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PubMedDate not supplied

[Developmental aspects of oral language in craniosynostosis].

BACKGROUND: Aspects of language development in craniosynostosis. Craniosynostosis (premature fusion of the cranial sutures) has an incidence of 0.4 to 1/1000 newborns. Etiology for this congenital anomaly includes environmental and genetic factors. Regarding the form of presentation, it can occur in its isolated form or associated to other congenital anomalies. For this last group, acrocephalosyndactilies are observed. These are genetically determined conditions which present phenotypic similarity, including the following syndromes: Saethre-Chotzen, Apert, Crouzon e Pfeiffer. As all of these conditions affect the craniofacial development, it is possible to find anatomic and functional interferences which determine language delays and/or deficits. AIM: To revise the literature concerning aspects related to normal verbal language development and to describe the main characteristics associated to this condition in children who present Apert, Crouzon, Pfeiffer and Saethre-Chotzen syndromes. A systematic review on syndromic craniosynostosis and oral language was performed, consulting Medline, Lilacs and other important references on this theme. CONCLUSION: Several manifestations related to hearing and language have been detected in individuals with syndromic craniosynostosis. The most important are alterations in the sound conduction system, leading to hearing losses, and consequently interfering in language acquisition and development. For this reason, speech-language diagnosis and early intervention are recommended in order to eliminate or minimize damages in language acquisition and development.

Child↗
PubMed2001

Auditory development and hearing evaluation in children.

This chapter provides an overview of (1) developmental timetables relevant to hearing, and (2) current pediatric audiological techniques and practices. Structural and functional development of the auditory pathway and the development of primary auditory processing are summarized. These developmental sequences appear to follow similar paths in humans and animals. Speech and music perception involve more complex processing and are strongly influenced by experience. Hearing disorders affect the perception of complex sounds in a variety of ways, depending on the sites of lesions. Early-onset hearing impairment, including conductive loss from chronic otitis media, can seriously impede language development. Language cannot develop normally without adequate speech stimulation, and deafness is more prevalent than any other handicapping condition for which mandated neonatal screening programs exist. Sensitive and inexpensive techniques are available for performing neonatal hearing screening, and early intervention has a documented positive effect on development of language skills in hearing-impaired children. Thus, the National Institutes of Health has recommended nationwide universal neonatal hearing screening. The rationale for and the methodology of universal screening programs are summarized. Advances in the genetics of hearing impairment are reviewed. Data from these studies have influenced testing and rehabilitative protocols and have implications for future prevention and treatment of hearing impairment.

Acoustic Impedance Tests↗
PubMed2004

The impact of child maltreatment on expressive syntax at 60 months.

Although child maltreatment has often been described as leading to language deficits, the few well-controlled investigations of language acquisition in maltreated children have focused on language content rather than form, or have used qualitative rather than quantitative measures. This study examines syntactic complexity in 19 maltreated and 14 nonmaltreated preschool-aged children. Mother-child dyads participated in play sessions that were transcribed and scored for the presence of morphosyntactic forms in child speech and for specific sentence constructions in maternal speech. Findings indicated that child maltreatment was associated with language delay in both vocabulary and production of syntactic structures. There were also qualitative differences in characteristics of maternal utterances between maltreating and comparison groups. Because maltreatment initially occurred before age 2, this study highlights the long-lasting negative influence of maltreatment on language development and also provides the first demonstration of child language delays and differences in maternal speech within a single maltreatment sample.

Child Abuse↗
PubMed2005

Adoption age effects on english language acquisition: infants and toddlers from China.

Children adopted from China represent the single largest group of internationally adopted children in this country. Because the adoptive families typically do not speak any Chinese language or dialect, most of these children experience an abrupt shift in their language environment. How age of adoption affects the course of English language development of children adopted from China is the focus of this study. All of the children in this study were either infants or toddlers at the time of adoption and all came from the same orphanage. The results showed that the older children (toddlers) were at both an advantage and a disadvantage when it came to English language development. The advantage of being older was that they learned faster. The disadvantage of being older was that there was more for them to learn to become age-appropriate in their English language development. There was, however, no evidence to suggest that the language switch from a Chinese- to an English-language environment was a formidable obstacle for either the infants or the toddlers.

Adoption↗
PubMed1989

Psychological linguistics: implications for a theory of initial development and a method for research.

