Interstitial deletion of a proximal 3p: a clinically recognisable syndrome

Interstitial deletions of the proximal short arm of chromosome 3 occurring as constitutional aberrations are rare and a defined clinical phenotype is not established yet. We report on a 30-months-old girl with distinct facial features (square facies, plagiocephaly, broad forehead, broad nasal bridge, long philtrum and low set ears) and psychomotor/speech delay associated with an interstitial deletion of 3p12 chromosomal band, del(3)(p12p12). Clinical manifestations of our child were compared with those of other eight patients with the same deletion previously described to further delineate the proximal 3p deletion syndrome.

Reading development subtypes and their early characteristics

The present findings are drawn from the Jyväskylä Longitudinal Study of Dyslexia (JLD), in which approximately 100 children with familial risk of dyslexia and 100 control children have been followed from birth. In this paper we report data on the reading development of the JLD children and their classmates, a total of 1,750 children from four measurement points during the first two school years. In the total sample, we examined whether heterogeneous developmental paths can be identified based on profiles of word recognition and reading comprehension. Secondly, we studied what kind of early language and literacy skill profiles and reading experiences characterize the children with differing reading development in the follow-up sample. The mixture modeling procedure resulted in five subtypes: (1) poor readers, (2) slow decoders, (3) poor comprehenders, (4) average readers, and (5) good readers. The children with familial risk for dyslexia performed on average at a lower level in all reading tasks than both their classmates and the controls, and they were overrepresented in slow decoders subtype. Differences between the subtypes were found in the early language and literacy skill development, as well as in the reading experiences of the reading subtypes.

Autism, Attachment and Parenting: A Comparison of Children with Autism Spectrum Disorder, Mental Retardation, Language Disorder, and Non-clinical Children

Children with Autism Spectrum Disorder (ASD) have severe and pervasive impairments in the development of social interaction, which may affect the attachment relationship with their parents and may have an impact on parenting. In the current investigation 89 families with young children (mean age 26.5 months) were involved, who were diagnosed as ASD, mentally retarded (MR), or language delayed (LD), or part of a non-clinical comparison group. Attachment security was observed with the Brief Attachment Screening Questionnaire, and several parental self-report questionnaires assessed the parenting style, parental efficacy, parental experiences of daily hassles, social support, and psychological problems. Children with ASD were rated as less secure compared to the other clinical and normal comparison groups. Parents of non-clinical children reported higher levels of authoritative parenting than parents in the ASD group and in the total clinical group, and they also received less social support. Parents of children with ASD coped remarkably well with the challenges of raising a child with ASD.

Enhancing early communication through infant sign training

Existing research suggests that there may be benefits to teaching signing to hearing infants who have not yet developed vocal communication. In the current study, each of 4 infants ranging in age from 6 to 10 months was taught a simple sign using delayed prompting and reinforcement. In addition, Experiment 1 showed that 2 children independently signed in a variety of novel stimulus conditions (e.g., in a classroom, with father) after participating in sign training under controlled experimental conditions. In Experiment 2, crying and whining were replaced with signing when sign training was implemented in combination with extinction.

[Therapeutic options in autism]

The etiology of autistic disorders is very probably genetic. The aim of treatment is to improve the child's ability to interact and communicate with others, as well as his language skills. For this purpose, various therapeutic behavioral options are available. In the case of the Frankfurt group therapy, group therapy is combined with special computer-based training aimed at identifying emotions. This can be supplemented by psychopharmaceutic co-treatment aimed at ameliorating accompanying dysfunctional behaviors, such as auto-aggression, hyperactivity, or motor stereotypes.

Effect of "missing" information on fast mapping by individuals with vocabulary limitations associated with intellectual disability

One phenomenon of language development is a dramatic increase in vocabulary size, driven by rapid word learning. For individuals with intellectual disabilities, the size of the lexicon often lags behind what would be expected both for CA and MA. I examined how well individuals with severely limited receptive vocabulary associated with intellectual disability retained a new word-picture map after a single exposure under conditions of varying difficulty. This study was a direct replication of a previous investigation with typically developing preschool children, enabling a direct comparison. Individuals with intellectual disabilities performed equally as well as control children in the initial exposure phase but poorer when asked to remember the initial map in the presence of other novel distracters or labels.

