How Much Does Syntactic Complexity Contribute to the Oral Narrative Performance of Prelingually Deaf Mandarin-Speaking Children With Cochlear Implants?

Purpose: This study aimed to examine the discourse-level syntactic complexity of school-age Mandarin-speaking children with cochlear implants (CIs) and its relationship with their oral narrative performance. Method: Oral narrative samples were spontaneously elicited from 34 school-age CI children and 34 normal-hearing (NH) controls through a picture description task. Subjective evaluation was conducted to assess oral narrative performance, focusing on discourse and articulation domains. Discourse-level syntactic complexity was quantified through fine-grained linguistic and cognitive measurements. Random forest regression was finally employed to determine the relative contributions of syntactic complexity to oral narrative performance. Results: School-age CI children typically exhibited marked delays in oral narrative performance, with uneven development across language and speech. Moreover, discourse-level syntactic complexity posed intertwined linguistic and cognitive challenges for them. At the macro level, they produced notably shorter and fewer utterances yet demonstrated relative strength in syntax diversity; at the micro level, they exhibited lower syntax density, an arbitrary overuse of the cohesive device "ranhou" (then), and limited cognitive resources for constructing hierarchically structured long utterances. These atypical syntactic patterns persisted even after statistically controlling for hearing age. Finally, CI children demonstrated a much stronger syntax-narrative link than their NH peers, with short syntactic units and coordinate structures as key contributors to their oral narrative performance, an adaptive strategy for managing cognitive-linguistic demands at the discourse level. Conclusion: Discourse-level syntactic complexity played a crucial role in predicting the oral narrative performance of school-age Mandarin-speaking CI children, highlighting the need for tailored, syntax-focused interventions in oral discourse. [ABSTRACT FROM AUTHOR]