Language Test Scores Research Articles

UK speech and language therapists' assessment of children's expressive language, and functional impairment and impact, following the CATALISE publications.

In 2016/17, the CATALISE Consortium published the results of a multinational and multidisciplinary Delphi consensus study, representing agreement among professionals about the definition and process of identification of children with Developmental Language Disorder (DLD) (Bishop etal., 2016, 2017). The extent to which the current clinical practice of UK speech and language therapists (SLTs) reflects the CATALISE consensus statements is unknown. To investigate how UK SLTs' expressive language assessment practices reflect the CATALISE documents' emphasis on the functional impairment and impact caused by DLD, by examining: whether multiple sources of assessment information are gathered; how standardised and non-standardised sources are combined in clinical decision-making, and how clinical observation and language sample analysis are utilised. An anonymous, online survey was carried out between August 2019 and January 2020. It was open to UK-based paediatric SLTs who assess children up to age 12 with unexplained difficulties using language. Questions probed different aspects of expressive language assessment which are referred to in the CATALISE consensus statements and supplementary comments, and asked about participants' familiarity with the CATALISE statements. Responses were analysed using simple descriptive statistics and content analysis. The questionnaire was completed by 104 participants, from all four regions of the United Kingdom, working in a range of clinical settings with different levels of professional experience of DLD. The findings indicate that clinical assessment practices broadly align with the CATALISE statements. Although clinicians carry out standardised assessments more frequently than other types of assessment, they also gather information from other sources and use this alongside standardised test scores to inform clinical decisions. Clinical observation and language sample analysis are commonly utilised to evaluate functional impairment and impact, along with parent/carer/teacher and child report. However, asking about the child's own perspective could be more widely utilised. The findings also highlight a lack of familiarity with the details of the CATALISE documents among two thirds of the participants. Assessment practices broadly align with the CATALISE statements, but there is a need for greater clarity regarding terminology and the assessment of functional language impairment and impact. This research should prompt discussion in the profession about how to further develop and adopt expressive language assessment practices which reflect the CATALISE consensus and support effective assessment. What is already known on the subject The CATALISE consortium documents on Developmental Language Disorder (DLD) were published in 2016/17. The extent to which expressive language assessment practice in the United Kingdom reflects the new definition and statements on assessment has not previously been investigated. What this paper adds to existing knowledge This survey indicates that speech and language therapists in the United Kingdom assessing children for DLD mostly balance standardised language test scores with other sources of information in clinical decision-making, and utilise clinical observation and language sample analysis to consider functional impairment and the impact of the language disorder. However, important questions are raised regarding the robustness and objectivity with which these key parameters are currently defined and evaluated. What are the potential or actual clinical implications of this work? Clinicians, individually and at service level, are encouraged to reflect on their assessment of functional impairment and the impact of language disorder and to take steps to incorporate this where necessary. Professional guidance and clinical tools to facilitate robust, objective assessment would support clinical practice that aligns with expert consensus.

Grammaticality Judgments of Tense and Agreement by Child Speakers of African American English: Effects of Clinical Status, Surface Form, and Grammatical Structure.

We examined the grammaticality judgments of tense and agreement (T/A) structures by children with and without developmental language disorder (DLD) within African American English (AAE). The children's judgments of T/A forms were also compared to their judgments of two control forms and, for some analyses, examined by surface form (i.e., overt, zero) and type of structure (i.e., BE, past tense, verbal -s). The judgments were from 91 AAE-speaking kindergartners (DLD = 34; typically developing = 57), elicited using items from the Rice/Wexler Test of Early Grammatical Impairment. The data were analyzed twice, once using General American English as the reference and A' scores and once using AAE as the reference and percentages of acceptability. Although the groups differed using both metrics, the percentages of acceptability tied the DLD T/A deficit to judgments of the overt forms, while also revealing a general DLD weakness judging sentences that are ungrammatical in AAE. Judgments of the overt T/A forms by both groups correlated with their productions of these forms and their language test scores, and both groups showed structure-specific form preferences ("is": overt > zero vs. verbal -s: overt = zero). The findings demonstrate the utility of grammaticality judgment tasks for revealing weaknesses in T/A within AAE-speaking children with DLD, while also calling for more studies using AAE as the dialect reference when designing stimuli and coding systems. https://doi.org/10.23641/asha.22534588.

