NARRATIVE SKILLS IN ITALIAN PRE-SCHOOL CHILDREN WITH COCHLEAR IMPLANTS. EFFECTS OF LATE LINGUISTIC EXPOSURE ON A LATE ACQUIRED DOMAIN

Children with severe/profound hearing impairment (SPHI) learning a spoken language have shown narrative development delays, although the advent of cochlear implants (CIs) significantly contributed to enhance language and the narrative ability of those children. In the present study we investigated narrative skills in 27 Italian pre-school children with SPHI (mean age = 61.44 months) fitted with CI before the age of three years and in 27 typically developing (TD) hearing children matched by age. Our goals were: i) to compare the performances of children with CI to those of TD children so to shed light on the effects of a delay in first language exposure on the early development of narrative skills and ii) to establish the linguistic predictors of early narrative skills in children with CI that could be boosted in rehabilitation programs. As for goal i), results indicated that the narratives produced by the present sample of children with CI included fewer words than those of TD children; nevertheless, the two groups of children had comparable proficiency in structuring narratives. At the group level, children with CI were impaired in the use of pronouns, even though at the individual level, some children revealed an adequate performance. Considering goal ii), the standardized test assessing lexical comprehension was a predictor of lexical abilities in a narrative context, but only in those children whose lexical ability was high. Children with CI with high lexical comprehension scores produced narratives with a richer vocabulary than children with CI with low lexical comprehension scores, although this was not the case in children with low pragmatics abilities. Considering overall narrative abilities, neither pragmatics nor grammatical abilities were predictors of the NAS score. We hypothesize that such a link will emerge at a later stage, when narratives become richer and more complex. All in all, we showed that it is important to assess narrative skills: In narratives, lexical, grammatical and pragmatics skills interact: a single impairment in one of those areas might result in impairments in some components of narratives. Moreover, as the group performance of children with CI was characterized by great variability, we suggest the necessity to consider strengths and weakness case-by-case in order to offer an efficient therapeutic intervention.