Expressive language during conversational speech in boys with fragile X syndrome

We compared the expressive syntax and vocabulary skills of 35 boys with fragile X syndrome and 27 younger typically developing boys who were at similar nonverbal mental levels. During a conversational speech sample, the boys with fragile X syndrome used shorter, less complex utterances and produced fewer different words than did the typically developing boys after controlling for their nonverbal MA, speech intelligibility, and mother's education. The boys with fragile X used less complex noun phrases, verb phrases, and sentence structure, but did not use fewer questions and negations. These findings suggest that the language difficulties in boys with fragile X reflect an overall expressive language delay and not a specific syntactic or vocabulary delay.

What happens to children with PDD when they grow up? Prospective follow-up of 219 children from preschool age to mid-childhood

OBJECTIVE

To describe the psychological development of children with pervasive developmental disorders over a period of 3 years and to identify the factors linked to their developmental paths.

METHOD

The study was a collaborative and prospective follow-up study of 219 preschoolers. Retrospective data and enrollment data were collected at the beginning of the study and 3 years later.

RESULTS

We observed high variability in the short-term outcomes of preschoolers. In line with previous research, our results showed that intellectual, linguistic and adaptive functioning were useful for predicting outcome. The severity of a child's autistic symptoms appears to be related to his or her future development. These variables can therefore be used as predictors of outcome for preschoolers with autism.

CONCLUSION

Developmental and symptom changes in young children with autism should not be overlooked and need to be assessed regularly in view of choosing suitable servicing programs.

Counting span and the identification of primary language impairment

BACKGROUND

In recent research, verbal working memory has been proposed as a primary area of deficit for children with language impairment (LI), and therefore a source of more sensitive assessment measures. In addition, research on non-linguistic tasks has suggested that children with LI may have deficits that extend beyond the linguistic domain. These dual lines of research can be connected to the drive for non-biased assessment tasks for children with diverse language learning experiences (such as bilingual children), because linguistic tasks may be intrinsically biased against such children.

AIMS

To investigate the usefulness of a working-memory task with a minimal linguistic load as a potential screening tool for children with primary LI.

METHODS & PROCEDURES

Three groups of children aged 7;10-13;11 participated in the study: monolingual English-speaking children with LI, typical monolingual English-speaking children, and typical Spanish-English bilingual children with several years of English experience. Performance of the three groups on the Counting Span task was explored through group comparisons and likelihood ratios.

OUTCOMES & RESULTS

Children with LI had significantly lower Counting Span Set score accuracy than either typical group, with the monolingual and bilingual groups showing equivalent task performance. However, results from likelihood ratios showed that Counting Span accuracy did not have compelling diagnostic power when the entire age group was considered. Children with less than 67% accuracy were only three times more likely to be from the LI group than from either of the two typical groups. In addition to language status (typical or LI), chronological age was a key contributor to Counting Span performance in this age group. Likelihood ratios for children aged 10;0 and above showed that children with less than 67% accuracy were nine times more likely to come from the LI group than the typical groups.

CONCLUSIONS

This intermediate diagnostic ability suggests that performance on the Counting Span alone is insufficient to identify LI among linguistically diverse learners. However, Counting Span may be a very useful component of a larger LI assessment battery, particularly for children over the age of 10;0.

Can a 'single hit' cause limitations in language development? A comparative study of Swedish children with hearing impairment and children with specific language impairment

BACKGROUND

Studies of language in children with mild-to-moderate hearing impairment (HI) indicate that they often have problems in phonological short-term memory (PSTM) and that they have linguistic weaknesses both in vocabulary and morphosyntax similar to children with specific language impairment (SLI). However, children with HI may be more likely than children with SLI to acquire typical language skills as they get older. It has been suggested that the more persisting problems in children with SLI are due to a combination of factors: perceptual, cognitive and/or linguistic.

AIMS

The main aim of this study was to explore language skills in children with HI in comparison with children with SLI, and how children with both HI and language impairment differ from those with non-impaired spoken language skills.

METHODS & PROCEDURES

PSTM, output phonology, lexical ability, receptive grammar and verb morphology were assessed in a group of children with mild-to-moderate HI (n = 11) and a group of children with SLI (n = 12) aged 5 years 6 months to 9 years 0 months.

OUTCOMES & RESULTS

The HI group tended to score higher than the SLI group on the language measures, although few of the differences were significant. The children with HI had their most obvious weaknesses in PSTM, vocabulary, receptive grammar and inflection of novel verbs. The subgroup of children with HI (five out of 10) who also showed evidence of grammatical output problems was significantly younger than the remaining children with HI. Correlation analysis showed that the language variables were not associated with age, whereas hearing level was associated with PSTM.