Evaluation of outcome of cochlear implanted children after 2 years of rehabilitation in Alexandria: a retrospective study

BackgroundCochlear implantation (CI) is an electronic hearing device that is surgically implanted to bypass damaged portions of the ear and directly stimulate the auditory nerve. Nowadays, CI prospects for children with profound hearing loss (HL) have been significantly improved. Now, most implanted children can expect similar audiological outcomes to those with moderate to severe HL with aids depending on the time of loss and cognitive function.AimThis study aimed at assessing the progress in all aspects of language acquisition and the effect of various factors on the outcome of cochlear implantation in children undergoing auditory training for at least 2 years after surgery.ResultsThe results showed the effectiveness of early implantation in terms of improvement in linguistic skills, indicated by significant change of language age scores when compared before and after surgery (median age 1.167 years to 4.75 years with p value < 0.0001). Significant improvement in degree of hearing level (HL median from 100 dB to 25 with p value < 0.0001), in addition to its effect on improving the general IQ (mean from 82.42 ± 9.46 to 88.61 ± 8.13 with p value = 0.006) and abstract IQ scores (mean from 83.48 ± 9.81 to 94.45 ± 10.41 with p value = 0.0001).ConclusionCI children showed significant improvement in speech perception, auditory skills, and IQ scores as well as receptive and expressive language after CI denoted by the improvement of language age. Significant improvement was found in early implantation age (under 2 years) in the postoperative degree of hearing level and in language test scores in comparison to older aged children.

Exploring Foreign Language Anxiety in China

Foreign language learning anxiety has been a heated topic in academia in recent years which explores the relationship between foreign language learning anxiety and test scores. Most researchers use Horwitz’s FLCAS foreign language classroom anxiety scale to research selected students and then analyze the data to draw conclusions. However, although there are many previous studies in terms of foreign language anxiety, there are still few studies on foreign language learning anxiety among Chinese college students, and most researchers focus on middle and high school students and ignore college students' foreign language learning anxiety. In view of this, this literature review draws on the previous research experience and is based on the relevant theories of foreign language learning anxiety, focusing on the correlation between foreign language learning anxiety and college students' foreign language learning performance. Therefore, this study will provide some implications and solutions for Chinese college students to reduce their foreign language anxiety.

What predicts individual response to language treatment in bilingual children with developmental language disorder?

For bilingual children with developmental language disorder (DLD), language treatment response is the degree to which an individual child progresses in both of their languages. Understanding what predicts language treatment response for an individual child can help clinicians plan treatment more effectively. This study is a retrospective analysis of data from Ebert et al. (2014). Participants included 32 school-age Spanish-English bilingual children with DLD who completed an intensive language treatment program. Gains in Spanish and English were measured using raw test scores in each language. Predictors of language gains include language, cognitive, and demographic variables. To examine which predictors were significant, we calculated partial correlations between the potential predictors and the posttreatment language test scores, controlling for the effects of pretreatment test scores. In Spanish, several predictors correlated with the outcome measures. After controlling for pretreatment scores, English grammaticality, female sex, processing speed, age, and fluid reasoning were related to Spanish posttreatment scores. In English, correlations with individual predictors were minimal. After controlling for pretreatment scores, only one variable was associated with one English posttreatment score: English grammaticality. The original study reported limited gains in Spanish compared to robust gains in English (Ebert et al., 2014). Treatment response in Spanish is more variable given the lack of environmental support for Spanish in the US. As a result, individual factors (including nonverbal cognition, pretreatment language levels, and demographic variables) influence treatment gains in Spanish. In contrast, strong environmental support for English supports a more consistent treatment response, with a smaller role for individual factors.

Language impairment in the genetic forms of behavioural variant frontotemporal dementia

