Expressive Language Quotients Research Articles

Preoperative variables affecting outcome of cochlear implant

BackgroundCochlear implants made a great impact in the management of severe-to-profound hearing loss in both children and adults. Its greatest impact is in helping children born with a profound hearing loss and implanted early to attend mainstream education and using spoken language to communicate. However, the final outcome in pediatric implantation is not predictable as there are large number of factors which will affect the outcome of cochlear implantation. Studying these determinants increases the ability of clinicians to offer educated preoperative prognosis and might potentially allow for manipulation of variables in an attempt to achieve the best possible outcome.ObjectiveThe aim of this study was to assess the preoperative factors affecting the audiological, speech, and language outcomes achieved by the recipients of cochlear implants.MethodologyA total of 39 children with severe-to-profound sensory neural hearing loss were implanted with cochlear implants. Children had received their implants before age of 5 years. Tests of receptive, expressive language quotient, aided cortical auditory-evoked potential using speech stimulus, aided free field audiometry, and aided speech reception thresholds were administered. Characteristics of the child and the family (age before implant and duration of implant use, cause of hearing loss, preimplant use of hearing aids and language therapy, and sociodemographic characteristics of their families) were the preoperative variables. These variables were considered predictors of audiological and language outcomes achieved by children and were determined using statistical analysis by univariate and multivariate analyses.ResultsAge of the studied children at time of cochlear implantation was statistically significant predictor for CI outcome as regard receptive language quotient and also for N1 latency. Hearing age of the studied children was a statistically significant predictor for CI outcome as regards P1 latency.ConclusionBased on our findings, two most important factors affecting outcome of cochlear implantation were the age at implantation and the hearing age. Other factors were important but did not affect the outcome significantly.

Effect of iron deficiency anemia on language development in preschool Egyptian children

BackgroundIron deficiency anemia (IDA) is the most common nutritional deficiency primarily in developing countries. ObjectiveThis study evaluates the effect of IDA on language development in preschool children. MethodologyThe study is a multicenter, comparative cross-sectional study included 226 children between ages 4–6 years. The children were classified into two groups’ anemic (patients) and non anemic (controls) according to the hemoglobin level. All anemic children subjected to complete iron study including; Serum iron, total iron binding capacity (TIBC), Serum ferritin level, to confirm the diagnosis of iron deficiency anemia. Cognitive assessment was done using the Arabic translation Stanford Binet intelligence scale, version four which comprised of four cognitive area scores; visual reasoning, verbal reasoning, quantitative reasoning and short-term memory. Measurement of IQ and mental age were calculated for each child. Language evaluation was done using the Arabic Language test. Receptive language quotient, expressive language quotient and total language quotient were calculated for each child. Results122 children were anemic and 90 were non-anemic with hemoglobin level 10.65 and 11.96 g/dL, respectively (P < 0.000). Anemic children had significantly lower serum ferritin (p < 0.0001), and serum iron (p < 0.0001) compared to the controls. Both groups were matched as regards age, sex, socioeconomic levels and parental educational level. No significant differences observed regarding IQ, mental age, receptive, expressive and total language quotients between anemic and non-anemic children. ConclusionsIDA does not seem to have an effect on language development in preschool Egyptian Children. Future large controlled studies with long follow-up time for the younger age group are needed to determine whether there are existent associations between IDA with language development.

A Comparative Analysis of Clinical Screening Test and Language Specific Test in Language Delay Children.

