Inclusion Criteria:  Hearing impaired children from 6 to 11 years of age who have severe unilateral or bilateral hearing loss from birth and for whom Urdu has their first language. There hearing age is at least one year. Their parents were not hearing impaired. Children used hearing aids. Unilateral & bilateral hearing impaired children were equally distributed.  Exclusion Criteria:  Children who did not present with HI as their main diagnosis or may have other co-morbid conditions.