Linsey Cushing
November 16, 2007
Introduction/Questioning
Literacy is an umbrella term that includes the essential areas of reading, writing, and digital skills. Before beginning my research, I recently discovered the vast amount of skills required to be considered literate in today’s society. You should be able to read, write, navigate the World Wide Web, differentiate meaningful versus false information, and utilize computer programs in order to make multimedia productions, among others. As I have learned from this class, literacy is no longer something you learn in elementary school. Rather, it is a never-ending process. Literacy is a gift that is often taken for granted by those who effortlessly read, write, and work on a computer on a daily basis. However, when this gift is taken away, or, in the case of hearing impaired people, never received in the first place, literacy is a looming challenge. Cochlear implants are currently aiding those who are deaf or who have a severe to profound hearing loss in hopes that one day, these people will become literate.
I decided to research a topic concerning cochlear implants and reading because I am very fascinated by cochlear implants and the reading aspect is something I am unfamiliar with. I’ve discovered that I am very drawn to therapy involving cochlear implants and find it very interesting and exciting. The fact that we, as speech-language pathologists, can help a deaf child hear and learn to read for the first time truly astounds me. I’ve realized that the impact cochlear implants have on the ability to communicate and understand language is profound. I chose this topic in hopes that I will possibly discover my “niche.” I figure that there’s no better way to discover what type of clients I want to work with in the future than through observation and research.
Lately, I have been hearing a lot about early intervention with cochlear implants. In other words, the earlier a child is identified with a hearing loss and considered to be a candidate for an implant, the sooner the child can be implanted. In turn, this earlier implantation leads to more exposure to auditory signals and better predictions for the child to be verbal someday. I applied this thought process to reading ability and came up with my essential question: “How does age of implantation have an effect on reading ability in cochlear implanted children?” After coming up with this main question, I thought of several supporting, or foundation, questions to help guide my research. First, I wanted to know, “What skills are required to learn how to read and which of these utilize the auditory channel?” Next, I needed information concerning, “What are cochlear implants?” Finally, I wondered, “What is the relationship between age of implantation and reading ability?” It is my hope that by researching these questions, I will come to a conclusion that will help to improve knowledge about the reading abilities of children with cochlear implants.
Searching
Although children with cochlear implants have additional handicaps when compared to hearing children, they all learn how to read the same way. Reading is not something that we are born with; rather, we have to learn how to read. There are five skills in particular that are essential to develop when learning how to read: phonemic awareness, phonics, comprehension, vocabulary, and fluency. Phonemic awareness involves the ability to comprehend that words are made up of sounds. Basically, sounds are like blocks that can be stacked together in order to form different words. Children must be able to hear and identify these sounds in order to recognize them in words. Phonics is a lot like phonemic awareness but it deals with letters and sounds instead of sounds and words. Phonics involves the child learning that each letter produces a certain sound and being able to combine the written aspect of letters and spoken aspect of sounds into reading. Reading comprehension is a complex skill that can only be achieved once the reader begins reading to learn. In other words, the reader must take in what he or she is reading and gain an understanding about the information. Vocabulary involves words within the reading that must be understood before the reader is able to gain meaning from the information. Finally, fluency involves the ability of the reader to read information accurately and at a steady pace (The reading skills pyramid: The key reading skills and the steps in acquiring them, 2004).
When looking at the five essential skills required when learning to read, I realized that two of these are learned primarily through the auditory channel and the other three are dependent on these in order to develop. Phonemic awareness and phonics both are highly involved with sounds and how they make up words or relate to letters. When a child is severely to profoundly deaf, as are children who receive cochlear implants, he or she receives little to no information through the auditory channel. Therefore, the child does not even have a basis to begin developing phonemic awareness or phonics. For this child, words are made up of letters rather than sounds and letters are simply letters and do not have sound associations. However, once a child receives a cochlear implant, the auditory channel can be utilized and these skills begin to develop. As I looked at the other three skills, reading comprehension, vocabulary, and fluency, I realized that they are dependent on the development of phonemic awareness and phonics. Until the child is able to utilize phonemic awareness and phonics to learn how to read, these three skills are unable to develop.
Along with the essential skills discussed above, research shows that readers develop in stages. Jeanne Chall developed five stages describing reading development. In the first stage, which spans from birth until six or seven years old, children begin to understand the syntax and semantics of language (Spencer, Barker, & Tomblin, 2003). Phonemic awareness and phonics are also developed during this stage (Scholastic Red, 2002). Stage 2, which occurs at seven or eight years old, involves moving from decoding words while reading to becoming a fluent reader. The most crucial stage, Stage 3, involves children using reading to learn. Words are no longer simply sound-letter associations that come with meaning. Instead, the child is able to read fluently, making connections with what he or she is reading and learning new information. Due to the complexity of the following stages, Stage 3 is often the stage at which deaf children plateau. Stage 3 develops from ages eight to fourteen (Spencer et al., 2003). Stage 4, which develops from ages fourteen to eighteen, involves the individual beginning to take different perspectives into consideration while reading (Spencer et al., 2003). Critical, analytical thinking is applied to information that is read (Scholastic Red, 2002). Finally, Stage 5, which occurs around eighteen years old and continues throughout college, involves the individual analyzing and synthesizing information that he or she reads. Readers must take the information and develop individual viewpoints based on the available information in conjunction with the reader’s previous knowledge (Spencer et al., 2003). This paper is a prime example of utilizing Stage 5 because in this section, I am presenting what I’ve discovered through my research. In the Conclusion/Answering section, I will develop my own conclusions based on the information I’ve found.
