الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 193 |  |  |
| | | from | 193 | | |
Abstract
Delayed language development (DLD) is common among toddlers and preschool-aged children. Pediatricians are critical in identifying, evaluating, and managing children who have these delays and diseases. To ascertain parental concerns regarding delayed language development, an initial and continuous examination of language utilizing particular screening tests or parent report inventories should be performed.
About sixty percent of all asthmatic children’ caregivers aged 2-5 years old either controlled or uncontrolled had accepted to sign the consent form to be enrolled in the study. The children who were enrolled in the study came to receive asthmatic treatment and follow-up services done along 12 months.
Children with mental retardation or any other medical illness rather than bronchial asthma, psychological illness, or sensory impairment (e.g., Hearing impairment) were excluded.
The children who were fulfilling the criteria mentioned above were subjected to the protocol for objective and subjective assessment including : History taking, Pediatric clinical examination, ENT clinical examination ,Laboratory investigation done in the hospital lab ,Radiological investigation done in hospital radiology unit ,Complete phoniatric evaluation done in hospital speech and audiology clinic using Abou-Hassiba test and Intelligence Quotient testing using Stanford-Binet Intelligence Scale V edition .
In this study, the association was assessed between asthma and DLD. A higher prevalence of DLD was found in children with Asthma than the actual prevalence in other studies that enrolled children with other presentations.
This is a cross sectional study detecting the delayed language development in children aged 2-5 years old with childhood asthma. The study included 366 children with bronchial asthma presented to Altahrir public hospital (governmental hospital), during the study period (April 2018 till April 2019). Male children were 219, (59.8%) and 147, (40.2%) were female patients. Delayed language development was noticed in 66 (18%) of the patients.
According to asthma severity in children with delayed language development, there were 38 child (57.6%) having mild intermittent asthma, 11 child (16.7%) having mild Persistent asthma, 14 (21.2%) having moderate Persistent asthma, 3 (4.5%) were having severe persistent asthma. The largest percentage of children with delayed language development was categorized as having mild persistent asthma with a P-value of 0.018.
According to this study, significant DLD is common in pediatric patients with asthma. So, the included children were divided into two main groups, according to presence of delayed language development. The instrument of Preschool Language Scale -IV (PLS-4) – Arabic version (Abu-Hassiba test), was applied by a phonetician.
According to this study the most important factors affecting the relationship between asthma and DLD were age, age at asthma onset, height as a growth parameter, eventful prenatal or postnatal history, type of education, Total Leucocytic Count (TLC), Platelet Count (PLT), recurrent Otitis Media (OM), family history of asthma, family history of delayed language and category of asthma severity.
There is a significant difference in age per months, height, age at asthma onset, TLC, and PLT count between children with delayed language development and children without delayed language development. The younger the age in months, the greater the height, and the earlier the onset of asthma, the greater the risk of delayed language development. The higher the total leukocyte count and platelet count, the more the liability of occurrence of delayed language development with P value =0.05.
As regard educational grade, (48.5%) of children with delayed language development were enrolled in Play school (nursery) in comparison to (18.2%) and (33.3%) in KG1grade and household education respectively and this is consistent with previous research in which age and educational environment were demonstrated to have a significant prediction to DLD. There are no significant associations of DLD with gender, consanguinity or type of the caregiver.
As regard pre-natal and post-natal history, family history of asthma and family history of delayed language, there is a statistically significant difference in between asthmatic children with delayed language development and asthmatic children without delayed language development suggesting the importance of this element in predicting DLD in children with asthma.
Significant correlation was found between recurrent otitis media and occurrence of delayed language development in asthmatic children. Recurrent otitis media occurred in (71.2%) of children with delayed language development in comparison to (18%) of the other group.
As well as, difficult toilet training, impaired development of the ability to imitate and using gestures are statistically significantly related to the occurrence of delayed language development in asthmatic children. These items are considered for probing the cognitive and social development influencing language development.
There are, to the best knowledge, only a few previous epidemiologic or prospective studies that have examined the relationship between asthma and delayed language development. Prospective and experimental research are required to elucidate the mechanisms behind these findings.
It is possible that children with asthma are more likely to have language impairments detected as a result of greater healthcare interactions. As a result, additional long-term research utilizing clinical cohorts are required to validate these findings.
The association between asthma and DLD is most likely complex, involving the influence of chronic disease in early childhood and sleep deprivation. Deprivation of sleep during a child’s formative years may damage the memory processes required for early language mastery. However, the current study reveals that, while children who have both asthma and sleep disruption have a significantly elevated risk of DLD, even those who do not have severe asthma or sleep disturbance have an increased risk.
Additionally, asthma, like other chronic childhood diseases, may impair language development. If this is the case, it is possible that other chronic childhood diseases also raise the chance of DLD. Alternatively, it is possible that DLD develops early in life and causes discomfort, increasing a child’s proclivity for wheezes and breath problems, which subsequently manifests as asthma.
There are a number of constraints. Due to the cross-sectional design, no conclusions about causation or direction of relationship can be drawn. Future experimental and prospective clinical investigations with exact quantification of DLD and asthma may contribute to this understanding.