Presented here are an hypothesis of language development and a description of a method for studying language, both based on Kantor's psychological linguistics. According to our hypothesis, language develops in four stages. In the first, which spans the first 9 to 15 months, random movements evolve into body management, manual, and locomotor skills that enable an infant to engage in play activities, among other things, with the mother and others. Simple gestural communication soon follows. Random babbling progresses beyond the sounds that are more universal in the language to the family's particular pattern of intonations and inflections, and receptive speech begins, that is, the infant learns to react to simple verbal-vocal requests. During the second stage, which coincides with the child's second year, vocalizations evolve into "idiosyncratic expressions" and rough approximations of heard sound patterns. Language is now holophrastic--one-word utterances--mostly of the mediative variety. During the third stage, which extends to about 30 months of age, language skills are described as first-approximation referential interactions: they are longer and more detailed, include some narrative interchanges, and refer to past and future events. Typically the child now talks to him or herself, or engages in expressive referential interactions. In the fourth stage, when the child reaches the age of 52 months or so, second-approximation speech begins. By now the vocal apparatus is sufficiently developed to enable a child to make most of the vowel sounds, and the enhanced language skills set the occasion for more frequent linguistic interchanges. He or she also begins to respond to symbols and other representations of objects and events. In other words, he or she begins to engage in symbolizing behavior. Language obviously continues to develop beyond the fourth stage. Social conditions outside of the family further affect language style and generate specialized forms of speech, notably the jargon of a particular occupation or hobby. The method for studying language interactions involves, through the use of TV tapes, a description of the behavior of a speaker and the listener, the referent, and the setting conditions. The behavior of a speaker is analyzed in terms of the frequency with which he or she begins a language interchange, the average length of the initiation, the modality (verbal-vocal, gestural, or both) and the accompanying behavior. It is also analyzed for content, including time frame, actuality, and persons, animals, objects, activities, and others. Noted, too, are the feeling reactions regarding the referents.(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗
PubMed1999

In the long run...longitudinal studies of psychopathology in children. Committee on Child Psychology. Group for the Advancement of Psychiatry. Report no.143.

Longitudinal studies are difficult to do well. Too short a study and the results may be meaningless. Too long a study and the subjects cannot be found, money runs out, and research methods become seriously out of date. Despite these problems, there have been some longitudinal studies done that have greatly advanced our understanding of the nature and the treatment of psychopathology in childhood. Without these studies, much less would be known about the clinical course of important disorders, the effects of treatments, and the various risk and protective factors. None of these studies has been perfect. Some longitudinal studies did not focus on quite the right questions, some produced contradictory results, and others produced results that were hard to interpret. What have we learned from the longitudinal studies reviewed in this Group for the Advancement of Psychiatry (GAP) report? Many of the things that we have learned have been surprising--even counterintuitive. Pre- and perinatal insults need not necessarily lead to serious consequences in later life. Premature infants, if raised in nondeprived settings, are not likely to be mentally retarded or learning disabled. Today, of course, premature infants who would not have been kept alive 15 years ago are surviving. Will this advancement led to an untoward outcome? We do not know. New longitudinal studies need to be done. Certain serious illnesses emerging later in childhood may be associated with a greater risk of psychopathology. This risk is true at least for those with asthma. Psychological factors, such as psychological stress, also may lead to exacerbation of asthmatic attacks. Whether other illnesses are associated with a greater risk of psychopathology simply has not been studied adequately. Infant temperamental characteristics can be classified and measured; however, they appear to predict little in terms of later personality development or psychopathology. Although temperamental characteristics measured in infancy correlate poorly with temperamental characteristics measured at age 4 or 5 years, they appear to be much more stable and correlate well with temperament at ages 8 and 12 years. Some of these temperamental characteristics, particularly aggressivity and negativity at age 5 years, are serious risk factors for behavioral psychopathology at age 8 or 12 years and, possibly, at later ages as well. Aggressive, negative 5-year-olds do not necessarily grow out of their problems. Their problems are important and should be dealt with when children are age 5 years. What does appear important is early language development. Delays in language development or developmental language disorders are risk factors for later psychopathology. Fifty percent of school-age children with language problems requiring speech and language therapy also have diagnosable psychopathology. Hyperactivity and short attention span are characteristics that tend to persist in later childhood--even adulthood. Alone, each of these characteristics may not be a risk factor for later psychopathology, but, when accompanied by oppositional behavior and conduct disorder, the outcome is detrimental to the child. Many studies have shown that children with these comorbid problems are at risk later for becoming delinquent and antisocial. Conduct disorder in childhood, which is much more common in males, is a risk factor for later delinquency, even if it is not associated with hyperactivity. Again, early intervention is important. The effects of comorbidity in this instance can be serious. Comorbidity in general, especially as children grow older, leads to adverse social, academic, and psychopathological outcomes. Depression does occur in children, in all of its adult manifestations. Mania, in contrast, is rarely seen in children younger than age 12 years. Depression in school-age children can be severe or mild. In contrast to adolescents with depression, depressed children are most likely to have somatic compla

