Project members Birgitta Sahlén, Magnus Lindgren, Susanne Schötz, Marianne Ors, Cecilia Nakeva von Mentzer  (doctoral candidate at HEAD, Linköping financed by FAS), Inger Uhlén, Karolinska Institutet, Björn Lyxell, Linköping University, Sweden.

Aim of project

To study feasibility and effectiveness of a computer-based intervention program for deaf and hard of hearing (DHH) children using cochlear implants, CI(s), hearing aids, HAs, or a combination of both, by means of behavioral tests and Event Related Potentials (ERP) measures. The program (Graphogame) was originally developed by prof Heikki Lyytinen , University of Jyväskylä for children with dyslexia. It has been translated and adapted to Swedish by Schötz/Sahlén. Our hypothesis is that by strengthening the correspondence between phonemes and graphemes, DHH children will develop their phonological skills.

Very few intervention studies are reported for DHH children in general, and for children with CI in particular. Ten years of research in the area of paediatric cochlear implants by Sahléns (Lund university) and Lyxells groups (Linköping university) point in the same direction: Phonology is particularly vulnerable in children with CI. This may explain why early, fairly good, reading skills in this group seem to plateau when the children reach their teens.  The orthographic reading strategies may lead to ‘resilient’ reading in adolescence.  Data from 32 DHH children using CI(s) or HAs and 16 children with normal hearing (NH), using the Graphogame, has been collected as well as data from children with NH not participating in the intervention. Currently ERP-data are analyzed from pre- and post intervention. Follow-up testings has started in fall 2013.

The intervention program is an evidence–based tool originally developed for children with dyslexia. It provides highly repetitive and individualized intervention in which the child matches auditory targets (phonemes or spoken words) with visual targets (graphemes or written words). Cecilia Nakeva von Mentzer will complete her thesis June 2014. Results so far reveal positive effects on accuracy of phoneme-grapheme correspondence for all children and a significant positive change on phonological processing skills for DHH children with weak initial phonological processing abilities. Analyses indicate that DHH children display a heterogeneous pattern of results, specifically with respect to their performance on the phonological processing tasks. Analysis of their performance at different levels of phonological processing indicates that weak initial phoneme discrimination was the only significant predictor of phonological change. Analysis of children’s reading ability shows that the intervention program has proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children.

Nakeva von Mentzer, C., Lyxell, B. Sahlén, B. Wass, M., Lindgren, M. Ors, M., Kallioinen, P., Engström, E. & Uhlén, I. (2012). Datorbaserad fonologisk intervention för barn med cochleaimplantat (CI) och/eller hörapparat (HA) – effekter på fonologiska färdigheter. Logopednytt, 3, 18- 23.

Nakeva von Mentzer, C., Lyxell, B., Sahlén, B., Wass, M., Lindgren, M., Ors, M., & Uhlén, I. (2013). Computer-assisted training of phoneme-grapheme correspondence for children who are deaf and hard of hearing: Effects on phonological processing skills. International Journal of Pediatric Otorhinolaryngology. doi: 10.1016/j.ijporl.2013.10.007

Nakeva von Mentzer, C., Lyxell, B. Sahlén, B. Dahlström, Ö., Lindgren, M. Ors, M., Kallioinen, P. & Uhlén, I. (2013). Ljudinriktad läsintervention vid datorn för barn med cochleaimplantat (CI) och/eller hörapparat (HA) – läsförändring och kognitiva faktorer. Logopednytt 4, 18-23.

Nakeva von Mentzer, C., Lyxell, B. Sahlén, B. Dahlström, Ö., Lindgren, M. Ors, M., Kallioinen, P. & Uhlén, I. (2013). Computer-assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids. Manuscript under review.

Nakeva von Mentzer, C., Lyxell, B. Sahlén, B. Dahlström, Ö., Lindgren, M. Ors, M., Kallioinen, P. & Uhlén, I. (2013). Predictors of phonological change in deaf and hard of hearing children who use cochlear implants or hearing aids. Submitted.

Nakeva von Mentzer, C., Lyxell, B. Sahlén, B. Dahlström, Ö., Lindgren, M. Ors, M., Kallioinen, P. & Uhlén, I. (2013). The role of phonology: Nonwords’ segmental and suprasegmental properties, associations to nonword decoding in children with normal hearing and children with cochlear implants. Manuscript.