BackgroundBehavioural variant fronto-temporal dementia (bvFTD) is characterised by a progressive change in personality in association with atrophy of the frontal and temporal lobes. Whilst language impairment has been described in people with bvFTD, little is currently known about the extent or type of linguistic difficulties that occur, particularly in the genetic forms.MethodsParticipants with genetic bvFTD along with healthy controls were recruited from the international multicentre Genetic FTD Initiative (GENFI). Linguistic symptoms were assessed using items from the Progressive Aphasia Severity Scale (PASS). Additionally, participants undertook the Boston Naming Test (BNT), modified Camel and Cactus Test (mCCT) and a category fluency test. Participants underwent a 3T volumetric T1-weighted MRI, with language network regional brain volumes measured and compared between the genetic groups and controls.Results76% of the genetic bvFTD cohort had impairment in at least one language symptom: 83% C9orf72, 80% MAPT and 56% GRN mutation carriers. All three genetic groups had significantly impaired functional communication, decreased fluency, and impaired sentence comprehension. C9orf72 mutation carriers also had significantly impaired articulation and word retrieval as well as dysgraphia whilst the MAPT mutation group also had impaired word retrieval and single word comprehension. All three groups had difficulties with naming, semantic knowledge and verbal fluency. Atrophy in key left perisylvian language regions differed between the groups, with generalised involvement in the C9orf72 group and more focal temporal and insula involvement in the other groups. Correlates of language symptoms and test scores also differed between the groups.ConclusionsLanguage deficits exist in a substantial proportion of people with familial bvFTD across all three genetic groups. Significant atrophy is seen in the dominant perisylvian language areas and correlates with language impairments within each of the genetic groups. Improved understanding of the language phenotype in the main genetic bvFTD subtypes will be helpful in future studies, particularly in clinical trials where accurate stratification and monitoring of disease progression is required.

Comparing long-term educational effects of two early childhood health interventions

We compare the educational effects of two medical protocols that mitigate long-term consequences of prematurity or low birth weight. The two protocols are Traditional Care (TC), which uses incubators, and Kangaroo Mother Care (KMC) which replaces incubators for 24-hour skin-to-skin contact between newborns and caregivers. We concentrate on educational outcomes addressing contradictory results in previous contributions. We use a randomized controlled trial implemented in 1993 that randomly assigned children to either TC or KMC. OLS results suggest that KMC children spent more time in preschool, had fewer temporary school absences, and showed lower math test scores. Both groups observed similar effects on high-school graduation and language test scores. We correct for attrition, small sample, and multiple outcomes. Effects on preschool attendance and school absenteeism are robust, particularly for more vulnerable infants (birth weight ≤ 1,800 g). The other effects lose statistical significance due to multiple outcome testing or attrition corrections.

Using English medium instruction to teach a general course in a College of Business and Management.

Even though learning can be complex when using a language other than one’s mother tongue, the English-medium communicative approach has been widely adopted in Saudi universities over recent years. Many universities in Saudi Arabia are teaching their courses through the medium of English rather than Arabic, as was previously the case. This also applies to the social and natural sciences. Moreover, instructors are trying to avoid using any Arabic in class, given that English has become the lingua franca in many domains. Thus, the current study seeks to understand how students in the College of Business and Management at Al-Imam University, Riyadh, Saudi Arabia feel about English being used as the medium of instruction (EMI) as they study general course. Also examined is the relationship between their previous language test scores and current reflections. Twenty-four female students participated in a survey adapted from generating results to reveal a positive attitude to using EMI on their course. However, no relationship was found between the participants’ language assessment test scores and current feelings.

A mixed-method investigation into international university students’ experience with academic language demands

Post-secondary education institutions with English as a medium of instruction have prioritized internationalization, and as a result, many universities have been experiencing rapid growth in numbers of international students who speak English as an additional language (EAL). While many EAL students are required to submit language test scores to satisfy university admission criteria, relatively little is known about how EAL students interpret admission criteria in relation to language demands post admission and what their language challenges are. This study, situated at a large Canadian university, integrated student and faculty member focus group data with data obtained from a domain analysis across three programs of study and a reading skills questionnaire. Findings suggest that many students and faculty members tend to misinterpret language test scores required for admission, resulting in surprise and frustration with unexpected level of language demands in their programs. Also, students experience complex and challenging language demands in their program of study, which change over time. Recommendations for increased student awareness of language demands at the pre-admission stage and a more system-wide and discipline-based approach to language support post-admission are discussed.

Preterm Birth is Associated with Lower Academic Attainment at Age 12 Years: A Matched Cohort Study by Linkage of Population-Based Datasets

To compare academic attainment at age 12years in preterm children born below 30weeks of gestation with matched term-born peers, using standardized, nationwide and well-validated school tests. This population-based, national cohort study was performed by linking perinatal data from the nationwide Netherlands Perinatal Registry with educational outcome data from Statistics Netherlands and included 4677 surviving preterm children born at 250/7-296/7weeks of gestational age and 366 561 controls born at 40weeks of gestational age in 2000-2007. First, special education participation rate was calculated. Subsequently, all preterm children with academic attainment test data derived at age 12years were matched to term-born children using year and month of birth, sex, parity, socioeconomic status, and maternal age. Total, language, and mathematics test scores and secondary school level advice were compared between these 2 groups. Children below 30weeks of gestation had a higher special education participation rate (10.2% vs 2.7%, P<.001) than term-born peers. Preterm children had lower total (-0.37 SD; 95% CI -0.42 to -0.31), language (-0.21 SD; 95% CI -0.27 to -0.15), and mathematics (-0.45 SD; 95%CI -0.51 to -0.38) z scores, and more often a prevocational secondary school level advice (62% vs 46%, P<.001). A substantial proportion of children born before 30weeks of gestation need special education at the end of elementary schooling. These children have significant deficits on all measures of academic attainment at age 12years, especially mathematics, compared with matched term-born peers.

