Language profile of children with cochlear implants: comparative study about the effect of age of cochlear implantation and the duration of rehabilitation.

PURPOSE: The analysis of different language domains and exploration of variables that affect the outcomes of cochlear implantation would help to document the efficacy of cochlear implantation and intervention programs. The aim of this work was to examine the language profile of children with Cochlear Implants (CI) and to assess the effect of age at the time of cochlear implantation and the impact of duration of rehabilitation on the development of linguistic abilities for cochlear implanted children. METHODS: The study was conducted on 46 Arabic speaking children using unilateral CI who are receiving regular post-cochlear auditory and language rehabilitation in the phoniatrics unit, Kasr Alaini hospital. A Proficient Preschooler Language Evaluation (APPEL TOOL) was applied for the assessment of different language domains. RESULTS: Children who received post implant rehabilitation for ≥ 2 years showed significant improvement in all subtests' scores of APPEL tool than children who received same rehabilitation for ≤ 1 year. There was no significant difference of language scores between children who have received CI before age of 3 years and those who have been implanted after age of 3 years. CONCLUSION: This study showed that the language profile of CI children was beneficially affected by the longer duration of therapy post implantation.

Pragmatic difficulties in children with Specific Language Impairment.

Most of the children having Specific Language Impairment (SLI) exhibit pragmatic difficulties that are often overlooked while their communication skills are being evaluated. Identifying pragmatic needs in such children can be lengthy and indeterminate as many of such children don't quite "fit" into a definite diagnostic category. This study aimed at identifying and clarifying the nature of pragmatic difficulties in a group of children with Specific Language Impairment by comparing their pragmatic skills with those of a group of normally developing children using a simple Pragmatic Screening protocol hoping that this would aid in reaching a better understanding of the nature of pragmatic difficulties in such children. The present study examined the pragmatic profiles of 60 age and gender matched native Cairo-Egyptian Arabic speaking children (with age range 4-6 years old). The children were divided into two groups; Group A and Group B. Group A included 30 children with normal language development whereas Group B included 30 children who had been previously diagnosed as having Specific Language Impairment. For each subject, history taking followed by audiological and psychometric evaluation to rule out the existence of any hearing difficulties or mental deficiency was performed. Afterwards, each child under study was subjected to the Arabic Pragmatic Screening tool [1]. For each child, the screening was scored by three readers; average scores were obtained and statistically analyzed. All the values obtained by the control group were found to be significantly higher than those obtained by the SLI group except for some non-verbal paralinguistic skills where non-significant differences were found between the two groups. Through the ROC curve, cut off level for Total Pragmatic Score (TPS) was found to be less than or equal to 78.16, i.e. 4-6 year old children with a TPS equal to or less than 78.16 were considered to have pragmatic difficulties. Thorough screening of pragmatic skills while evaluating the communication skills of children with specific Language Impairment should be seriously considered.

Childhood apraxia of speech and multiple phonological disorders in Cairo-Egyptian Arabic speaking children: language, speech, and oro-motor differences.

Childhood apraxia of speech is a neurological childhood speech-sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits. Children with childhood apraxia of speech and those with multiple phonological disorder share some common phonological errors that can be misleading in diagnosis. This study posed a question about a possible significant difference in language, speech and non-speech oral performances between children with childhood apraxia of speech, multiple phonological disorder and normal children that can be used for a differential diagnostic purpose. 30 pre-school children between the ages of 4 and 6 years served as participants. Each of these children represented one of 3 possible subject-groups: Group 1: multiple phonological disorder; Group 2: suspected cases of childhood apraxia of speech; Group 3: control group with no communication disorder. Assessment procedures included: parent interviews; testing of non-speech oral motor skills and testing of speech skills. Data showed that children with suspected childhood apraxia of speech showed significantly lower language score only in their expressive abilities. Non-speech tasks did not identify significant differences between childhood apraxia of speech and multiple phonological disorder groups except for those which required two sequential motor performances. In speech tasks, both consonant and vowel accuracy were significantly lower and inconsistent in childhood apraxia of speech group than in the multiple phonological disorder group. Syllable number, shape and sequence accuracy differed significantly in the childhood apraxia of speech group than the other two groups. In addition, children with childhood apraxia of speech showed greater difficulty in processing prosodic features indicating a clear need to address these variables for differential diagnosis and treatment of children with childhood apraxia of speech.