Background: The aim of this study was to analyze how the reading process of deaf Spanish elementary school students is affected both by those components that explain reading comprehension according to the Simple View of Reading model: decoding and linguistic comprehension (both lexical and grammatical) and by other variables that are external to the reading process: the type of assistive technology used, the age at which it is implanted or fitted, the participant's socioeconomic status and school stage.
Design: Forty-seven students aged between 6 and 13 years participated in the study; all presented with profound or severe prelingual bilateral deafness, and all used digital hearing aids or cochlear implants. Students' text comprehension skills, decoding skills and oral comprehension skills (both lexical and grammatical) were evaluated.
Results: Logistic regression analysis indicated that neither the type of assistive technology, age at time of fitting or activation, socioeconomic status, nor school stage could predict the presence or absence of difficulties in text comprehension. Furthermore, logistic regression analysis indicated that neither decoding skills, nor lexical age could predict competency in text comprehension; however, grammatical age could explain 41% of the variance. Probing deeper into the effect of grammatical understanding, logistic regression analysis indicated that a participant's understanding of reversible passive object-verb-subject sentences and reversible predicative subject-verb-object sentences accounted for 38% of the variance in text comprehension.
Conclusions: Based on these results, we suggest that it might be beneficial to devise and evaluate interventions that focus specifically on grammatical comprehension.
Keywords: Cochlear implant; Deaf children; Digital aid; Grammatical comprehension; Lexical comprehension; Text comprehension.
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