Evaluating Fairness and Justice of External English Language Test Score Interpretation and Use for Japanese University Admission

ABSTRACT The study evaluated a recently postponed national test policy on the use of external agencies’ English tests measuring four skills for Japanese university admission purposes. Using Kunnan’s principles of fairness and justice, we generated and evaluated three claims regarding the test policy: vocabulary coverage of the tests, the justifiability of the Common European Framework of References for Languages (CEFR)-based concordance table, and tests’ impact on teaching and learning productive skills. Scrutinizing the backing and rebuttal evidence from the test agencies’ voices to the key literature, we arrived at a partial acceptance of all three claims with the need for further research, calling into question a optimistic outlook underlying the test policy.

Aligning Language Test Scores to Local Proficiency Levels: The Case of China’s Standards of English Language Ability (CSE)

The past decade has seen an emerging interest in aligning test scores to language proficiency levels of external performance scales or frameworks, such as the Common European Framework of Reference (CEFR). Such alignment is ultimately a claim about the interpretation of test scores in relation to external levels of language proficiency. To support such a claim, established procedures should be carefully implemented and documented, and multiple sources of evidence should be collected. This paper demonstrates the steps in building an argument for aligning the scores of an international English language proficiency test to the levels of China’s Standards of English Language Ability, or CSE, a localized language proficiency framework for English as a foreign language. Aligning an international examination to a localized framework serves to make the test score more relevant to the intended context of its use. We discuss the contextual issues that should be considered when interpreting test scores in relation to local proficiency levels, given the potential impact of score-based decisions on individuals and institutions. The implications for similar alignment research will also be presented.

School closures and educational attainment in Ethiopia: Can extra classes help children to catch up?

AbstractSchool closures impact children's attainment adversely, but understanding the effects of closures on children's attainment in lower‐income countries is still limited. Addressing this deficit, this study examines how past school closures have impacted children's educational attainment in Ethiopia. The study uses individual student‐level data from the Young Lives School Survey and standardised test scores in mathematics and language recorded at the start and end of the school year to model children's attainment. Multiple regression with propensity score matching is used to analyse how attainment over the school year is impacted by school closures for a matched sub‐sample of 4842 students. The effectiveness of additional classes to make up for lost learning is also evaluated. Past school closures have had a detrimental effect on attainment in mathematics, but not literacy. Extra classes, specifically those that families do not pay for, have helped children in the past to recuperate lost learning and could serve this function post‐Covid‐19. Inequalities in learning outcomes, measured by Gini coefficients in educational attainment, are widened by school closures. Applying these results to the extensive school closures under Covid‐19 furthers our understanding of the likely effects on academic attainment and can inform policy to mitigate the impact.

Full-time schools, policy-induced school switching, and academic performance

While many developing countries are extending their school day from half- to full-time, little is known about the effects of such programs on student outcomes. Mexico recently extended its school-day duration from 4.5 h to 8 h through a full-time schools program. Using administrative student-level panel data, I exploit variation in the rollout of this program to identify its effect on math and language test scores. Controlling for endogenous switching between schools, I find that full-time schooling improves students’ math and language test scores, respectively, by 2.4 and 1.5 percent of a standard deviation in the first year of implementation. These results persist, growing to 13.7 and 10.8 percent of a standard deviation after five years. Moreover, the main results indicate that failure to control for endogenous school switching inflates the effects of five years of exposure to full-time schooling by a factor of 1.2 on math test scores and by a factor of 1.6 on language test scores.

Examining the Associations Between Parent Concerns and School-Age Children's Language and Reading Abilities: A Comparison of Samples Recruited for In-School Versus Online Participation.