CONCLUSIONS

Children with HI are at risk for at least a delay in lexical ability, receptive grammar and grammatical production. The problems seen in the HI group might be explained by their low-level perceptual deficit and weak PSTM. For the SLI group the impairment is more severe. From a clinical perspective an important conclusion is that the language development in children with even mild-to-moderate HI deserves attention and support.

22q11.2 deletion syndrome: behaviour problems of infants and parental stress

BACKGROUND

22q11.2 deletion syndrome (22q11.2 DS) can be associated with a variety of somatic symptoms, developmental delays and psychiatric disorders. At present, there is little information on early behaviour problems, and nothing is known about parental stress and possible relations between these factors. Therefore, the aim of this study was to investigate behaviour problems of infants with 22q11.2 DS, and their primary caregivers' stress.

METHODS

Parents of infants with 22q11.2 DS known to the German 22q11.2 deletion syndrome foundation were anonymously asked to fill out several questionnaires, e.g. the Child Behavior Checklist (CBCL) 1.5-5.

RESULTS

The primary caregivers of 22/30 children [12 boys and 10 girls aged 1 year 8 months to 3 years 11 months (mean age: 2 years 9 months)] sent back filled-out questionnaires. Seventeen out of 21 children showed motor, and 15/21 language delay. Five out of 21 children were rated as clinical on at least one CBCL 1.5-5 scale. The patients' age was correlated with anxiety problems, and girls had significantly more sleep problems than boys. Compared with the general population, the primary caregivers did not experience higher levels of strain, and compared with parents of mentally and/or physically handicapped children, their parental stress was significantly lower. Parental stress and strain were correlated to a variety of child behaviour problems, e.g. externalizing and anxious/depressed behaviour.

CONCLUSIONS

Longitudinal studies are required to show whether behaviour problems and parental stress worsen when 22q11.2 DS patients grow older.

Subject-verb agreement and phonological processing in developmental dyslexia and specific language impairment (SLI): a closer look

BACKGROUND

Problems with subject-verb agreement and phonological (processing) skills have been reported to occur in children with specific language impairment (SLI) and in those with developmental dyslexia, but only a few studies have compared such problems in these two groups. Previous studies have claimed a causal relationship between phonological processing deficits and morphosyntactic problems.

AIMS

The following questions were addressed in this study: (1) Are children with developmental dyslexia and SLI comparable in the level of sensitivity to subject-verb agreement, phonological awareness, and non-word repetition? (2) Are children with developmental dyslexia and SLI comparable in their performance profiles on tasks tapping subject-verb agreement, phonological awareness, and non-word repetition? (3) Are deficits in phonological processing skills related to morphosyntactic deficits?

METHODS & PROCEDURES

Forty-five children (mean age = 8;6 years) with developmental dyslexia, SLI and typically developing children participated. The sensitivity to subject-verb agreement, phonological awareness, and non-word repetition was measured.

OUTCOMES & RESULTS

Both the children with dyslexia and with SLI made more errors than the control children on the subject-verb agreement task, with the children with dyslexia scoring significantly better than the children with SLI. Similarly, the children with SLI and dyslexia both performed more poorly on the phoneme-deletion task than the control group. Both clinical groups performed more poorly on the non-word repetition task than the control children, with the children with dyslexia outperforming the children with SLI. In all three tasks differences in performance profiles were found between the children with developmental dyslexia and SLI. Across all three groups non-word repetition was correlated with morphosyntactic sensitivity.

CONCLUSIONS

The results show similarities between the performances of children with SLI and dyslexia on tasks tapping subject-verb agreement, phonological awareness, and non-word repetition: they scored more poorly than typically developing children. Qualitative analyses revealed, however, differences in the error patterns on all three tasks. Associations between non-word repetition and sensitivity to subject-verb agreement were found, suggesting that problems with phonological processing impact on morphosyntactic skills.

Influence of phonology on morpho-syntax in Romance languages in children with Specific Language Impairment (SLI)

BACKGROUND

The profiles of children with Specific Language Impairment (SLI) differ greatly according to the language they speak. The Surface Hypothesis attempts to explain these differences through the theory that children with SLI will incorrectly produce elements in their language with low phonological weights or that are produced in a non-canonical prosodic structure.

