Narrative Noun Phrase Elements in Tamil-Speaking Unilateral Cochlear Implant Users and Typically Developing Children: Findings from a Secondary Analysis

This cross-sectional secondary analysis investigated syntactic complexity in narrative production among Tamilspeaking children with and without hearing impairment. Narrative retellings from 30 children aged 3 to 5 years: 15 typically developing (TD) children and 15 unilateral cochlear implant users (UCCIU), matched by language age, were re-analysed for noun phrase element (NPE) usage. In a study examining eight types of noun phrase (NPE) constructions namely determiners, possessive nouns, possessive pronouns, attributive adjectives, participial adjectives, pre-modifiers, conjunctions, and personal nouns significant differences emerged between typically developing (TD) children and children with unilateral congenital conductive hearing loss (UCCIU). The TD group demonstrated notably higher usage of determiners, attributive adjectives, pre-modifiers, and conjunctions (p < 0.01), suggesting greater syntactic elaboration in their language development. In contrast, UCCIU children showed a marked preference for personal nouns (p = 0.043), indicating a potential reduction in their complex syntactic structures. Interestingly, no significant differences were observed in the use of possessive or participial forms between the groups. These findings elucidate how auditory deprivation may adversely affect grammatical development, particularly in morpho-syntactically rich languages like Tamil. The results also imply that limited exposure to complex noun phrases could hinder narrative cohesion among UCCIU children. This study emphasizes the urgent need for tailored language interventions that foster syntactic elaboration in narrative construction, particularly in low- and middle-income contexts such as India. Furthermore, future longitudinal research is recommended to assess the efficacy of these interventions and to explore the developmental trajectories of affected children.