The effect of age on the degree of improvement of pragmatics in delayed language developed children

Abstract

Background The study of actual language use is called “pragmatics.” The literal meaning of an utterance is necessary, but not sufficient for the partner to reconstruct the meaning conveyed by the actor. The interventions of pragmatic impairments depend mainly on improving the four important aspects for any effective social communication contexts that are social interactions, social cognition, language processing, and pragmatic skills. Aim The paper aims to study the effect of age on pragmatic intervention to decide what age is more appropriate to give the better response of pragmatic impaired children. Patients and methods This study was conducted on 20 children with pragmatic impairments attending the Unit of Phoniatrics, in the outpatient clinic of Alexandria Main University Hospital. The children of the study were divided into two groups: group A: 10 children with pragmatic skill impairments aged (5–<6.5) years old and group B: 10 children with pragmatic skills impairments aged (6.5–8) years old. First, Initial assessment: (A) elementary diagnostic procedures: history taking, general examination. (B) Clinical diagnostic aids: psychometric evaluation, Arabic language test, and pragmatic language skills evaluation by using the Arabic version of Test of Pragmatic Language second edition, which is a subtest of Comprehensive Arabic language test. Second, Intervention: the program was applied to all children in groups of 2–3 children, one session per week, each session ranging from 45 to 60 min. Two types of interventions were applied which were: (a) direct intervention: typically delivered by speech-language pathologist and (b) indirect interventions: typically consisted of advices and instructions to the parents or to support the generalization of social communication skills in the child’s environment. “Say and Do Positive Pragmatic Fun Sheets” program helps children learn to use appropriate social communication skills in everyday situations. The fun sheets target a variety of social communication skills in the following areas: giving information, persuasion, requesting, problem solving, feelings, appropriate interaction, greetings/politeness, and topic maintenance. The duration of therapy was about 3–6 months. Third, Reevaluation: after a period of 3–6 months of therapy using the protocol of initial assessment. Results A statistically highly significant increase in the scores of the cases of the school-age studied groups A and B was seen when comparing between pre- and posttherapy, and no statistically significant difference when comparing posttherapy scores between the two studied groups. Conclusion There is no difference in improvement degree of pragmatics in the two age groups so starting therapy can be done at any age to improve the pragmatic skills of children.