According to Dalquist, approximately 75% of the school day involves listening activities that utilize the auditory channel for children in kindergarten through third grade. When hearing impaired or deaf children are taken into consideration, they are dropped off the map. After all, as Dr. Mark Ross said, “Hearing is the primary channel for learning. The more children hear, the better they learn,” (Lagotic, Hofstetter, James, & Rosenberg, 2007). When hearing impaired or deaf children do not receive any benefit from hearing aids, cochlear implants provide a hearing source (Connor & Zwolan, 2004). Cochlear implants are devices that are surgically implanted into the cochlea of people with severe to profound hearing losses. Cochlear implants bypass hair cells within the cochlea and send messages through nerve fibers to the brain so that the person is able to hear (Cole & Flexer, 2007). However, the auditory information that a child with a cochlear implant hears is much different than what a hearing person would hear. In fact, the hearing of a child with a cochlear implant is somewhat like that of a severely deaf child who uses hearing aids (Boothroyd & Boothroyd, 2002). Therefore, the challenges that a cochlear implanted child faces when he or she begins reading are tremendous.
Although the road to reading success is a difficult one for cochlear implanted children, it is possible. As stated in numerous studies, children with cochlear implants show improvements in speech perception, speech production, vocabulary, and reading comprehension after using the cochlear implant for a period of time (Connor & Zwolan, 2004). In addition, the earlier the child is implanted, the more plastic the brain will be for receiving new types of auditory input. Any language delay would also be fairly small at a younger age. This would amount in a somewhat normal development of language and literacy (Boothroyd & Boothroyd, 2002).
When implanted early in life, children can possibly have normal literacy development. Children who receive their implants before three years old have shown better vocabulary and word reading ability than children fitted after three years old (Sherman & Cruse, 2004). The younger the child is when implanted, the higher that child’s reading comprehension scores will be. Because early implantation allows the child to access speech during a critical time period for language development, the child’s language skills are stronger which in turn would create stronger reading skills (Connor & Zwolan, 2004).
In a study done by Archbold, Nikolopoulos, & O’Donoghue, age of implantation had an effect on reading ability. The children tested were implanted between 1.3 and 6.9 years old and the study was done seven years post-implantation. Of the children who were implanted between six and seven years old, 100% were reading at more than one year below the grade level. Those implanted between four and five years old had 81% reading at more than one year below the grade level. However, the children implanted between one and three years old had only 44% reading at more than one year below the grade level. The other 46% were reading within one year of their grade levels, with 10% reading more than one year ahead (Marschark, Rhoten, & Fabich, 2007).
Although the previous study showed potential for those implanted early in life, in a study performed by Geers, the results showed that implanted children are often not catching up with their hearing classmates when reading (2003). Boothroyd and Boothroyd discovered that children with implants did not have age-appropriate literacy or language skills (2002). Progress with reading is fairly slow for children with cochlear implants. The average yearly improvement for these children is one to six months for every year of education (Spencer et al., 2003). The research is somewhat variable concerning age of implantation and reading ability (Marschark et al., 2007). In fact, some studies have even proven that age of implantation has no impact on reading ability (Geers, 2003). However, as stated by Geers when concluding a study, “As implant technology continues to undergo improvement in its capacity to deliver speech and as children are being implanted at younger ages, before language delays are established, the progress for more normal acquisition of literacy may improve even more,” (2003).
Concluding/Answering
As I researched this topic, I discovered that the information varied greatly concerning age of implantation and reading ability. From the research I’ve presented, I realize that the results seem to vary depending on the experiment. However, I found more information supporting early implantation producing an improvement in reading skills. In my opinion, I think that early implantation is critical for success with cochlear implants. As I demonstrated in my research, there are five skills that are essential to develop when learning how to read: phonemic awareness, phonics, reading comprehension, vocabulary, and fluency. All of these are either directly or indirectly dependent on information received through the auditory channel. The five stages of reading development presented similar information; hearing is needed to develop reading skills that progress past Stage 3 where most deaf people plateau. The role of the cochlear implant in improving children’s hearing goes hand-in-hand with the information I have learned about beginning reading skills and stages.
I believe that age of implantation has a positive effect on reading ability in cochlear implanted children. Children who are implanted early in life produce better reading comprehension scores, vocabulary scores, and word reading scores. Earlier implanted children also have better language skills, which in turn facilitates reading development. As seen in the Archbold et al. study, the earlier a child is implanted, the closer that child gets to a normal child’s reading ability. Because the brain is still somewhat plastic when children are younger, early implantation allows the brain to reroute its pathways to fit the cochlear implant’s signals. Therefore, early intervention is absolutely necessary with cochlear implants. The earlier a child is implanted, the better that child’s future will be because he or she will be able to read and achieve just like his or her classmates.
