Assessment of phonological awareness in adult CI users

While phonological awareness (PA) is commonly tested in children (BAKO 1-4), there are only a few tests for adults, such as the LEMO for aphasia. The aim of the present study was to adapt the BAKO to adult CI users and to study PA with regard to p.o. speech outcome after cochlear implantation. 30 CI users aged 61.6 years (SD 13.0) with a mean CI experience of 11.4 months (SD 7.9) performed the Freiburger monosyllabic test (FET) at 65 and 80 dB and the Hochmair-Schulz-Moser sentence test (HSM) at 65 dB as well as two non-auditory tests to assess PA: 1) a newly developed adaptation of BAKO 1-4 for adults with hearing impairment, which consists of 7 subtests: (1)word segmentation, (2)vowel replacement, (3)determination of residual words, (4)phoneme mutation, (5)phoneme categorization, (6)determination of vowel length and (7)word reversal) and 2) the subtests V9 (lexical decision-making) and V18 (identification of rhymes) of the LEMO test battery. The LEMO subtests and 2 subtests of the adapted BAKO (3 and 5) were correctly answered in 84%. In contrast, (1)word segmentation was quite difficult for most CI users. The BAKO subtest (5)phoneme categorization highly correlated with the FET at 65 and at 80 dB and with the HSM (p<.05), while the subtest (6)determination of vowel length correlated only with the FET at 65 dB (p<.01). V9 and V18 correlated with the FET at 65 dB (p<.05), but not with the HSM. Phoneme identification, lexical decision-making and rhyme identification seem to be important for speech understanding after CI. Whether a phonological training in p.o. rehabilitation might improve postoperative speech outcome in CI users has to be clarified in further studies.