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The most typical birth defect is hearing impairment. Hearing impairment has a negative impact on the development of early communication skills. Objectives: To compare the pragmatic abilities of both children who are hearing aid users and normal hearing to asses pragmatics based on instrumental, regulatory, personal, interactional, need explanations, knowledge sharing and explanation. Methods: It was a comparative cross-sectional survey. Total sample of 54 children were included. 27 children were hearing aid users and 27 with the normal hearing. Purposive sampling technique was used in this study. All individuals with normal hearing and those who use hearing aid were included with the age range of 3 to 7 years. Social communication pragmatics checklist was used for collecting the data. Results: Results showed that children with normal hearing had overall better pragmatic abilities as contrast to the children who use hearing aid. Independent sample t test was using for analysis of data and p-value was less than 0.05. Conclusions: It was concluded that communication-pragmatic abilities are good in children with normal hearing as compared to children who are hearing aid users.

Background: Hearing loss (HL) in adults is loss of ability to perceive surrounding environmental sounds. There may be environmental or genetic cause of this disability. Presently expectancy of old adult age is going to increase as in the same way hearing problems and its negative impact on health wellbeing standard of living also increased, the beneficial of current study is to be addressed, or give awareness about health consequences to adult population with hearing impairment. Aim: To determine the quality of life in adults with hearing impairment. Place and Duration of Study: Riphah international University, Lahore campus between December 2018 to May 2019. Methodology: A cross sectional survey was conducted on 67 adults with hearing impairment (sample size was calculated on the base of prevalence of hearing loss in the Express Tribute, (March 4, 2014) which was a Pakistani study on hearing impaired population the president of famous organization the developmental diseases and community of auditory handicap MR Afzal estimated the occurrence of auditory deficits in Pakistan region was in between 7 to 8 percent on per 10,000 living birth ,this prevalence was used to calculate sample size by using online calculator).(1), their age range were 18 to 55 (elder adults) and 56 to 97(older adults). Data collection tool which was used in this research was 15D Quality of life questionnaire to find out the influence of hearing loss (HL) on daily living activities in adult’s life. Sampling technique used in this research was convenient sampling. For this purpose, descriptive analysis was done for demographics and chi square was used for inferential analysis by using SPSS20. Endnote was used for references. Results: There are four domains of quality of life (speech, usual activities, mental functioning, and vitality status of participants) which have highly significant relationship value(0.05)with hearing impairment. Conclusion: Research concluded that domains of quality of life are significantly associated with hearing loss which have negative impact on the QOL(quality of life) except visual or sexual activity, but these two domains may also indirectly have associated or may affect the quality of life individually in adults with hearing impairment.

Objective: To investigate the occurrence of language and swallowing problem in individuals with cerebral palsy. Methods: The cross-sectional survey was conducted at the Riphah International University, Rawalpindi, Pakistan, from September 2018 to January 2019 while data was collected from the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, a tertiary care hospital. The sample comprised individuals with cerebral palsy of either gender aged 5-18 years. Language Sample Checklist was used for language problems and the Northwestern Dysphagia Patient Checklist was used for swallowing problems.Data was analysed using SPSS- Version 21. Results: Of the55 subjects,62% were males, 38% were females, 76% were from urban areas and 24% were from rural areas.In terms of concepts, processing, and comprehension, 18(33%) persons were able to attempt the tasks, 45(81%) were unable to attempt morphological tasks, 41(74%) were unable to attempt sentence structure tasks, 40(72%) were unable to attempt literacy and narrative skills tasks, 41(74%)could not fulfil pragmatic tasks and 49(89%) had unintelligible speech. The patient checklist showed that 47(85%) children had normal medical history, 41(75%) had normal behavioural variable, 29(52%) had normal gross motor ability,40(73%) completed oral motor test, and 39(71%) had normal swallow trials. Conclusion: Language problems were more prevalent in children with cerebral palsy compared to swallowing difficulties. Key Words: Cerebral palsy, Dysarthria, Language, Swallowing, Dysphagia.

Aphasia, an acquired language disorder, commonly results from a stroke affecting network of cortical and subcortical structures. Aphasia lacks effective standardised treatment. Neuroimaging and behavioural research indicate that some interventions promote neuroplasticity changes in aphasia. Research has suggested that non-invasive brain stimulation may be effective, causing functional reorganisation of language areas between the two hemispheres. This reorganisation evolves from different researches exploring novel procedures, including transcranial magnetic stimulation and intracranial direct current stimulation, which may modulate cortical activity in aphasia. The current narrative review was planned to assess these techniques while examining the casual role of specific regions of brain and the understanding of the underlying mechanism for treatment effects of brain stimulation. Literature was explored on search engines and databases, like Medline, Web of Science and bibliography of published studies. The key words used for the search were 'non-invasive brain stimulation', 'post-stroke aphasia', 'transcranial magnetic stimulation' and 'transcranial direct current stimulation'. Of the 175 publications downloaded, 40(23%) full-text English publications were reviewed.

Background: Inclusive education is a global agenda, generally inclusion in education means full inclusion of children with various abilities in all aspects of schooling that other children have. Teachers have been seen as key persons to implement inclusive education and considered to play a substantial role in the implementation of such educational change. Objective: To see the factors that influence the attitude and concerns of teachers regarding the inclusive education of special needs children. Methodology: It was a cross sectional survey. Sample of 100 (50 mainstream school and 50 special education) teachers were taken by using a convenient sampling technique. The study was conducted from October 2017 to December 2017 in two special education center school of government and two private mainstream schools of Lahore, Pakistan. A questionnaire containing two sections was used to collect data. A sheet containing demographic details of study participants and associated factors and Sentiments, Attitude, and Concerns (SACIE-R), data was gathered and analyzed using SPSS-version 21. Results: 89% were females and 11% were males. The teacher type (mainstream and special) had a statically significant effect on attitude towards inclusive education by showing p value=0.02. Variables like gender, age, and contact with person having disability, experience, education, and confidence levels all had a significant impact on the teacher’s attitude. \ Conclusion: It was concluded that all children can learn when teaching is effective and meets individual strengths and needs. There must be an emphasis on changing schools' culture for providing resources and to build enough capacity in special as well as regular schools to offer new opportunities to pupils who experience difficulties in learning. Keywords: Child, Special, Education, Teachers, Concerns, Attitude, Inclusive

Purpose of the study is to determine the frequency of dysphagia after stroke and to see the factors associated with it.Cross Sectional study design was used by including individuals pre-diagnosed as stroke on the basis of CT scan or MRI findings. Study was conducted in three hospitals of Lahore within six months. Sample size of 150 patients of any age and both gender was taken by using convenient sampling technique. To assess the conscious level, Glasgow coma scale was administered and those who scored mild or moderate on GCS were included in the study. Modified Massey Bedside Swallow Screener was used to screen out the patients for dysphagia. SPSS-19 was used for the statistical analysis.In the sample of 150 individuals with stroke 53% of patients had dysphagia. Females were 38% while males were 62%. Individuals who were older were more likely to have dysphagia. Among dysphagic individuals 65% had ischemic stroke while 35% were with haemorrhagic. There were 87% of dysphagic individuals who presented with history of smoking and 13% were without any. These factors demonstrate significant relationship by showing p-value0.05. While no significant difference was seen between levels of alertness and risk of dyspagia by showing p-value 0.2.Dysphagia after stroke occurs frequently that should be actively assessed and factors like type of stroke and history of smoking are significantly related to this condition.