The purpose of this study was to examine the relationship between parent concerns about children's oral language, reading, and related skills and their children's performance on standardized assessments of language and reading, with a particular focus on whether those relationships differed between children recruited for in-school versus online participation. This study used data from a larger, longitudinal project focused on children with and without developmental language disorder (DLD) and/or dyslexia. The "in-school" sample (n = 133) completed assessments in-person before school closures, and the "online" sample (n = 84) recruited via advertisements completed assessments online. Parents completed a checklist of concerns. All children completed norm-referenced assessments of language and reading. The two recruitment strategies yielded samples that differed in racial diversity (higher in the in-school sample), caregiver education levels (higher in the online sample), and word reading test scores (higher in the online sample). Parents in both samples reported higher levels of concerns about literacy skills than oral language skills, and the correlation between parent concerns about literacy and children's word reading test scores was stronger than the correlation between parent concerns about oral language and children's language test scores. Researchers and clinicians should be aware of how recruitment strategies and assessment modalities (e.g., in-person vs. tele-assessment) may impact participation in studies and clinical service. A reliance on parent concerns about oral language to prompt a language evaluation may contribute to low rates of identification of children who meet criteria for DLD. Future research can consider parent concerns about literacy, attention, and executive functions as indicators of a need for language evaluation, especially considering the high comorbidity between language and other developmental disorders.

Maternal antidepressant use linked to small decline in children's mathematics scores

Schoolchildren whose mothers had received an antidepressant during pregnancy showed a small but statistically significant decline in performance in mathematics on standardized tests when compared with children whose mothers had not received an antidepressant, a retrospective cohort study has found. There were no significant differences in language test scores between the antidepressant‐exposed and ‐unexposed groups.

Using a digital spelling aid to improve writing in persons with post-stroke aphasia: An intervention study.

Intervention studies aimed to improve the written production of single words by persons with aphasia have yielded promising results and there is growing interest in interventions targeting text writing. The development of technical writing aids offers opportunities for persons with aphasia, and studies have shown that using them can have a positive impact on written output. The aim was to investigate what impact training to use a computerised spell checker had on text writing in persons with aphasia. The study had a multiple-baseline single-case experimental design replicated across six male Swedish participants with mild-to-moderate post-stroke aphasia. The participants received training twice a week during 8weeks, learning how to use the spell checker. At baseline and before every session, the participants wrote two texts which were logged in a keystroke-logging tool. Dependent variables were continuously measured in the texts, and the participants performed tests of language function and answered questionnaires on reading and writing habits and health-related quality of life before and after the intervention. The participants were also interviewed about how they had experienced the training. The results were evaluated on individual and group level. The study showed that systematic individual training involving a spell checker was experienced as positive by the participants and that they all described their writing ability in more positive terms after the intervention. Evaluation showed statistically significant improvements on group level for the dependent variables of spelling accuracy, rated syntax, writing speed and proportion of unedited text during text writing when using the spell checker. The intervention also had a generalising effect on writing speed and editing during text writing without the spell checker and on spelling accuracy in a dictation test. The participants who had the greatest spelling problems were the ones who showed the most progress, but participants with only minor writing difficulties at baseline also improved. The study shows that a digital spelling aid constitutes effective support for people with aphasia and may also affect levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. Although writing difficulties is a persisting symptom in aphasia, it can be supported and improved through use of digital spelling aids. Hence, treatment of writing ability should always be included in the rehabilitation of people with aphasia. What is already known on this subject Use of a technical writing aid can have a positive impact on the written output of persons with aphasia. Using a digital spell checker may improve spelling as well as other levels of writing, but it has not been investigated using a keystroke-logging tool in combination with language-test scores and results from questionnaires. What this paper adds to existing knowledge Through analyses on both individual and group level, this study shows that a digital spelling aid constitutes effective support for people with aphasia and also affects levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. What are the potential or actual clinical implications of this work? Digital spelling support, which is a relatively simple and inexpensive technology, can support and improve text writing in persons with post-stroke aphasia.

The effect of breakfast after the bell on student academic achievement

Many schools are beginning to serve breakfast after the bell (BAB) in order to expand breakfast participation. Improved nutrition may lead to better academic achievement, but BAB may also cut into instruction time. Using a difference-in-differences (DID) estimation with variation in treatment timing, we find modest negative effects of BAB on math and no effects on English, Language, and Arts (ELA) test scores. The negative effects, while small, were driven by more affluent children. The null findings cannot be explained by the lack of an effect on breakfast participation or school attendance increases. Average treatment effects by grade indicate positive effects on math scores for vulnerable children when BAB is adopted in earlier grades and negative but modest effects in later grades for more affluent children. Overall, we conclude that BAB can be incorporated into the school day without adversely impacting academic achievement in a meaningful way.

