Adjective and semantic category production in children with cochlear implants and typical hearing

Early cochlear implantation has improved language outcomes in children with hearing loss. While research has mainly focused on nominal semantics, evidence suggests that children with cochlear implants (CIs) show specific difficulties in lexical domains requiring higher conceptual abstraction, such as adjectives and semantic categories, compared to children with typical hearing (TH). The aim of the present study was to explore children’s knowledge of adjectives and semantic categories in children with CIs and their TH peers. The study included 62 children aged 5 to 7 years (31 with CIs and 31 with TH). Data were collected using a picture-naming task from the speech assessment test AREPA [Aguilar, E., & Serra, M. (2003). AREPA. Anàlisi del retard de la parla: protocols per el anàlisi de la fonètica y la fonologia infantil. UB Ediciones]. Results showed that while both groups shared a parallel accuracy hierarchy – exhibiting lower performance in semantic categories than in adjectives – children with CIs scored significantly lower than their TH peers specifically in correct adjective responses. The analysis of incorrect answers revealed a distinct pattern: the CI group produced significantly more non-responses in semantic categories, reflecting accessibility difficulties, whereas their challenge with adjectives was characterised by a significantly higher rate of formal errors. Hearing age was not a significant predictor of correct responses across either domain, but it was significantly associated with a reduction in non-responses. These findings suggest distinct profiles of lexical difficulty in children with CIs, highlighting that while auditory experience reduces non-responses, naming precision may depend on qualitative language input, reinforcing the need for targeted speech-language interventions.