Pragmatic abilities of children with hearing loss using cochlear implants or hearing aids compared to hearing children

This study characterized the profile of pragmatic abilities among 24 children with hearing loss (HL) aged 6.3-9.4 years, 13 using hearing aids (HAs) and 11 using cochlear implants (CIs), in comparison to those of 13 hearing children with similar chronological and language ages. All the children with HL used spoken language, attended regular schools, and received communication therapy twice a week. They had no disabilities other than the HL. We assessed pragmatic abilities using the pragmatic protocol of C. A. Prutting & D. M. Kirchner (1987. A clinical appraisal of the pragmatic aspects of language. Journal of Speech and Hearing Disorders, 52, 105-119), which includes verbal, nonverbal, and paralinguistic aspects. Findings showed that children with HL used varied pragmatic functions but revealed more incidents of inappropriate use of the different abilities, compared to hearing children. Intergroup differences were significant only for verbal parameters. No differences emerged between children who used CIs vs. HAs. It seems that the CI group had the same pragmatic abilities as severe HA children. The different or less effective pragmatic abilities of children with HL may be explained by less flexible use of language structures, difficulties in theory of mind, difficulties in auditory perception of spoken language, and less exposure to varied pragmatic situations and strategies. Results indicated the need to incorporate pragmatic communication abilities into rehabilitation programs.