The aim of this study was to investigate the usefulness of a clinical screening test [the Korean Infant and Child Developmental Test (KICDT)] compared to language specific tests: the sequenced language scale for infant (SELSI) and the Preschool Receptive-Expressive language Scale (PRES) in children with delayed language development. A retrospective chart review was conducted on 615 children who visited the Department of Pediatrics at Chonbuk National University Hospital from January 2013 to December 2016. All patients were evaluated with KICDT as a clinical screening test and SELSI or PRES as a language specific test. Language Developmental Quotients (LDQs) from the KICDT were compared with the Receptive Language Quotient (RLQ) and expressive language quotient (ELQ) from the SELSI or PRES. The sensitivity, specificity and predictive values of LDQ of KICDT were calculated by comparing with SELSI/PRES. Language DQs from the KICDT were significantly correlated with the RLQ (r=0.706), ELQ (r=0.768), and total language quotient (TLQ) (r=0.766) from the SELSI/PRES (p<0.05). In cross tabulation, the patients belonging to the retardation groups in both KICDT and SELSI/PRES were 417 (67.8%). Otherwise, patients belonging to the normal group in KICDT but not in SELSI/PRES were 151 (24.6%). Sensitivity and specificity of LDQ of KICDT relative to SELSI/PRES were 72.3% and 92.2% respectively (p<0.05). Our data suggests that clinical screening tests alone, not cumbersome language specific tests, can determine language developmental delays in children.

Effects of Copy Number Variations on Developmental Aspects of Children With Delayed Development.

ObjectiveTo determine effects of copy number variations (CNV) on developmental aspects of children suspected of having delayed development.MethodsA retrospective chart review was done for 65 children who underwent array-comparative genomic hybridization after visiting physical medicine & rehabilitation department of outpatient clinic with delayed development as chief complaints. Children were evaluated with Denver Developmental Screening Test II (DDST-II), Sequenced Language Scale for Infants (SELSI), or Preschool Receptive-Expressive Language Scale (PRES). A Mann-Whitney U test was conducted to determine statistical differences of developmental quotient (DQ), receptive language quotient (RLQ), and expressive language quotient (ELQ) between children with CNV (CNV(+) group, n=16) and children without CNV (CNV(–) group, n=37).ResultsOf these subjects, the average age was 35.1 months (mean age, 35.1±24.2 months). Sixteen (30.2%) patients had copy number variations. In the CNV(+) group, 14 children underwent DDST-II. In the CNV(–) group, 29 children underwent DDST-II. Among variables, gross motor scale was significantly (p=0.038) lower in the CNV(+) group compared with the CNV(–) group. In the CNV(+) group, 5 children underwent either SELSI or PRES. In the CNV(–) group, 27 children underwent above language assessment examination. Both RLQ and ELQ were similar between the two groups.ConclusionThe gross motor domain in DQ was significantly lower in children with CNV compared to that in children without CNV. This result suggests that additional genetic factors contribute to this variability. Active detection of genomic imbalance could play a vital role when prominent gross motor delay is presented in children with delayed development.

The clinical aspect of delayed development in the children with copy number variations

Microarray-based comparative genomic hybridization (array CGH) has been widely adopted as a valuable clinical diagnostic test for children with delayed development. Bradley P. Coe et al. suggested copy number variants (CNVs) are associated with many neurocognitive disorders. Hence, overall development was measured between two groups divided by array CGH results. A retrospective chart review was done in 42 children who underwent array CGH after visiting PM&R Department outpatient clinic with delayed development as chief complaints. Children were evaluated for Denver Developmental Screening Test (DDST), Sequenced Language Scale for Infants (SELSI)/Preschool Receptive-Expressive Language Scale (PRES). A Mann-Whitney U test was conducted to determine statistical differences of Developmental Quotient (DQ), Receptive Language Quotient (RLQ) and Expressive Language Quotient (ELQ) between two groups: 14 children with CNVs and 28 children without CNVs. DDST showed that personal social and language DQ were higher and fine motor and gross motor were lower in CNV (+) group than in CNV (−) group, but the difference was not statistically significant. All 22 children who underwent SELSI or PRES showed delayed language in all domains and RLQ and ELQ were higher in CNV (+) group than in CNV (−) group and the difference was statistically significant for ELQ ( P < 0.05). In the CNV (+) group, ELQ was assessed higher than RLQ; In the CNV (−) group, ELQ was assessed lower than RLQ, but statistical significance was not observed in both inter-group. DQ in all domains was not significantly lower in children with CNV compared to children without CNV. However, tendency of milder delay of ELQ was observed in children with CNV. Active detection of genomic imbalance could play some vital role in assessing development aspect in children with delayed development.

The differences in clinical aspect between specific language impairment and global developmental delay.

