The Effectiveness of Educational Intervention of Phonological Awareness on the Increase of Phonological Awareness among the Persian-Speaking Students with Cochlear Implant in First Grade of Primary Schools in Ahvaz City, Iran

Document Type : Original Articles


1 MSc Student in Speech Therapy, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Instructor, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran



Introduction: Deaf children have lost part of their language learning course due to the lack of auditory input, and in most cases, they will face with many problems in their language-learning growth. One aspects of the language is phonological awareness that can be seen as an introduction to the development of future reading; moreover, training in phonological awareness is effective on development of decoding skills. The present study aimed to investigate the effectiveness of an educational intervention of phonological awareness, on the increase of phonological awareness among the Persian-speaking students with cochlear implant in first grade of primary schools in Ahvaz City, Iran.Materials and Methods: 28 Persian-speaking children with cochlear implant were randomly assigned to equal groups of experimental and control. The students’ parents signed the formal consent form; then, the phonological awareness skill test was administered in both groups. The experimental group received the phonological awareness training, and the phonological awareness skill test was administered again in both groups.Results: After the intervention, the mean score of phonological awareness skill increased significantly in experimental group (P = 0.001). Moreover, the mean score of each phonological awareness subskill was significantly more increased in the experimental group compared to the control group (P < 0.050 for all). The intervention was most effective on segmentation skill, and least effective on awareness of the rhyme.Conclusion: The results of the study showed that the proposed phonological training program improved phonological awareness skills in children with cochlear implant. Application of this program is recommended.


