526.
8.
Eisenberg LS, Kirk KI, Martinez AS, et al: Communication abilities of children with aided residual hearing. Arch Otolarngol Head Neck Surg 2004;130:563–569.
9.
El-Hakim H, Levasseur J, Papsin BC, et al: Assessment of vocabulary development in children after cochlear implantation. Arch Otolaryngol Head Neck Surg 2001;127:1053–1059.
10.
Fagan MK, Pisoni DB, Horn D, et al: Neuropsychological correlates of vocabulary, reading, and working memory in deaf children with cochlear implants. J Deaf Stud Deaf Educ 2007;12:461–471.
11.
Faulkner A, Rosen S, Smith C: Effects of the salience of pitch and periodicity information on the intelligibility of four-channel vocoded speech: implications for cochlear implants. J Acoust Soc Am 2000;108:1877–1887.
12.
Geers AE: Predictors of reading skill development in children with early cochlear implantation. Ear Hear 2003;24:59s–68s.
13.
Geers AE: Speech, language, and reading skills after early cochlear implantation. Arch Otolaryngol Head Neck Surg 2004;130:634–638.
14.
Geers AE: Factors influencing spoken language outcomes in children following early cochlear implantation. Adv Otorhinolaryngol 2006;64:50–65.
15.
Geers AE, Moog JS: Spoken language results: vocabulary, syntax, and communication. Volta Rev 1994;96:131–148.
16.
Geers AE, Moog JS, Biedenstein J, et al: Spoken language scores of children using cochlear implants compared to hearing age-mates at school entry. J Deaf Stud Deaf Educ 2009;14:371–385.
17.
Geers AE, Nicholas JG, Sedey AL: Language skills of children with early cochlear implantation. Ear Hear 2003;24:46s–58s.
18.
Geers A, Tobey E, Moog J, et al: Long-term outcomes of cochlear implantation in the preschool years: from elementary grades to high school. Int J Audiol 2008;47(suppl 2):S21–S30.
19.
Haensel J, Engelke J, Ottenjann W, et al: Long-term results of cochlear implantation in children. Otolaryngol Head Neck Surg 2005;132:456–458.
20.
Han D, Zhou N, Li Y, et al: Tone production of Mandarin Chinese speaking children with cochlear implants. Int J Pediatr Otolaryngol 2007;71:75–80.
21.
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 Hear 2009;30:128–135.
22.
Huang CY, Yang HM, Sher YJ, et al: Speech intelligibility of Mandarin-speaking deaf children with cochlear implants. Int J Pediatr Otolaryngol 2005;69:505–511.
23.
Huang SS: Graded Chinese Character Recognition Test: Instruction Manual. Taipei, Psychological Publisher, 2001.
24.
Johnson CA, Goswami UC: Phonological skills, vocabulary development, and reading development in children with cochlear implants. 20th Int Congr Educ Deaf, Maastricht, 2005.
25.
Kirk KI, Miyamoto RT, Ying EA, et al: Cochlear implantation in young children: effects of age at implantation and communication mode. Volta Rev 2002;102:127–144.
26.
Lin BG, Chi PH: The Assessment of School Language Disorders. Taipei, National Taiwan Normal University Press, 2007.
27.
Lu L, Liu H: Peabody Picture Vocabulary Test – Mandarin Version, Revised Form. Taipei, Psychological Publishing Co, 1988.
28.
Lyxell B, Sahlén B, Wass M, Ibertsson T, Larsby B, Hällgren M, Mäki-Torkko E: Cognitive development in children with cochlear implants: relations to reading and communication. Int J Audiol 2008;47(suppl 2):47–52.
29.
Miyamoto RT, Kirk KI, Svirsky MA, et al: Communication skills in pediatric cochlear implant recipients. Acta Otolaryngol 1999;119:219–224.
30.
Moog J, Geers A: Speech and language acquisition in young children after cochlear implantation; in Horn KL, McDaniel SA (eds): Early Identification and Intervention of Hearing-Impaired Infants. Otolaryngol Clin North Am 1999;32:1127–1142.
31.
Moog J, Geers A: Epilogue: major findings. Conclusions and implications for deaf education. Ear Hear 2003;24:121S–125S.
32.
Moog JS: Changing expectations for children with cochlear implants. Ann Otol Rhinol Laryngol Suppl 2002;189:138–142.