Adolescent↗
PubMed1978

Behavior, language, and development in three-year-old children.

An epidemiological study of 3-year-old children showed there to be a marked association between behavior problems and language delay. Behavior problems were present in 14% of a random sample of 705 children, whereas 59% of 22 children with language delay had such problems. Data obtained from a battery of developmental tests were analyzed to examine the differences between children with behavior problems, matched controls, and children with language delay. It was found that children with behavior problems scored significantly lower on these tests, particularly those concerned with language. There were no significant differences in test scores between children with language delay only and those with combined behavior problems and language delay.

Child Behavior↗
PubMed1978

Maternal speech to normal and Down's syndrome children matched for mean length of utterance.

The study was designed to provide data on the maternal linguistic environments of normal and Down's syndrome children at three levels of language development, as assessed by children's mean length of utterances (MLU). The three MLU levels were 1.00--1.50, 1.75--2.25, and 2.50--3.00, respectively. The subjects were 21 Down's syndrome children and their natural mothers and 21 normal children and their natural mothers. Normal children ranged in chronological age from 20 to 32 months and Down's syndrome children from 3 to 12 years. A one-hour verbal interaction between mother and child was tape recorded at home in a free-play situation. Maternal speech was analyzed using 20 measures related to its output-numerical, lexical, syntactical, semantic-structural, semantic-pragmatic, and language-teaching aspects. Additionally, eight measures of children's speech related to the output-numerical, lexical, syntactical semantic-structural aspects, and to imitativeness of maternal speech were computed as a means of testing the validity of the MLU-matching that forms a basis for this study. Except for the Type-token ratio, which favored Down's syndrome children, normal and Down's syndrome children were not found to differ. In contrast, there were numerous differences between the children in the different aspects of speech considered according to language level. None of the comparisons made of mother's speech to normal and to Down's syndrome children led to differences for any of the three children's language levels studied. It appeared that the maternal linguistic environments of language-learning Down's syndrome and normal children of corresponding MLU were similar in most respects. In contrast, there were numerous differences in mother's speech according to the language level of the children addressed. This confirmed that the expressive language level of the children is a far more powerful factor in influencing maternal speech than whether they are normal or Down's syndrome children. The implications of these findings were related to the delay-difference question in the language development of Down's syndrome children and to various interpretations of the effects of maternal linguistic input for language development and for intervention programs of language enhancement in the Down's syndrome child.

Adult↗
PubMed2005

Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children.

