Paragraph‐reading comprehension ability in M andarin‐speaking children with cochlear implants

Objectives 1) 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 Design Cross‐sectional, case‐controlled study. Methods Fifty‐three students with CIs (aged 11.0 ± 1.4 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. Results The 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). Conclusions Specialists 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 Evidence 3b. Laryngoscope , 125:1449–1455, 2015