Assessment package for language development in Japanese hearing-impaired children (ALADJIN) as a test battery for the development of practical communication.

OBJECTIVES: The measurement of language development in hearing-impaired children is an important step in assessing the appropriateness of an intervention. We proposed a set of language tests (the Assessment Package for Language Development in Japanese Hearing-Impaired Children [ALADJIN]) to evaluate the development of practical communication skills. This package consisted of communication skills (TQAID), comprehensive (PVT-R and SCTAW) and productive vocabulary (WFT), comprehensive and productive syntax (STA), and the STRAW. METHODS: A total of 638 children with greater than 70-dB hearing impairment were subjected to this set of language tests. Additional tests, including the PARS, the RCPM, and parental questionnaires, were administered to assess the backgrounds of the children. RESULTS: A trimodal distribution was observed among hearing-impaired children by the histogram-based analysis of each test. CONCLUSIONS: The ALADJIN is a useful Japanese-language evaluation kit for hearing-impaired children.

Language ability in the intermediate-scoring group of hearing-impaired children.

OBJECTIVES: Language development is a key issue in hearing-impaired children. However, interpersonal differences complicate our understanding of the situation. The bimodal or trimodal distribution of language scores in our other reports in this publication imply the presence of fundamental differences among these groups. The characteristic aspects of each group were profiled according to language data. METHODS: We divided 268 children with prelingual severe to profound hearing impairment into 3 groups according to their trimodal distribution observed on histogram-based analysis of their responses to the Test of Question-Answer Interaction Development. Test results in several language domains, including productive and comprehensive vocabulary, productive and comprehensive syntax, and academic achievement, were profiled and compared among these 3 groups. RESULTS: Significant differences were observed in the results of the Word Fluency Test, the Picture Vocabulary Test-Revised, and the Syntax Test of Aphasia among the 3 groups. No significant difference was observed between groups who were lower-scoring and intermediate-scoring on the academic achievement tests referred to as Criterion Referenced Test-II and the Standardized Comprehension Test for Abstract Words. Only the higher-scoring group showed excellent results. The demographic factors were not significantly different among the 3 groups. CONCLUSIONS: Relatively poor academic achievement despite fair language production was the dominant feature of the intermediate-scoring group. This profile might correlate with academic failure in school.

Effects of early identification and intervention on language development in Japanese children with prelingual severe to profound hearing impairment.

OBJECTIVES: Early identification and intervention for prelingual bilateral severe to profound hearing loss is supposed to reduce the delay in language development. Many countries have implemented early detection and hearing intervention and conducted regional universal newborn hearing screening (UNHS). However, the benefits of UNHS in later childhood have not yet been confirmed, although language development at school age has a lifelong impact on children's future. Our Research on Sensory and Communicative Disorders project attempted to reveal the effects of UNHS and those of early intervention on the development of verbal communication in Japanese children. METHODS: In this study, 319 children with prelingual bilateral severe to profound hearing loss, 4 to 10 years of age, were evaluated with the Test of Question-Answer Interaction Development used as an objective variable. Participation in UNHS and early intervention were used as explanatory variables. The adjusted odds ratio (AOR) was calculated after adjusting several confounding factors with use of logistic regression analysis. In addition, caregivers' answers were obtained by a questionnaire, and the process of diagnosis with and without UNHS was analyzed retrospectively. RESULTS: Early intervention was significantly associated with better language development (AOR, 3.23; p < 0.01). Participation in UNHS may contribute to better language development to some extent (AOR, 1.32), but not one that was statistically significant (p = 0.37). However, UNHS was significantly associated with early intervention (AOR, 20.21; p < 0.001). The questionnaire results indicated a lag in treatment after UNHS in more than 40% of screened cases. CONCLUSIONS: Early intervention strongly influenced language development. It is necessary to ensure that early identification leads directly to early intervention.

Language development, interpersonal communication, and academic achievement among Japanese children as assessed by the ALADJIN.

OBJECTIVES: Japanese-speaking children in a standard sample were subjected to a test battery (ALADJIN: Assessment Package for Language Development in Japanese Hearing-Impaired Children) to evaluate the effect of language development on both interpersonal communication skills and academic achievement. METHODS: A total of 414 preschool and school-age children without hearing impairment were included in this study. The following tests make up the ALADJIN: the Test of Question-Answer Interaction Development (TQAID), the Japanese Language by Criterion Referenced Test-II (CRT-II) for measuring academic achievement, the Picture Vocabulary Test-Revised (PVT-R), the Standardized Comprehension Test of Abstract Words (SCTAW), both parts of the Syntactic Processing Test for Aphasia (STA), and the Word Fluency Test (WFT). Means and standard deviations at each academic grade level were calculated, and a multiple regression analysis was performed. RESULTS: A ceiling effect was observed for the TQAID and the STA in children in grade 3 of elementary school, and the scores for the PVT-R, SCTAW, and WFT increased incrementally according to grade level. Multiple regression analysis revealed that the PVT-R, WFT, and STA (production) have predictive power for the results of the TQAID (R = 0.59; R2 = 0.58; p <0.0001), whereas the SCTAW and STA (comprehension) have predictive power for the results of the CRT-II. CONCLUSIONS: Both vocabulary and syntax are important in communication development among children. The results of our multiple regression analysis suggest that different language domains may play different roles in the development of interpersonal communication skills and in academic achievement. The development of interpersonal communication skills is largely based on productive vocabulary and syntax abilities, whereas academic achievement is largely based on comprehensive vocabulary and syntax abilities. Children who have difficulties in either area should be evaluated with detailed language assessment tools such as the ALADJIN in an effort to aid in the selection of appropriate intervention.

Syntactic development in Japanese hearing-impaired children.

OBJECTIVES: This study examined syntactic development of auditory comprehension of sentences in Japanese-speaking school-age children with and without hearing impairment. METHODS: In total, 592 preschool and school-age children (421 normal-hearing and 171 hearing-impaired) were included in this cross-sectional observation study conducted using the Syntactic Processing Test for Aphasia for Japanese language users. Linear regression analysis was used to determine the estimated age at which each syntactic structure was acquired. RESULTS: Acquisition of syntactic structures was observed in hearing-impaired and normal-hearing children. Basic word order sentences of agent-object-verb and the goal benefactive construction were acquired at preschool age (earlier group), whereas reverse word order sentences of object-agent-verb, source benefactive construction, passive voice, and relative clauses were acquired at school age (later group). The results showed that many hearing-impaired children may not acquire Japanese grammatical structures until the age of 12 years. CONCLUSIONS: Adequate screening for language development for school-age hearing-impaired children is required for an effective intervention.