BACKGROUND: Otitis media with effusion (OME), or 'glue ear', is very common in children, especially between the ages of one and three years with a prevalence of 10% to 30% and a cumulative incidence of 80% at the age of four years. OME is defined as middle ear effusion without signs or symptoms of an acute infection. OME may occur as a primary disorder or as a sequel to acute otitis media. The functional effect of OME is a conductive hearing level of about 25 to 30 dB associated with fluid in the middle ear. Both the high incidence and the high rate of spontaneous resolution suggest that the presence of OME is a natural phenomenon, its presence at some stage in childhood being a normal finding. Notwithstanding this, some children with OME may go on to develop chronic otitis media with structural changes (tympanic membrane retraction pockets, erosion of portions of the ossicular chain and cholesteatoma), language delays and behavioural problems. It remains uncertain whether or not any of these findings are direct consequences of OME. The most common medical treatment options include the use of decongestants, mucolytics, steroids, antihistamines and antibiotics. The effectiveness of these therapies has not been established. Surgical treatment options include grommet (ventilation or tympanostomy tube) insertion, adenoidectomy or both. Opinions regarding the risks and benefits of grommet insertion vary greatly. The management of OME therefore remains controversial. OBJECTIVES: To assess the effectiveness of grommet insertion compared with myringotomy or non-surgical treatment in children with OME. The outcomes studied were (i) hearing level, (ii) duration of middle ear effusion, (iii) well-being (quality of life) and (iv) prevention of developmental sequelae possibly attributable to the hearing loss (for example, impairment in impressive and expressive language development (measured using standardised tests), verbal intelligence, and behaviour). SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to 2003), EMBASE (1973 to 2003) and reference lists of all identified studies. The date of the last systematic search was March 2003, and personal non-systematic searches have been performed up to August 2004. SELECTION CRITERIA: Randomised controlled trials (RCTs) evaluating the effect of grommets on hearing, duration of effusion, development of language, cognition, behaviour or quality of life. Only studies using common types of grommets (mean function time of 6 to 12 months) were included. DATA COLLECTION AND ANALYSIS: Data from studies were extracted by two reviewers and checked by the other reviewers. MAIN RESULTS: Children treated with grommets spent 32% less time (95% confidence interval (CI) 17% to 48%) with effusion during the first year of follow-up. Treatment with grommets improved hearing levels, especially during the first six months. In the randomised controlled trials that studied the effect of grommet insertion alone, the mean hearing levels improved by around 9 dB (95% CI 4 dB to 14 dB) after the first six months, and 6 dB (95% CI 3 dB to 9 dB) after 12 months. In the randomised controlled trials that studied the combined effect of grommets and adenoidectomy, the additional effect of the grommets on hearing levels was improvement by 3 to 4 dB (95% CI 2 dB to 5 dB) at six months and about 1 to 2 dB (95% CI 0 dB to 3 dB) at 12 months. Ears treated with grommets had an additional risk for tympanosclerosis of 0.33 (95% CI 0.21 to 0.45) one to five years later. In otherwise healthy children with long-standing OME and hearing loss, early insertion of grommets had no effect on language development or cognition. One randomised controlled trial in children with OME more than nine months, hearing loss and disruptions to speech, language, learning or behaviour showed a very marginal effect of grommets on comprehensive language. AUTHORS' CONCLUSIONS: The benefits of grommets in children appear small. The effect of grommets on hearing diminished during the first year. Potentially adverse effects on the tympanic membrane are common after grommet insertion. Therefore an initial period of watchful waiting seems to be an appropriate management strategy for most children with OME. As no evidence is yet available for the subgroups of children with speech or language delays, behavioural and learning problems or children with defined clinical syndromes (generally excluded from the primary studies included in this review), the clinician will need to make decisions regarding treatment for such children based on other evidence and indications of disability related to hearing impairment. This review does not resolve the discrepancy between parental and clinical observation of a beneficial treatment effect and the results in the reviewed RCT showing only a short-term effect on hearing and virtually no effect on development. Is the perceived, often dramatic, effect of grommets only a short-term one? Are some children more sensitive to OME-related hearing loss than others? If so, how do we identify them?Further research should focus upon indications. Studies should use sufficiently large sample sizes to show significant interactions. There is a need to determine the most suitable variables and appropriate "softer" outcomes to be the subject of these interaction tests. Interesting options include measures of speech-in-noise and binaural hearing. The generally modest results in the trials which are included in this review should make it easier to justify randomisation of more severely affected and higher-risk children in appropriately constructed trials. Randomised controlled trials are necessary in these children before more detailed conclusions about the effectiveness of grommets can be drawn.

Child↗
PubMed2001

Supporting communication in young children with developmental disabilities.

The behavior of parents, adult caregivers, and peers comprises the critical features of community support for the development of communication in young children with developmental disabilities. In a bio-ecological model of development, communication development is the result of the interactions of individuals with specific characteristics, in particular contexts over time. From the perspective of this model, foundational findings of intervention research to current views of communication development in children with developmental disabilities are summarized. The contributions of individual child characteristics to child-caregiver interactions that support language development are illustrated based on research with children who have autism, Williams syndrome, Down syndrome, and children who use augmentative communication systems. Parent-child interaction and the quality and quantity of parent talk are discussed as factors in children's language development. The effects of young children's delayed language on their interactions with peers, the contributions of peers to children's language learning and use, and the critical features of classroom settings that support child language development are reviewed. MRDD Research Reviews 7:143-150, 2001.