ObjectiveTo compare and analyze the clinical characteristics of children with delayed language acquisition due to two different diagnoses, which were specific language impairment (SLI, a primarily delayed language development) and global developmental delay (GDD, a language delay related to cognitive impairment).MethodsAmong 1,598 children who had visited the developmental delay clinic from March 2005 to February 2011, 467 children who were diagnosed with GDD and 183 children who were diagnosed with SLI were included in this study. All children were questioned about past, family, and developmental history, and their language competences and cognitive function were assessed. Some children got electroencephalography (EEG), in case of need.ResultsThe presence of the perinatal risk factors showed no difference in two groups. In the children with GDD, they had more delayed acquisition of independent walking and more frequent EEG abnormalities compared with the children with SLI (p<0.01). The positive family history of delayed language development was more prevalent in children with SLI (p<0.01). In areas of language ability, the quotient of receptive language and expressive language did not show any meaningful statistical differences between the two groups. Analyzing in each group, the receptive language quotient was higher than expressive language quotient in both group (p<0.01). In the GDD group, the Bayley Scales of Infant Development II (BSID-II) showed a marked low mental and motor quotient while the Wechsler Intelligence Scale showed low verbal and nonverbal IQ. In the SLI group, the BSID-II and Wechsler Intelligence Scale showed low scores in mental area and verbal IQ but sparing motor area and nonverbal IQ.ConclusionThe linguistic profiles of children with language delay could not differentiate between SLI and GDD. The clinicians needed to be aware of these developmental issues, and history taking and clinical evaluation, including cognitive assessment, could be helpful to diagnose adequately and set the treatment plan for each child.

Evaluation of a parent-based behavioral intervention program for children with autism in a low-resource setting

Background:Intensive behavioral intervention programs are recommended for children with autism. However, in resource-constraint settings, such programs are largely inaccessible, and there is an urgent need for development of low-cost interventions.Aim:To evaluate the efficacy of a parent-based behavioral intervention program in Indian autistic children.Materials and Methods:Sixteen children with autistic disorder undergoing the intervention for at least six months were enrolled. The mean development, social, expressive, and receptive language quotients, and the Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) scores were compared before and after the intervention.Results:The average duration of therapy was 19.5±11.78 months. There was a significant improvement in the development quotient (P=0.015), social quotient (P=0.004), expressive language quotient (P=0.03), CARS (P=0.001), and ABC (P=0.014) scores.Conclusion:Parent-based behavioral intervention programs have a promising role in management of children with autism in resource-constraint settings.

Social and emotional components of book reading between caregivers and their toddlers in a high-risk sample

In this collective case study of caregiver behaviors with their toddlers, two-minute videotaped reading interactions were analyzed using a constant comparative method. Twenty-four caregiver—toddler dyads from a high-risk sample of children prenatally exposed to cocaine were selected from a larger sample because they represented the extremes of expressive language scores on the Reynell Expressive Language Quotient at 36 months, one year after the reading interactions. Caregivers in the high-scoring group shared control of the book and discourse, were ‘in tune’ with the child’s needs and abilities, and answered their own questions to the children. This was in contrast to the behaviors of caregivers of the low-scoring children, who appeared unaware of the child’s developmental needs in the interaction, particularly in their ability to respond to the questions posed. Implications of the results for future research on caregiver reading with young children are discussed.

School-Age Outcome of Children With Prenatal Cocaine Exposure Following Early Case Management