AIMS

Previous studies have shown that the most characteristics errors produced by Catalan and Spanish-speaking children with SLI include function word omission (morpho-syntax) and weak syllable omission (phonology). The omission of function words points to a morpho-syntactic explanation of SLI, while weak syllable omission supports a phonological explanation of SLI. Yet, function words are weak syllables; thus, it is possible that the same mechanism underlies both problems.

METHODS & PROCEDURES

Data were extracted from spontaneous language produced by five children with SLI and five comparison children matched for age and MLU-w. They were assessed on two occasions: at 3;10 and 4;9 years of age. These interviews were then transcribed and the morphological and phonological errors coded. A non-parametric mean analysis and various regression analyses were conducted.

OUTCOMES & RESULTS

The results show that function word omission and weak syllable omission were the most characteristic errors made by Spanish and Catalan-speaking children with SLI and established that omissions increase as prosodic weight decreases. They also indicated that weak syllabic omission may explain most function word omissions.

CONCLUSIONS & IMPLICATIONS

The data support the Surface Hypothesis and suggest that the same impaired mechanism may underlie the morphological and phonological problems SLI children display.

The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism

This study assessed the relation between pre-intervention variables (cognition, socialization and communication) to outcome in young children with autism.

METHOD

Twenty five children with autism (20-32 months) were enrolled in intensive behavior intervention. The children were divided into groups based on their IQ scores and on the severity of their social interaction and communication deficits [per autism diagnostic observation schedule (ADOS) scores]. Six developmental-behavioral domains including, imitation, receptive language, expressive language, nonverbal communication skills, play skills and stereotyped behaviors were assessed at pre- and post-1 year of intervention times.

RESULTS

Significant progress was noted in all the six developmental-behavioral domains after 1 year of intervention. Children with higher initial cognitive levels and children with fewer measured early social interaction deficits showed better acquisition of skills in three developmental areas, receptive language, expressive language and play skills. Both groups showed better progress in Receptive language skills. Better progress in expressive language was associated with the child's social abilities, while more significant progress in play skills was related to pre-intervention cognitive level.

CONCLUSIONS

These findings emphasize the importance of early intensive intervention in autism and the value of pre-intervention cognitive and social interaction levels for predicting outcome.

A comparative study of vocal fundamental frequency in the speech of Japanese and American hearing-impaired children

The mean fundamental frequency (F(0)) of 10 normal-hearing (NH) and 10 hearing-impaired (HI) Japanese-speaking children were compared to those of 10 NH and 10 HI American English-speaking children. Results indicated no difference in F(0) between the NH groups; while the Japanese-speaking HI children exhibited a significantly higher mean F(0) than English-speaking HI children. The HI Japanese-speaking children also exhibited significantly higher F(0) values than the NH Japanese-speaking children. The influence of a language-specific difference in pitch application was assumed to be a contributing factor to the F(0) differences between the HI groups.

Does Executive Function Matter for Preschoolers’ Problem Behaviors?

Early problem behaviors are associated with a variety of cognitive deficits: in verbal ability, executive function (EF) and theory of mind (ToM). Previous studies with different age-groups yield contrasting results: for 2-year-olds, ToM skills appear particularly salient (Hughes & Ensor, 2006), but for 4-year-olds EF appears more important (Hughes, White, Sharpen, & Dunn, 2000). To examine this apparent developmental change in the relative salience of cognitive deficits we followed 122 children from Hughes and Ensor's (2006) sample at ages 3 and 4. Tests of ToM, EF and verbal ability were included at each time-point and multi-informant, multi-measure, multi-setting ratings provided aggregate measures of problem behaviors. ToM and verbal ability showed non-specific associations with problem behaviors, but associations between EF and problem behaviors were strong and specific. In addition, age-3 EF mediated relations between age-2 verbal ability and age-4 problem behaviors.

Neurobiology and Neurodevelopmental Impact of Childhood Traumatic Stress and Prenatal Alcohol Exposure

Purpose

Research reveals that prenatal alcohol exposure and child trauma (i.e., abuse, neglect, sexual abuse) can have deleterious effects on child development across multiple domains. This study analyzed the impact on childhood neurodevelopment of prenatal alcohol exposure and postnatal traumatic experience compared to postnatal traumatic experience alone. Although the harmful effects of both have been well documented individually, there is no research documenting the concurrent effects of prenatal alcohol exposure and postnatal trauma on a child’s developmental process.

