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) have shown narrative development delays, although the advent of cochlear implants (CIs) significantly contributed to enhance their narrative ability. 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 and in 27 typically developing (TD) hearing children matched by age. We compared the performances of children with CI and TD children to shed light on the effects of a delay in first language exposure on the early development of narrative skills, and we established the linguistic predictors of early narrative skills in children with CI that could be boosted in rehabilitation programs. The narratives produced by children with CI included fewer words than those by TD children, though with comparable proficiency in structuring narratives. At the group level, children with CI were impaired in the use of pronouns, although some children revealed an adequate performance. The standardized test assessing lexical comprehension was a predictor of lexical abilities in a narrative context only for those children with high lexical ability. Children with CI with high lexical comprehension scores produced narratives with a richer vocabulary than those with low lexical comprehension scores. Overall, neither pragmatics nor grammatical abilities were predictors of the narrative abilities score (NAS). We hypothesize that such a link will emerge later when narratives become richer and more complex. We will suggest the necessity to consider strengths and weakness case-by-case in order to offer an efficient therapeutic intervention.