Paragraph-reading comprehension ability in Mandarin-speaking children with cochlear implants

Che Ming Wu*, Li Ang Lee, Wei Chieh Chao, Yung Ting Tsou, Yen An Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

6 Scopus citations


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 (R2 = 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.

Original languageEnglish
Pages (from-to)1449-1455
Number of pages7
Issue number6
StatePublished - 01 06 2015

Bibliographical note

Publisher Copyright:
© 2014 The American Laryngological, Rhinological and Otological Society, Inc.


  • Mandarin Chinese
  • Paragraph-reading comprehension
  • cochlear implant
  • deafness


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