Method

Transdisciplinary assessment of the children included the core disciplines of medicine, speech-language pathology, occupational therapy, social work, and psychology. Medical examination, standardized developmental and intelligence testing, projective tools, parent questionnaires, and psychosocial interviews provided information in the primary developmental areas.

Results

Findings indicated that children who had been exposed prenatally to alcohol along with postnatal traumatic experience had lower intelligence scores and more severe neurodevelopmental deficits in language, memory, visual processing, motor skills, and attention than did traumatized children without prenatal alcohol exposure, as well as greater oppositional/defiant behavior, inattention, hyperactivity, impulsivity, and social problems.

Clinical Implications

Successful teacher and speech-language pathologist interventions with traumatized children with prenatal alcohol exposure demand a paradigm shift that requires the development of new perspectives and ongoing training.

Epilogue: Understanding Children Who Have Been Affected by Maltreatment and Prenatal Alcohol Exposure: Future Directions

This epilogue summarizes the six articles presented in the clinical forum focused on understanding children who have been affected by maltreatment and prenatal alcohol exposure. It presents common themes that emerged among the articles and future research directions.

A review of neurocognitive and behavioral profiles associated with 22q11 deletion syndrome: implications for clinical evaluation and treatment

22q11 deletion syndrome (22q11DS) is a chromosomal disorder that results in variable multisystem abnormalities, including conotruncal cardiac malformations, aplasia or hypoplasia of the thymus and/or parathyroid glands, immunodeficiency, dysmorphic facial features, and cleft palate and other nasopharyngeal and dental anomalies. Individuals with 22q11DS also exhibit cognitive and behavioral difficulties, including delayed motor and speech-language development, mental retardation, low academic achievement, impaired spatial reasoning, poor attentional and executive functioning, attention-deficit hyperactivity disorder, autism spectrum disorders, mood disorders, and/or schizophrenia spectrum disorders. Interventions should be designed based on the results of periodic developmental and neuropsychological assessments and psychiatric screening. Future research should focus on understanding deletion-related gene-environment interactions and their effects on developmental and behavioral outcomes, identifying neurodegenerative processes in 22q11DS, and developing preventive models of behavioral and psychopharmacologic treatment.

A State of Double Jeopardy: Impact of Prenatal Alcohol Exposure and Adverse Environments on the Social Communicative Abilities of School-Age Children With Fetal Alcohol Spectrum Disorder

Purpose

This article is a retrospective examination of environmental risk, language performance, and narrative discourse data from a clinical database of school-age children with fetal alcohol spectrum disorder (FASD).

Method

A case-defined diagnostic approach for measuring and reporting the full spectrum of disabilities in children with prenatal alcohol exposure is presented. Demographic, environmental, language, and social communication (as reflected by narrative discourse) data are reported for a large cohort of children with FASD between the ages of 6;0 (years;months) and 12;0.

Results

Children with FASD are a heterogeneous group with varying levels of compromise. The data demonstrate a substantial comorbidity between the effects of prenatal alcohol exposure and adverse caregiving environments. The data further reveal that school-age children with FASD often exhibit clinically meaningful deficits in language and social communication.

Clinical Implication

Children with FASD may be particularly vulnerable to language and social communication deficits as a result of prenatal alcohol exposure and atypical or adverse social interactive experiences. Comprehensive assessment is recommended. Dynamic and functional assessment paradigms may document the language and social communicative deficits in children with FASD and other clinical populations with complex neurodevelopmental profiles.

Sensory Modulation Disorders Among Children With a History of Trauma: A Frame of Reference for Speech-Language Pathologists

Purpose

The purpose of this article is to present definitions and concepts about sensory modulation, illustrate behavioral aspects of sensory modulation disorders, describe a framework for assessment and intervention, and present advances in research.

Method

A review of descriptive and evidence-based literature related to the impact of exposure to both prenatal and postnatal trauma on sensory modulation is provided, with additional information gleaned from recent assessment data on children with a history of trauma who are served by the Southwest Michigan Children’s Trauma Assessment Center (CTAC).