Child↗
PubMedDate not supplied

Developing a language screening test for Arabic-speaking children.

This report gives an account of general and specific issues associated with developing an Arabic-language screening test for children aged between 3 and 12 years. Challenges, dilemmas and stages in the developmental process are discussed. The development of the Arabic Language Screening Test: Preschool and School Age illustrates the process. Issues and stages included: (1) arriving at a consensus about scope and purpose; (2) conceptualizing tasks and items; (3) specifying item content and structure; (4) field-testing the screening tool in a circumscribed environment; (5) developing a robust scoring and interpretation system for determining Pass or Fail, and (6) establishing the degree of accuracy in differentiating children with and without language disorders. The product is a screening test of verbal and related nonverbal abilities with parallel components for children of preschool (3-5 years) and elementary school age (6-12 years). Normative data were collected for 750 Arabic-speaking children in Jordan and Palestine, distributed fairly equally between the ages of 3 and 12 years. Normative means increased with age and standard deviations decreased. Interscorer agreement (99%), internal consistency (Cronbach alpha = 0.98) and diagnostic sensitivity (over 90% accuracy) were high. Constraints and limitations in the development of the test are described and discussed from both objective and personal perspectives.

Child↗
PubMed1998

Language, social cognitive processing, and behavioral characteristics of psychiatrically disturbed children with previously identified and unsuspected language impairments.

This study examined characteristics of social cognitive processing, psychiatric disorder, and behavioral ratings of 380 children aged 7 to 14 years who had been referred consecutively for child psychiatric services with identified and unsuspected language impairments and with normally developing language. The results indicated that children with language impairments generally exhibited greater deficits in social cognitive processing, and particularly emotion decoding and social problem solving, than children who have language that is developing normally. Differences in psychiatric diagnosis and behavior problems were observed only between children with previously identified language impairments and children with normally developing language; children with previously identified language impairments were more likely to be diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD) and to be rated by both parents and teachers as having more severe attentional problems. In addition, teachers rated them as more socially withdrawn. The results suggest that it is important to incorporate measures of both social cognition and language functioning routinely into clinical assessment, something that currently is rarely done.

Adolescent↗
PubMedDate not supplied

The child's route into reading and what can go wrong.

Two strands of linguistic development critically important for successful reading acquisition are outlined. One of these ontogenetic roots concerns phonological development and projects onto word decoding. The other root concerns the development of vocabulary and syntax projecting onto reading comprehension. Language development starts very early in infancy when the child learns to categorize the speech sounds according to the pattern typical of the mother tongue. Equipped with these sound categories the child is ready to learn to understand and to use new words. The precise phonological representation of words will facilitate the important development of phonological awareness. The paper reviews some longitudinal research and training studies indicating the causal direction of the relation between phonological awareness and reading. Preventive implications are pointed out. The preventive power of the second strand of development is discussed with reference to vocabulary exposure in different social environments and to informal early literacy socialization. In particular, the benefits of the prototypical situation of reading aloud to children are discussed. Finally, the complexity of the causal relationships between different aspects of early language development and later reading is pointed out.

Awareness↗
PubMed2004

Improving reading and writing learning in underprivileged pluri-ethnic settings.