Association of Maternal Antidepressant Prescription During Pregnancy With Standardized Test Scores of Danish School-aged Children

Concerns exist about long-term neurodevelopmental consequences of prenatal exposure to antidepressants. To evaluate whether maternal prescription fill for antidepressants in pregnancy was associated with performance in standardized tests among Danish schoolchildren. Population-based retrospective cohort study of children born in Denmark between January 1, 1997, and December 31, 2009, attending public primary and lower secondary school. The children included had completed a language or mathematics test as part of the Danish National Test Program between January 1, 2010, and December 31, 2018. The age range of the eligible schoolchildren was 7 to 17 years. Maternal prescription fill for antidepressants during pregnancy, obtained from the Danish Prescription Register. The difference in standardized scores between children with and without maternal prescription fill for antidepressants in mathematics and language tests (scale, 1-100; higher scores indicate better test results) was estimated using linear regression models, adjusted for relevant confounders. Ten sensitivity analyses were performed, including a sibling-controlled analysis. Among the 575 369 children included (51.1% males), 10 198 (1.8%) were born to mothers filling an antidepressant prescription during pregnancy. The mean (SD) age of children at the time of testing spanned from 8.9 (0.4) years in grade 2 to 14.9 (0.4) years in grade 8. Maternal prescription fill for antidepressants was significantly associated with a poorer performance in mathematics (mean test scores for the group exposed to maternal antidepressant fill: 52.1 [95% CI, 51.7-52.6] and for the group not exposed to maternal antidepressant fill: 57.4 [95% CI, 57.3-57.4]; adjusted difference, -2.2 [95% CI, -2.7 to -1.6]), but not in language (mean test scores for the exposed group: 53.4 [95% CI, 53.1-53.7] and for the not exposed group: 56.6 [95% CI, 56.5-56.6]; adjusted difference, -0.1 [95% CI, -0.6 to 0.3]). In the sibling-controlled analysis, the adjusted difference in mathematics (mean scores for the exposed group: 53.5 [95% CI, 52.7-54.3] and for the not exposed group: 59.0 [95% CI, 58.9-59.1]) was -2.8 (95% CI, -4.5 to -1.2) and in language (mean test scores for the exposed group: 53.9 [95% CI, 53.2-54.6] and for the not exposed group: 56.6 [95% CI, 56.5-56.7]) was -0.3 (95% CI, -1.9 to 1.2). In this study of public schoolchildren in Denmark, children whose mothers had filled prescriptions for antidepressants during pregnancy, compared with children whose mothers did not fill prescriptions for antidepressants during pregnancy, had a 2-point lower standardized test score in mathematics, a difference that was statistically significant, but had no significant difference in language test scores. The magnitude of the difference in the mathematics test score was small and of uncertain clinical importance, and the findings must be weighed against the benefits of treating maternal depression during pregnancy.

The Impact of the Age at the Cochlear Implantation on the Pragmatic Development of the Prelingual Hearing Impaired Egyptian Arabic Speaking Children

Abstract Background Hearing impaired children have delayed development of pragmatic skills as hearing impairment (HI) deprives them from exposure to natural communication interactions. The rehabilitation of children with HI aims to improve their listening skills for better language development and better communication and social interactions. Aim of this work to compare the pragmatic language development of the prelingual hearing impaired children who were cochlearly implanted before the age of 3 years and those who were cochlearly implanted after the age of 3 years. Methods Sixty Egyptian Arabic-speaking children with prelingual severe to profound sensory neural hearing loss, thirty children who were cochlearly implanted before the age of 3.0 years compared to thirty children who were cochlearly implanted after the age of 3.0 years. Language assessment was done by Modified Preschool Language Scale – 4th edition (PLS–4), the Arabic version and pragmatic development was assessed by Standardized Egyptian Arabic Pragmatic Language Test (EAPLT). Results The two study groups showed no significant differences regarding the receptive, expressive, and total language test scores by PLS-4. Group I showed a significant difference (improvement) regarding the pragmatic factors while there were no significant differences between the two study groups regarding the rest of the pragmatics scores by EAPLT. Conclusion The pragmatic language of cochlearly implanted children either who have been implanted before or after 3 years old is affected. This higher susceptibility to pragmatic impairment in prelingual cochlearly implanted children, as well as the importance of pragmatic skills for further social-communicative and academic careers, should be considered in their rehabilitative plan and advocate the importance for early incorporation of pragmatic behaviors into their intervention programs.