Passive sentence comprehension difficulties and its related factors in children with cochlear implants

Objectives: The purposes of this study were to investigate which syntactic structures, from active and passive sentences, sensitively differentiate children with cochlear implants (CIs) from children with normal hearing (NH), to explore the correlations among working memory (WM) and other factors for each group, and to examine predictors of the active and passive sentence scores for both groups. Methods: Twenty deaf children with CIs and 20 children with NH, aged 8–14 years, were included in this study. Sentence comprehension skills were measured using the picture-pointing comprehension task, which consisted of active and passive sentences. The WM capacity was tested by the digit forward, digit backward, word forward, and word backward span tasks. Results: Passive sentence type was a significant predictor to differentiate between the two groups (p <.05). In the CI group, passive sentence scores were significantly correlated with age, duration of an implant use, receptive vocabulary scores, and WM scores (all p values <.05). In the stepwise regression analysis, WM capacity was a significant factor in predicting the passive sentence scores of children with CIs (p <.05). Conclusion: Passive sentence type was a significant factor in distinguishing the CI group from the NH group. The WM capacity was an important predictor accounting for individual differences in processing complex sentence types for children with CIs. The results indicate that a complex syntactic form may serve as a clinically critical index in detecting higher-level cognitive and linguistic processing difficulties in good performers after implantation.