Morpho-Syntactic Deficit in Children with Cochlear Implant: Consequence of Hearing Loss or Concomitant Impairment to the Language System?

Background: Among implanted children with similar duration of auditory deprivation and clinical history, the morpho-syntactic skills remain highly variable, suggesting that other fundamental factors may determine the linguistic outcomes of these children, beyond their auditory recovery. The present study analyzed the morpho-syntactic discrepancies among three children with cochlear implant (CI), with the aim of understanding if morpho-syntactic deficits may be characterized as a domain-specific language disorder. Method: The three children (mean age = 7.2; SD = 0.4) received their CI at 2.7, 3.7, and 5.9 years of age. Their morpho-syntactic skills were evaluated in both comprehension and production and compared with 15 age-matched normal-hearing children (mean age = 6.6; SD = 0.3). Results: Cases 1 and 2 displayed a marked impairment across morphology and syntax, whereas Case 3, the late-implanted child, showed a morpho-syntactic profile well within the normal boundaries. A qualitative analysis showed, in Cases 1 and 2, language deficits similar to those of normal hearing children with Developmental Language Disorder (DLD). Conclusions: We suggest that a severe grammatical deficit may be, in some implanted children, the final outcome of a concomitant impairment to the language system. Clinical implications for assessment and intervention are discussed.

Referral profile of child guidance clinic of a tertiary care hospital in central Maharashtra: a retrospective observational study

Background: Developmental disabilities occur in approximately 5-10% of the childhood population. The paucity of data regarding the burden and risk factors slows down the programs and policymaking actions for these highly prevalent conditions in developing countries.Methods: A retrospective review of records of 264 children below 12 years referred to CGC of a Tertiary Care Hospital from November 2016 to December 2018 was done. Data was analysed using SPSS software and is described in terms of frequency and mean. Results: 264 new cases that were referred to the CGC were enrolled. The mean age of referral was 2.54 yrs. (±1.00) with M: F ratio being 1.4:1. In religion, Hindu predominance (56.4%) was found.76.5% hailed from urban area. 39% of all cases showed Consanguinity.37% belonged to Class IV(Upper Lower) and 89% had chronic malnutrition. 46.2% of cases had NICU stay of which perinatal asphyxia(PA) was found in 40%.Majority of children (45.7%) had Global developmental delay (GDD)/Mental Retardation (MR), 37.7% had various forms of CP, Attention Deficit Hyperactivity Disorder(ADHD) was seen in 13%, 3.4% had Autism, 4.5% had specific language disorder, Learning disability was seen in 2.7% and only 2.7% had Isolated motor delay.Conclusions: Early Intervention services for children lag behind in developing countries and the proportion of children referred to CGC with severe disabling conditions is high. This study provides baseline data for further planning of services and interventions for these children in Maharashtra.

A System for the Diagnosis of Specific Language Impairment in Kindergarten Children

A valid and reliable diagnostic standard for language impairment is required for the conduct of epidemiologic research on specific language disorder. A rationale is provided for such a diagnostic system labeled the EpiSLI system. This system employed five composite scores representing norm-referenced performance in three domains of language (vocabulary, grammar, and narration) and two modalities (comprehension and production). Children who have two or more composite scores below –1.25 standard deviations were considered as children with language disorder. The performance of the EpiSLI diagnostic system was examined on a sample of 1,502 kindergarten children and it was shown that this diagnostic system yielded results that were consistent with clinician rating and previous research results.

Familial language impairment: The evidence

Müller argues that general cognitive skills and linguistic skills are not necessarily independent. However, cross-linguistic evidence from an inherited specific language disorder affecting productive rules suggests significant degrees of modularity, innateness, and universality of language. Confident claims about the overall nature of such a complex system still await more interdisciplinary research.