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Language development and speech intelligibility of Egyptian children using cochlear implant
El-Shazly M. , Hegazi M. , Abdelghaffar H. , El Dessoki T. , Nagib S. , Abdelhamid A. , Abdelmonem A.A. ,
Radwan A.
Cairo University, Otorhinolaryngology Department, Cairo, Egypt, 2Ain Shams University, Otorhinolaryngology Department - Phoniatrics Unit,
Cairo, Egypt, 3Elfayoum University, Otorhinolaryngology Department, Elfayoum, Egypt, 4Banisuef University, Otorhinolaryngology
Department, Banisuef, Egypt, 5Banisuef University, Otorhinolaryngology Department - Phoniatrics Unit, Banisuef, Egypt, 6Cairo University,
Otorhinolaryngology Department - Phoniatrics Unit, Cairo, Egypt
Introduction: Children with profound sensorineural hearing loss (SNHL) experience delay in learning to
understand the speech of others and to produce intelligible speech. This delay is rooted in a lack of refined
access to the spectral and temporal cues of the acoustic-phonologic components of speech. When traditional
amplification devices (hearing aids) are unable to restore access to the full range of phonemic components of
speech, a cochlear implant is a widely used treatment option for those children.
Methods: Thirty Egyptian children aged from 4 to 6 years with bilateral severe to profound and profound SNHL.
They were fitted by bilateral behind ear hearing aids and had regular language therapy for one year with poor
response, and then they were implanted &enrolled in rehabilitation with CROP team for another one year. Lack
of benefit from appropriately fit hearing aids is determined by the lack of progress in the development of simple
auditory skills& by poor language development.
Battery included:
1. Modified preschool language scale (El Sady et al., 2010) is used for language assessment.
2. Speech intelligibility assessment is measured by the Arabic Speech Intelligibility Test for Children
(Bassiouny et al., 2011). Language test before using hearing aids is retrieved from the children
medical profiles. Other assessments were done twice
1 before implantation& the 2 assessment was done after 1 year of regular rehabilitation with cochlear implant.
Language development after rehabilitation with hearing aids is compared with language development after one
year of rehabilitation with cochlear implant.
Result: The receptive language with cochlear implant is higher (28.3 ± 4.7) than with hearing aids(17.3 ±0.8),
this difference was statistically significant. The expressive language with cochlear implant is higher (32.5±7.2)
than with hearing aids (22.5±1.1), this difference was statistically significant. The total language development
with cochlear implant was higher (60.8±11.6) than with hearing aids (39.9 ±1.4), it was statistical significant
difference. Frontal phonemes are developed with a significant difference compared to the back phonemes
Speech intelligibility is improved dramatically by using cochlear implant.
Discussion: This study shows children who get little benefit from hearing aids had benefit from using cochlear
implant. Other studies indicate greater vocabulary improvement in children enrolled in total communication
programs after cochlear implant.
Conclusion: Cochlear implantation is a safe and reliable technique. The fact that many profoundly hearingimpaired children using cochlear implant can develop functional levels of speech perception and production,
attain age-appropriate oral Language, develop competency level in a language other than their primary
Learning outcome: Continuation of language therapy together with proper mapping accordingly is a must to
enroll these children in main stream school.