The impact of prenatal cocaine exposure on neurodevelopmental outcome in childhood continues to be in question. Objectives of this study were to determine if there are differences in growth, behavioral, cognitive or verbal functioning or caregiver-child dyad interactions for inner-city, school-aged children with and without prenatal cocaine exposure, and if these measures would be affected by early family case management. From an initial sample of 118 cocaine-exposed children who were evaluated to 36 months of age, 47 were able to be contacted and 39 (83%) completed a follow-up evaluation at 84 +/- 11 months of age. Subjects had been assigned at birth to early case management (CM, 24) and routine care (RC, 15). Eighteen children from the initial non-cocaine-exposed comparison sample of 41 children were able to be contacted and 12 (67%) were evaluated at 85 +/- 16 months of age. Evaluation included growth measurements, Stanford-Binet IQ, receptive and expressive language quotients, parent-reported Child Behavior Checklists (CBCL), and assessment of caregiver-child interactions by scored videotaped free-play sessions. No differences were found in growth, mean IQ, language quotients, CBCL scores or videotaped caregiver-child play interactions as a function of cocaine exposure. Within the cocaine-exposed group, there were no outcome differences between CM and RC children. However, during the play sessions, CM caregivers had more positive affect in interactions with the child than RC. Within the RC dyads, birthmothers had significantly more positive interactions than non-birthmothers. In summary, no differences in growth, behavioral, cognitive, or language function were evident for inner-city, school-aged children related to prenatal cocaine exposure or early case management. CM caregivers demonstrated more positive interactions during a play session than RC; within the RC group, non birthmothers had the least positive affective interactions. Further study of influences on caregiver-child interactions may lead to effective intervention strategies for drug-exposed infants.

Mastery motivation and expressive language in young children with hearing loss.

We studied the relation between mastery motivation and expressive language in 200 young children with hearing loss. Hearing mothers assessed their children's expressive language (Minnesota Child Development Inventory; Ireton & Thwing, 1974) and several aspects of mastery motivation including mastery pleasure and three components of mastery persistence (gross motor, object oriented, and social/symbolic) using the Dimensions of Mastery Motivation Questionnaire (Morgan et al., 1992). Simple correlations revealed significant relations between expressive language and all mastery motivation scales. When demographic and hearing loss variables were entered into a regression equation, only increased social/symbolic persistence was significantly related to, and increased object-oriented persistence was marginally related to, increases in expressive language quotients. Expressive language quotients also increased significantly as child age and degree of hearing loss decreased and as mothers' ratings of their child's general competence increased. In addition, decreases in the age at which the child was enrolled in intervention were marginally related to increases in expressive language quotients (f =.06).

Developmental outcomes of children with hearing loss born in Colorado hospitals with and without universal newborn hearing screening programs

The developmental outcomes of children born in hospitals with universal newborn hearing screening programs were compared with children born in hospitals without universal newborn hearing screening programs. Eight-four percent of children born in screening hospitals were early-identified with hearing loss prior to 6 months of age as compared to 8% of the children in the non-screen group. The participants in the screen group had an average language quotient of 82 while the participants in the non-screen group had an average language quotient of 62. Children in the screen group had better receptive and expressive language quotients, more different consonants in the spontaneous phonetic repertoire, better speech intelligibility, and larger expressive vocabulary inventories. Odds risk ratio estimates indicate that 80% of the children with cognitive quotients 80 or greater or four out of five children had language quotients within the normal range, 80 or greater, when they were in the screen group.

Exploring stimulus equivalence formation in infants.

A systmatic replication of the Devany, Hayes and Nelson (1986) and the Augustson and Dougher (1992) studies was conducted with infants to explore the relation of stimulus equivalence to language development. 9 normal infants, age 21 to 25 months participated in 5 to 15 experimental sessions, each session on a different day. Infants expressive language skills were assessed (REEL Scale 2, 1991) before submitting each of them to a learning task consisting of matching different animal-like figures in a matching-ta-sample (visualvisual) conditional discriminationformat. In a single-subject design, infants were taught four conditional discriminations: if A, then B; if A, then C; if D, then E; and if D, then F. The order of presentation and the left-right position of correct response were counterbalanced across training and testing trials. Once an infant learned these mixed relations under various reinforcers, the transitivity test was given. Equivalence was established when a child matched Band C, in as much as A had been the matching samplefor both and when a child matched E and F. both of which earlier had been paired to D. Every subject attained criterion on the four independent conditional discriminations and on the mixed training. 5 subjects who attained transitivity (at 80% or above), performed below chance level on at least one of thefour symmetry tests. 8 out of our 10 subjects performed between 80 and 100 % correct responses in the transitivity tests. Wefound a significant negative correlation between the total number of trials to criterion during the conditional discrimination training and the combined receptive and expressive language quotient. Those infants with higher language-skill scores required fewer trials to complete the conditional-discrimination training. The results suggest that language skills play a role in stimulus equivalence formation.