Background and purpose: Hearing improvement tools like cochlear implants and hearing aids have largely helped children with hearing loss in terms of the speech production and comprehension by providing them with auditory input. The aim of this study was to investigate the phonological skills in the six-year-old children with cochlear implants and severe hearing aids and normal hearing children.

Materials and methods: This cross-sectional study was conducted in 60 six-year-old children, selected using convenience sampling. The participants were divided into three groups (n= 20 per group): cochlear implant, hearing aid, and normal hearing. The phonological processes were examined using phonological analysis. Kruskal-Wallis test and Dunn's test were used to compare the phonological skills in three groups. Additionally, the Kruskal-Wallis test (followed by the Dunn post-hoc test) was used to compare the phonological skills in these three groups.

Results: Some phonological processes, percentage of consonants correct, and concurrence between single word and connected speech in disorder group were significantly higher than those in normal hearing (P<0.05), but this difference was not significant between cochlear implanted and hearing aid users (P>0.05).

Conclusion: Generally, children with hearing loss that use cochlear implants and hearing aids could not completely accomplish all the phonetics. Therefore, they should reverie hearing and speech rehabilitation which helps them avoid further phonological problems.