  1. Schorr EA, Roth FP, Fox NA. A comparison of the speech and language skills of children with cochlear implants and children with normal hearing. Commun Disord Q 2008; 29(4): 195-210.
  2. Skarakis-Doyle E, Dempsey L. The detection and monitoring of comprehension errors by preschool children with and without language impairment. J Speech Lang Hear Res 2008; 51(5): 1227-43.
  3. Delage H, Tuller L. Language development and mild-to-moderate hearing loss: does language normalize with age? J Speech Lang Hear Res 2007; 50(5): 1300-13.
  4. Mahmoodabadi N, Soleymani Z, Khodami M, Ajalloeian M, Jalaei S. A comparative study of performance of normal and cochlear implanted children in two phonological awareness tests. J Sabzevar Univ Med Sci 2014; 20(4): 547-55. [In Persian].
  5. Geers AE, Hayes H. Reading, writing, and phonological processing skills of adolescents with 10 or more years of cochlear implant experience. Ear Hear 2011; 32(1 Suppl): 49S-59S.
  6. Rastegarianzadeh N, Shahbodaghi M, Faghihzadeh S. Study of phonological awareness of preschool and school aged children with cochlear implant and normal hearing. Korean J Audiol 2014; 18(2): 50-3.
  7. Nittrouer S, Sansom E, Low K, Rice C, Caldwell-Tarr A. Language structures used by kindergartners with cochlear implants: relationship to phonological awareness, lexical knowledge and hearing loss. Ear Hear 2014; 35(5): 506-18.
  8. Narimani M, Nori R, Abolghasemi A. Comparison of the effectiveness of phonological awareness strategies and Fernald multi-sensory to improve reading skill and comprehension of dyslexia students. Journal of Learning Disabilities 2015; 4(3): 104-20. [In Persian].
  9. Stackhouse J, Wells B. Children's speech and literacy difficulties: A psycholinguistic framework. London, UK: Whurr; 1997.
  10. Moradi MR, Faramarzi S, Abedi A. The efficacy of phoneme plays on reading performance of dyslectic boy students. Knowledge and Research in Applied Psychology 2014; 15(1): 44-51. [In Persian].
  11. Goodman KS. Why whole language is today's agenda in education. Language Arts 1992; 69(5): 354-63.
  12. Alipour A, Karimi Torkadah T, Zandi B, Yazdanfar M. The effectiveness of phonological awareness training on phone awareness skills, unmeaningful word reading and speed of reading in boys with dyslexia. Journal of Exceptional Children 2012; 11(4): 343-52. [In Persian].
  13. Pirzadi H, Ghobari-Bonab B, Shokoohi-Yekta M, Yaryari F, Hasanzadeh S, Sharifi A. The impact of teaching phonemic awareness by means of direct instruction on reading achievement of students with reading disorder. Audiology 2012; 2(1): 83-93. [In Persian].
  14. Mohseni Z. Developing a program for training phonological awareness and study of its effectiveness on phonologicl awareness skills of children with Down syndrome [MSc Thesis].Tehran, Iran: University of Social Welfare and Rehabilitation Sciences; 2014. [In Persian].
  15. Tyler AA, Gillon G, Macrae T, Johnson RL. Direct and indirect effects of stimulating phoneme awareness vs. other linguistic skills in preschoolers with co-occurring speech and language impairments. Top Lang Disord 2011; 31(2): 128-44.
  16. McNeill BC, Gillon GT, Dodd B. Effectiveness of an integrated phonological awareness approach for children with childhood apraxia of speech (CAS). Child Language Teaching and Therapy 2009; 25(3): 341-66.
  17. McConkey RA, Koch DB, Osberger MJ, Zimmerman-Phillips S, Kishon-Rabin L. Effect of age at cochlear implantation on auditory skill development in infants and toddlers. Arch Otolaryngol Head Neck Surg 2004; 130(5): 570-4.
  18. Zwolan TA, Ashbaugh CM, Alarfaj A, Kileny PR, Arts HA, El-Kashlan HK, et al. Pediatric cochlear implant patient performance as a function of age at implantation. Otol Neurotol 2004; 25(2): 112-20.
  19. Tye-Murray N, Spencer L, Woodworth GG. Acquisition of speech by children who have prolonged cochlear implant experience. J Speech Hear Res 1995; 38(2): 327-37.
  20. Flipsen P, Jr. Intelligibility of spontaneous conversational speech produced by children with cochlear implants: a review. Int J Pediatr Otorhinolaryngol 2008; 72(5): 559-64.
  21. Spencer LJ, Tomblin JB. Evaluating phonological processing skills in children with prelingual deafness who use cochlear implants. J Deaf Stud Deaf Educ 2009; 14(1): 1-21.
  22. Geers AE, Nicholas JG, Sedey AL. Language skills of children with early cochlear implantation. Ear Hear 2003; 24(1 Suppl): 46S-58S.
  23. Svirsky MA, Robbins AM, Kirk KI, Pisoni DB, Miyamoto RT. Language development in profoundly deaf children with cochlear implants. Psychol Sci 2000; 11(2): 153-8.
  24. Tomblin JB, Spencer L, Flock S, Tyler R, Gantz B. A comparison of language achievement in children with cochlear implants and children using hearing aids. J Speech Lang Hear Res 1999; 42(2): 497-509.
  25. Hasanzadeh S, Minaei A. Adaptation and Standardization of the test of TOLD-P: 3 for Farsi-speaking children of Tehran. Journal of Exceptional Children 2002; 1(2): 119-34. [In Persian].
  26. Ghasisin L, Ahmadi T, Mostajeran F, Moazam M, Derakhshande F. Evaluating the reliability and validity of phonetic information test in normal 3-6 year-old children of Isfahan city. J Res Rehabil Sci 2013; 9(2): 153-60. [In Persian].
  27. Kennedy EJ, Flynn MC. Training phonological awareness skills in children with Down syndrome. Res Dev Disabil 2003; 24(1): 44-57.
  28. Goetz K, Hulme C, Brigstocke S, Carroll JM, Nasir L, Snowling M. Training reading and phoneme awareness skills in children with Down syndrome. Read Writ 2008; 21(4): 395-412.
  29. van Bysterveldt AK, Gillon GT, Moran C. Enhancing phonological awareness and letter knowledge in preschool children with Down syndrome. International Journal of Disability, Development and Education 2006; 53(3): 301-29.
Volume 13, Issue 4 - Serial Number 4
October 2017
Pages 209-215
  • Receive Date: 05 July 2017
  • Revise Date: 19 April 2024
  • Accept Date: 22 May 2022