الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 149 |  |  |
| | | from | 149 | | |
Abstract
Language is the process that conveys meanings to words. Normal language acquisition requires interference of multiple factors-which includes- intact intellectual ability, intact sensory channels, and normal child psychology. Intact auditory cues are very effective in promoting early language development. So, HI is the main contributing factor leading to DLD.
HI is established when the hearing threshold is above 15 dB by pure-tone audiometry. According to the site of affection and its pathology, we can classify HL into CHL, SNHL, mixed HL, and central HL. SNHL is categorized into (slight, mild, moderate, moderately severe, severe, and profound hearing loss) as regards its degree.
Effect of HI on language development depends on several factors: onset of HI, its degree, laterality, and its type, (age, regularity, and duration) of HA fitting, other factors like rehabilitation, family condition, and maternal level of education.
The relationship between HI and language development is inversed in nature. Children with SNHL (from moderate to severe degree) showed obvious affection of language skills relative to age-matched peers with normal hearing. The degree of its affection on language development became more obvious with increased severity of HI and the presence of other previously mentioned factors.
HI affects all language parameters (semantics, morphosyntax, phonology, and pragmatics). Hearing-impaired children have small vocabulary sizes that grow slowly compared to normal developing peers. They tend to use simple and short utterances. Moreover, they
Summary
105
have multiple phonological processes that affect their speech intelligibility. Using more instructions and fewer questions, failure to maintain a conversation, and less clear pragmatic communication functions, all were found in their language.
To improve the language skills of hearing-impaired children, we need to improve the audibility with the regular wearing of HA; better audibility will increase the rate of language outcomes in the preschool years. Also, early HA fitting with proper rehabilitation had better early language development than children fitted and rehabilitated later.
Children need good language skills for better communication and for better life quality, so early detection and remediation of language disorders are mandatory to achieve that. With the help of UNHS programs, better results will be reached.
In this study, the development of different language skills were assessed in a group of SNHL children (from moderate to severe degree) and another normal developing group. This study was conducted on 25 hearing-impaired children (14 male and 11 females) and 25 control subjects (16 males and 9 females). Cases were divided into 2 groups: group A consisted of 10 cases, their ages ranged from 3years to 3years, 11 months, 29 days, and group B consisted of 15 cases, their ages ranged from 4 years to 4 years, 11 months, 29 days. Controls were divided with same age ranges in to 2 groups group A-I consisted of 12 cases, group B-I consisted of 13 cases. Each group was assessed by „APPLE‟ tool. The results of the cases were compared to the results of control subjects and also the results of the studied cases were compared to each other.
Summary
106
By studying the correlation between hearing HI and normal hearing peers as regard to the development of different language skills using APPLE tool which presented in (receptive language subtests, expressive language subtests, total language test, action picture subtests, oral narrative skills subtests, oral comprehension skills test, understanding simple yes/no questions, and articulation test), there were highly significant correlations. A highly significant correlation was found between the duration of HA use and language development. Also, there was a highly significant correlation between duration of rehabilitation and language development. The results from this study provided consistent evidence that HI has an impact on the development of different language skills.
The results of this study demonstrated that there was no significant difference between the degree of HI in the different studied cases and parameters of APPLE tool. For explaining these results: this study has explored multiple factors besides the degree of HI that may moderate its effect on language development and leads to a disabling condition in most of these children.
First, it is important to ensure that regular and early wearing of HA decreases the effects of HI on language development. Moreover, proper planning intervention programs and their duration also improve the linguistic experience. Finally, other factors were noted from the child‟s history such as family condition, socioeconomic level, and parents‟ education. Furthermore, we hypothesized that these factors suggest that hearing-impaired children appeared with reduced language levels during the preschool years compared to normal-hearing children.
Summary
107
So these results demonstrated that language acquisition can be enhanced by adequately exposure to auditory stimuli carried by early and regular hearing aid fitting and proper rehabilitation programs in order to ensure optimum linguistic experience in hearing-impaired children.