While normal-hearing (NH) children have already mastered oral language when they learn to read, two possible factors could influence the perception of speech sounds by children with cochlear implants (CI). First, CI children have experienced a period of hearing deprivation which might correspond to a sensitive period in language development. Second, there are several differences between electrical and auditory stimulation. These two constraints might lead to less accurate phonemic perception in CI children in comparison to NH children. Thus, we studied speech perception skills in CI children in order to assess their influence on abilities to recognize written words. The first two studies assessing phoneme perception skills showed that CI children use phonemic and lexical processing similar to NH children but with lesser efficacy. The following three studies evaluated reading skills and showed deficits in the development of reading-related skills (phonemic awareness and phonological short-term memory), the accuracy of reading procedures (sublexical and lexical procedures), and the automaticity of the activation of phonological representations in silent reading. Overall, these results suggest that CI children's difficulties in reading are due to phonemic representations that are less accurate than those of NH children. Nevertheless, the use of cued speech with CI effectively aids the acquisition of phonemic representations by promoting the development of phonemic awareness and the use of reading procedures.
