Phonological Outcomes in Children Aged 6-7 Years With Bilateral Cochlear Implants

The aim of this study was to examine the phonological development of 6- to 7-year-old children using cochlear implants (CIs) and to compare the findings with normative data from typically hearing (TH) children.

The study included 30 children with bilateral CIs, aged 6 years (72-83 months; eight girls, six boys; M_age ± SD = 75.6 ± 2.8 months) and 7 years (84-95 months; seven girls, nine boys; M_age ± SD = 87.5 ± 2.9 months). Phoneme production and phonological process use were evaluated using the Bankson-Bernthal Test of Phonology. Data were analyzed for phoneme accuracy, types and frequencies of phonological processes, and differences by age group.

A total of 891 speech sound errors were identified, with 22 phonological processes suitable for statistical analysis. In the 6-year-old group, the most common process was dentalization (92.9%), while in the 7-year-old group, it was cluster simplification (87.5%). Although not statistically significant, the 7-year-old group showed fewer speech sound errors and used fewer processes than the 6-year-old group. Children with CIs made the most errors with trills, fricatives, and affricates, and the fewest with bilabial consonants (p > .05).

This study shows that children with CIs can follow a phonological development sequence similar to their TH peers, although more slowly and with more errors. The fewer speech sound errors and processes seen in the 7-year-olds suggest that the system becomes more organized as hearing age increases. Process similarities between CI users and TH children highlight the benefits of early implantation and advanced CI technology.