BACKGROUND: Many studies carried out in first language contexts tend to demonstrate the positive effects of activity programmes aimed at (1) developing metaphonological abilities and (2) developing language skills through active story listening on learning to read and to spell by first-grade students. AIMS: This study seeks to extend previous findings by (a) including children, the majority of whom have French as a second language, who attend plurilingual schools and have not been included in previous studies, and (b) providing training based on three essential principles shared by the two kinds of programmes: integrating activities into realistic literacy practice contexts; encouraging active student participation through tasks which very often require problem solving; and tackling, one after the other, different kinds of operations or strategies. SAMPLE: Three groups of students were created out a pool of 202 children enrolled in nine first-grade classes in three underprivileged pluri-ethnic schools. The control group was composed of 46 students who received typical, first-grade methods for teaching reading and spelling. Experimental group 1 (DMPA), 91 students, received a training programme aimed at metaphonological abilities development. Experimental group 2 (DLS), 65 students, received a training intended to develop language skills through active story listening and production. METHOD: The students from the three groups were evaluated at the beginning (metaphonological task I, pre-reading task) and at the end (metaphonological task II, word recognition task, text comprehension task, word spelling task) of their first year in elementary school. RESULTS: The programme for the development of metaphonological abilities enabled DMPA group students to obtain significantly higher scores than the control group on metaphonological task II and word recognition task. The DMPA group children also did significantly better than the control and the DLS groups on the word spelling task. However, the DLS group, who benefited from language skills development activities, also progressed in that they obtained significantly better results than the control group in the word recognition task. Moreover, at the end of grade one, there was no difference in the scores obtained by the groups on a comprehension questionnaire administered after the reading of the narrative text. CONCLUSION: The word reading skills of first-grade children in underprivileged pluriethnic settings can be improved through activities aimed at metaphonological abilities development or language skills development by means of active story listening and production. On the other hand, in order to develop word spelling abilities, the development of metaphonological abilities was more effective. Lastly, further research should seek to improve understanding of the absence of effects of either learning programme on narrative text comprehension.

Attention↗
PubMed2001

Incorporating language phenotypes strengthens evidence of linkage to autism.

We investigated the effect of incorporating information about proband and parental structural language phenotypes into linkage analyses in the two regions for which we found the highest signals in our first-stage affected sibling pair genome screen: chromosomes 13q and 7q. We were particularly interested in following up on our chromosome 7q finding in light of two prior reports of linkage of this region to developmental language disorder, since one of the diagnostic criteria for autism is absent or abnormal language development. We hypothesized that if the language phenotype were genetically relevant to linkage at the chromosome 7q locus, then incorporating parents phenotypes would increase the signal at that locus, and most of the signal would originate from the subset of families in which both probands had severe language delay. The results support these hypotheses. The linkage signals we obtained on chromosome 7q as well as at least one signal on chromosome 13q are mainly attributable to the subgroup of families in which both probands had language delay. This became apparent only when the parents' history of language-related difficulties was also incorporated into the analyses. Although based on our data, we were not able to distinguish between epistasis or heterogeneity models, we tentatively concluded that there may be more than one autism susceptibility locus related to language development.

Autistic Disorder↗
PubMed1984

Speech and language disorders in children.

Speech and language development is a sensitive and important diagnostic tool for the family physician. Speech defects and delayed speech and language development can be the presenting evidence for neurologic abnormalities, cognitive difficulties and abnormal hearing. They can also be signs of emotional, social, family and behavioral problems. Finally, they can signify the need for evaluation of abnormalities of tracheal and laryngeal function and oral-motor development.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Incorporating language phenotypes strengthens evidence of linkage to autism.

We investigated the effect of incorporating information about proband and parental structural language phenotypes into linkage analyses in the two regions for which we found the highest signals in our first-stage affected sibling pair genome screen: chromosomes 13q and 7q. We were particularly interested in following up on our chromosome 7q finding in light of two prior reports of linkage of this region to developmental language disorder, since one of the diagnostic criteria for autism is absent or abnormal language development. We hypothesized that if the language phenotype were genetically relevant to linkage at the chromosome 7q locus, then incorporating parents phenotypes would increase the signal at that locus, and most of the signal would originate from the subset of families in which both probands had severe language delay. The results support these hypotheses. The linkage signals we obtained on chromosome 7q as well as at least one signal on chromosome 13q are mainly attributable to the subgroup of families in which both probands had language delay. This became apparent only when the parents' history of language-related difficulties was also incorporated into the analyses. Although based on our data, we were not able to distinguish between epistasis or heterogeneity models, we tentatively concluded that there may be more than one autism susceptibility locus related to language development.

Autistic Disorder↗
PubMed1999

Benefits of early intervention for children with hearing loss.

This article discusses the relationship between language development and degree of hearing loss and how these factors relate to the age of identification of hearing loss. An interesting effect caused by the interaction of these variables has been discussed in this article. The relationship of speech production, degree of hearing loss, language development, and age of identification are also presented. Social-emotional development of deaf and hard-of-hearing children and the variables that impact this development, in particular the strong relationship with language development, is included.

Age Factors↗