The diagnosis of hearing loss in children with speech and language deficits by the otorhinolaryngologist involves a large allocation of sources. The ability to assess the efficacy of intervention in order to minimize speech and language deficits is an aspect in the care of these children which has not been generally considered as part of the child's ongoing medical care. These children have speech and language deficits predominantly from hearing impairment and occasionally from a primary language disorder. The effect of intervention (usually a hearing aid), the special education program for the hearing impaired child, and the language therapy for the child with a primary language disorder are seldom measured. The ability to assess and monitor the child's progress is essential for the care of these patients. The continual monitoring of the child's progress is accomplished by periodic assessment of the child's speech and language. An instrument to do this has been developed and used by the Department of Otorhinolaryngectomy at the Albert Einstein College of Medicine for a number of years. The utilization of this instrument, as demonstrated by a series of case reports, will be presented. These will include children in which intervention was successful and those for whom it was unsuccessful, with an analysis of the reasons underlying the effectiveness for each child. It is recommended that every child with a speech and language deficit should be monitored periodically so that the child's progress, or lack of progress, can be determined. If the child is not progressing, additional remediation can be instituted to attempt to prevent a permanent speech and language deficiency.
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