Cognition and communication in children/adolescents with cochlear implant

Abstract: A cochlear implant (CI) is a device that provides individuals with severe to profound hearing impairment (SPHI) with auditory stimulation, which makes it possible for them to develop skills related to spoken communication. We have little knowledge about how hearing with a CI influences cognitive and communicative development and there is a need for development of methods for assessment. The general purpose of this thesis was to explore the interaction between cognition (working memory capacity) and phonological processing and more complex skills such as the ability to interact with hearing peers, speech recognition in noise and aspects of reading and writing in children/adolescents with CI. The ability to repeat and discriminate nonwords was assessed in 26 children/adolescents with CI aged 5;2-19;1. Thirteen of these, aged 9;0-19;1 were also assessed in a set of experimental tasks regarding general working memory, speech recognition in noise and some aspects of reading and writing and participated in a referential communication task for the assessment of conversational skills. The methods used were found adequate. The children/adolescents with CI had weak phonological processing skills, but in spite of this did not differ much from controls in reading, writing and conversation, even if phonological processing seemed to be related to reading skills. However, they tended to use different strategies than peers in requesting clarification in conversation and in reading, perhaps as an adaptation to their impairment. General working memory capacity was associated with strategies in requesting clarification and with the construction of written narratives and thus is a further factor influencing outcome.