Assessment of Behavioral Problems in Children Pre- and Post-Cochlear Implant: An Egyptian Study.

OBJECTIVE: The present study aimed to detect the behavioral problems pre- and post-cochlear implantation in comparison to normal hearing group to be able to manage these problems to get more benefit from using cochlear implants. METHODS: A case-control study included 53 children was done. They were divided into 2 groups, the control group included 28 healthy volunteers with normal hearing and the case group included 25 children with severe to profound hearing loss, fitted for cochlear implantation. The Arabic Child Behavior Checklist (CBCL) was used to detect different behavioral problems in both groups. Case group children were followed up and reassessed again by CBCL 3 months later after cochlear implantation. RESULTS: There were highly significant differences regarding total scores of internalizing and externalizing domains of empirically based CBCL between the control group and the case group after cochlear implants (p=0.001). There were non-significant differences in children within case group (pre- and post-cochlear implantation) regarding emotional and behavioral problems on both empirically based and Diagnostic and Statistical Manual of Mental Disorders-based CBCL. CONCLUSION: For better results, it is necessary to include a specialist of psychosomatic medicine in the cochlear rehabilitation teamwork.

A New Perspective of Attention Deficit Hyperactivity Disorder Associated With Delayed Language Development: An Egyptian Sample.

OBJECTIVE: The current study aimed to get an easy objective method to detect attention deficit hyperactivity disorder (ADHD) by investigating the simple inflammatory blood ratios platelet/lymphocyte ratio (PRL), neutrophil/lymphocyte ratio (NLR) & the monocyte/lymphocyte ratio (MLR), for the sake of receiving early management to such cases and overcoming language affection as a comorbid symptom. METHODS: This study was conducted on two groups: Group 1 (SG) consisted of 70 ADHD children who had delayed language development (DLD), freshly diagnosed, according to DSM-V criteria, and those patients were not on medical treatment. Group 2 healthy group (HG) consisted of 44 healthy control normal children that were both physically and mentally free of the same socio-demographic characters of the first group. RESULTS: The PLR, NLR and MLR, were significantly higher in the ADHD group than the healthy control group (HG) group, although the simple blood indices were average. CONCLUSION: Inflammation has a role as a comorbid cause of ADHD. Simple blood inflammatory mediators may be used as comorbid factors in ADHD. This study explained that the language abilities must be taken in consideration when assessing children with ADHD. The screening tools for inflammatory markers are important when dealing with ADHD children with/ without delayed language development (DLD). Also, working memory assessment is mandatory in ADHD with DLD to assign a special program in language therapy for each child.

Morphosyntactic profile of Egyptian children after 5 years of using unilateral cochlear implants.

OBJECTIVE: to assess the morphosyntactic aspect of language in Egyptian children after 5 years of using unilateral cochlear implants and studying the factors that affect their progress: the chronological age, the age of implantation, the gender, and the duration of using cochlear implant. Also, to assess which of the subcategories of the morphosyntax are affected to help in designing a suitable rehabilitation program. MATERIALS AND METHODS: 36 Egyptian children using unilateral cochlear implants regularly were enrolled in this cross-sectional study. During the assessment, the chronological age of all children was ranged from 6 years, 7 months to 11 years, 9 months, the duration of using cochlear implants of all children was at least 5 years. The morphosyntactic aspect of language as a part of the REAL scale (Receptive Expressive Arabic Language Scale) was applied by expert Phoniatricians. RESULTS: Morphosyntactic score was affected negatively by the chronological age, on the other hand, it was not affected by the age of implantation, the gender, or the duration of using cochlear implant. CONCLUSION: After 5 years of regular rehabilitation of Egyptian children using unilateral cochlear implants, the morphosyntactic profile can be described as still low compared to normal children. These children have developed many items in morphosyntactic aspects like possessiveness, derivative adjectives, and passive tense but still have a defect especially in male plural formation, past tense, adjectives, and irregular plural formation.