33.
Nicholas JG, Geers AE: Effects of early auditory experience on the spoken language of deaf children at 3 years of age. Ear Hear 2006;27:286–298.
34.
Nicholas JG, Geers AE: Will they catch up? The role of age at cochlear implantation in the spoken language level of children with severe to profound hearing loss. J Speech Lang Hear Res 2007;50:1048–1062.
35.
Niparko JK, Tobey EA, Thal DJ, Eisenberg LS, Wang NY, Quittner AL, Fink NE, CDaCI Investigative Team: Spoken language development in children following cochlear implantation. JAMA 2010;303:1498–1506.
36.
Peng SC, Spencer LJ, Tomblin JB: Speech intelligibility of pediatric cochlear implant recipients with 7 years of device experience. J Speech Lang Hear Res 2004a;47:1227–1236.
37.
Peng SC, Tomblin JB, Cheung H, et al: Perception and production of mandarin tones in prelingually deaf children with cochlear implants. Ear Hear 2004b;25:251–264.
38.
Peng SC, Weiss AL, Cheung H, et al: Consonant production and language skills in Mandarin-speaking children with cochlear implants. Arch Otolaryngol Head Neck Surg 2004c;130:592–597.
39.
Quellect C, Cohen H: Speech and language level following cochlear implantation. J Neurolinguistics 1999;12:271–288.
40.
Richter B, Eissele S, Laszig R, et al: Receptive and expressive language skills of 106 children with a minimum of 2 years’ experience in hearing with a cochlear implant. Int J Pediatr Otolaryngol 2002;64:111–125.
41.
Spencer LJ, Barker BA, Tomblin JB: Exploring the language and literacy outcomes of pediatric cochlear implant users. Ear Hear 2003;24:236–247.
42.
Spencer LJ, Oleson JJ: Early listening and speaking skills predict later reading proficiency in pediatric cochlear implant users. Ear Hear 2008;29:270–280.
43.
Spencer PE: Individual differences in language performance after cochlear implantation at one to three years of age: child, family, and linguistic factors. J Deaf Stud Deaf Educ 2004;9:395–412.
44.
Spencer PE, Marschark M: Cochlear implants: issues and implications; in Marschark M, Spencer PE (eds): Oxford Handbook of Deaf Studies, Language, and Education. New York, Oxford University Press, 2003, pp 434–448.
45.
Staller SJ, Beiter AL, Brimacombe JA, et al: Pediatric performance with the Nucleus 22-channel cochlear implant system. Am J Otol 1991;12:126–136.
46.
Svirsky MA, Robbins AM, Kirk KI, et al: Language development in profoundly deaf children with cochlear implants. Psychol Sci 2000;11:153–158.
47.
Tomblin JB, Barker BA, Spencer LJ, et al: The effects of age at cochlear implant initial stimulation on expressive language growth in infants and toddlers. J Speech Lang Hear Res 2005;48:853–867.
48.
Tomblin JB, Spencer LJ, Gantz BJ: Language and reading acquisition in children with and without cochlear implants. Adv Otorhinolaryngol 2000;57:300–304.
49.
Waltzman SB: Cochlear implants: current status. Expert Rev Med Devices 2006;3:647–655.
50.
Wang NM, Huang TS, Wu CM, et al: Pediatric cochlear implantation in Taiwan: long term communication outcomes. Int J Pediatr Otolaryngol 2007;71:1775–1782.
51.
Wu CM, Sun YS, Liu TC: Long-term categorical auditory performance and speech intelligibility in Mandarin-speaking prelingually deaf children with early cochlear implantation in Taiwan. Clin Otolaryngol 2008;33:35–38.
52.
Wu JL, Yang HM: Speech perception of Mandarin Chinese speaking young children after cochlear implant use: effect of age at implantation. Int J Pediatr Otolaryngol 2003;67:247–253.
53.
Xu L, Tsai Y, Pfingst BE: Features of stimulation affecting tonal-speech perception: implications for cochlear prostheses. J Acoust Soc Am 2002;112:247–258.
54.
Zwolan TA, El-Kashlan HK, Telian SA: Pediatric cochlear implant patient performance as a function of age at implantation. Otol Neurotol 2004;25:112–120.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.