Clinical Implications

The review of the literature indicates support for the presence of sensory modulation disorders among traumatized children. In addition, the emerging data now being gathered on children who have been assessed by CTAC indicate a significant prevalence of sensory modulation disorders among children with a history of trauma alone, and those with both trauma and a diagnosis of fetal alcohol spectrum disorder (FASD). Awareness, recognition, and identification of behaviors associated with this disorder, and referral to appropriate professionals, is essential to ensure effective preventive and intervention services.

Can autism, language and coordination disorders be differentiated based on ability profiles?

Children with autistic disorder (AD), mixed receptive-expressive language disorder (RELD), or developmental coordination disorder (DCD) have impairments in common. We assess which abilities differentiate the disorders. Children aged 3-13 years diagnosed with AD (n = 30), RELD (n = 30), or DCD (n = 22) were tested on measures of language, intelligence, social cognition, motor coordination, and executive functioning. Results indicate that the AD and DCD groups have poorer fine and gross motor coordination and better response inhibition than the RELD group. The AD and DCD groups differ in fine and gross motor coordination, emotion understanding, and theory of mind scores (AD always lower), but discriminant function analysis yielded a non-significant function and more classification errors for these groups. In terms of ability scores, the AD and DCD groups appear to differ more in severity than in kind.

Birth order effects on autism symptom domains

Autism is predominantly genetically determined. Evidence supports familiality of the main sets of behavioral characteristics that define the syndrome of autism; however, possible non-genetic effects have also been suggested. The present study compared levels of autism symptom domains, as measured by the Autism Diagnostic Interview, and useful phrase speech scores between 106 pairs of first- and second-born siblings from multiply affected families. In addition, the intercorrelations between the measures were compared between siblings. The overall mean repetitive behavior total score was significantly higher (worse) in first-born than in second-born siblings. In contrast, first-born siblings had significantly lower (better) useful phrase speech than their younger siblings. Autism social and non-verbal communication scores were significantly correlated in first- and in second-born siblings. However, there was a significant difference in the coefficients between first- and second-born siblings. Performance on the non-verbal communication domain was also significantly and positively correlated with useful phrase speech score in both first- and second-born siblings. It is unclear at this time whether these results are of biologic origin. Nevertheless, the findings suggest that genetic studies in autism using specific levels of familial autism traits as phenotypes should take into account their intercorrelations and birth order effects embedded in the instrument.

Reducing skin picking via competing activities

This study examined the outcomes of a competing activities intervention to decrease skin picking exhibited by a 9-year-old student with comorbid diagnoses. Results of an ABCBAB design revealed that the use of student-selected manipulatives resulted in reduced skin picking.

[Lexical outcomes in auditory closure in children with sensorineural hearing loss]

OBJECTIVE

The aim of this study was to assess the lexical outcomes in auditory closure of children with aided residual hearing.

PATIENTS AND METHODS

A total of 37 children (from 4;7 to 8;2 years old) with bilateral (n = 23) or unilateral (n = 14) sensorineural hearing loss (average at frequencies of 0.5, 1, 2, 4 kHz >20 to >90 dB in the better ear) of unknown onset (n = 31) were recruited out of the 1994 implemented Gottinger Hor-Sprachregister (Go HSR). Mean age at diagnosis: 72.0 months (SD 9.8; min. 48; max. 88), mean age at hearing aid implementation: 73.0 months (SD 9.4). All children demonstrated an average nonverbal intelligence, and none suffered from major comorbidities. The subtest 'Auditory Closure' of the standardized (compared to normally developing hearing children) German version of the Illinois Test of Psycholinguistic Abilities was carried out at 3 time points (t1-t3). Mean time interval t1-t3: 20.3 months (SD 4.7). The test raw scores were converted to T scores (mean = 50, SD = 10). The first psychometric examination took place after the ascertainment of the hearing loss (t1). Two follow-ups (t2, t3) were performed at 6- to 9-month time intervals.

RESULTS

On average, the study group exhibited age-appropriate performances at t1 and significantly improved over time. The average performance of bilaterally impaired children increased most notably (t1-t3; p = 0.008). Subgrouped by age at diagnosis < or =73 months (cut-off for split-half comparison), the performances at t3 were statistically significantly different from those of t1 (t1-t3; p = 0.002). A multiple regression analysis demonstrated the effect of the ability of auditory closure at t1 (p < 0.001) and of nonverbal intelligence (p = 0.002) on the outcome measure at t3.

CONCLUSION

Auditory closure is less determined by degree of hearing loss than by the size of the individual vocabulary and the nonverbal intelligence potential.