In this study we compared the lexical access skills of 25 deaf children with cochlear implants, 13 hard-of-hearing children and 20 children with specific language impairments (SLI). Twenty-one age-matched typically developing children served as controls. The two groups of children with hearing loss in the present study had good speech perception abilities. We used a cross-modal picture-word interference paradigm to examine the lexical access skills. Results showed that children with SLI revealed overall slower reaction times and produced more errors than the implanted children, the hard-of-hearing children, and the control children. Both groups of children with hearing loss did not reveal slower reaction times than the control children. Semantic and phonological representations in long-term memory were affected more by inadequacies in linguistic processing than by a deficit in auditory perception, suggesting that a measure of lexical access could be a suitable clinical marker for SLI identification. We recommend to differentiate between the clinical groups of children regarding the focus of their language training.

Results suggest that the underlying nature of spoken language problems in most children with CIs manifests in limited auditory perception instead of language processing difficulties. However, there appears to be a subgroup of children with CIs whose linguistic profiles resemble those of children with SLI.

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