The conversational skills of school-aged children with cochlear implants

Children with cochlear implants have been shown to have language skills on a par with children with severe hearing losses who have hearing aids. Earlier implants, bilateral implantation, and focused intervention programmes may result in some children with cochlear implants displaying similar language skills to their hearing peers. The development of pragmatic skills is central to communication competence and underpins the development of friendships. Although some studies of pragmatic skills in children with cochlear implants have been reported, most have used a contrived referential communication task rather than free conversation. Method: This study investigated the conversational skills of 20 children with cochlear implants, aged between 9 and 12 years, in free conversation with their hearing peers. The pragmatic skills of these 20 deaf/hearing pairs or dyads were compared with the pragmatic skills of 20 hearing/hearing dyads. Pragmatic skills were analysed in terms of conversational balance, conversational turn types, and conversational maintenance. The impact of the participants’ level of speech intelligibility was also investigated. Results: Children with cochlear implants tend to dominate conversations with their hearing peers. They initiated more topics, took longer turns, asked more questions, and tended to make more personal comments while their hearing friends tended to use more conversational devices and minimal answers. In contrast, pairs of matched hearing children were very balanced in all of these aspects of conversation. Speech intelligibility did not appear to impact consistently on the pragmatic skills of the children with cochlear implants but all children had a relatively high level of speech intelligibility. Discussion: Rather than being characterized by frequent conversational breakdown as in older studies, children with cochlear implants had a strong grasp of basic conversational rules. They conversed in a similar way to some deaf adults who also have been shown to take control of the conversation. Findings are discussed for their implications for intervention and future research.