Hearing assessment in pre-school children with speech delay.
OBJECTIVE
The purpose of this study was to detect any underlying hearing loss among the healthy pre-school children with speech delay.


METHODS
76 children, aged from 1 to 5 years, underwent a thorough audiological examination consisting of tympanometry, free field testing, otoacoustic emission recordings and auditory brainstem responses (ABRs). If hearing was normal, then they were evaluated by a child neurologist-psychiatrist.


RESULTS
According to our findings, the children were classified into 3 groups; those with normal hearing levels (group I, 52 children, 68.4%), sensorineural hearing loss (group II, 22 children, 28.9%) and conductive hearing loss (group III, 2 children, 2.6%). In group I, speech delay was attributed to pervasive developmental disorder (PDD), which represents high-functioning autistic children (37 cases). Other causes were specific language impairment (SLI)-expressive (3 cases), bilingualism (2 cases), and unknown etiology (10 cases). More than half (59%) of the children diagnosed with PDD evidenced significant language impairment limited to more than two words. Children with SLI-expressive and bilingualism used a maximum of two words. In group II, 13 children suffered from profound hearing loss in both ears, 3 from severe, 3 had profound hearing loss in one ear and severe in the other, 2 from moderate, and 1 had moderate in one ear and severe in the other. No child had mild sensorineural hearing loss. The children with profound hearing loss in at least one ear had total language impairment using no word at all (10 cases), or a maximum of two words (6 cases). When hearing loss was moderate to severe, then the speech vocabulary was confined to several words (more than two words-6 cases). Only two children suffering from conductive hearing loss both presented with complete lack of speech.


CONCLUSIONS
A great number of healthy pre-school children with speech delay were found to have normal hearing. In this case, the otolaryngologist should be aware of the possible underlying clinical entities, especially of psychiatric nature. The children with profound sensorineural hearing loss exhibited more severe speech delay than those with moderate to severe. Regardless of etiology, the early identification and intervention contribute to positive outcome in this critical period of childhood for language development.
Psillas
George
G
1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital 1, Stilponos Kyriakidi St., GR 540 06 Thessaloniki, Greece. psillasgeo@the.forthnet.gr
Psifidis
Anestis
A
Antoniadou-Hitoglou
Magda
M
Kouloulas
Athanasios
A
D000158:Acoustic Impedance Tests; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D001309:Auditory Threshold / Q000502:physiology*; D002675:Child, Preschool; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006314:Hearing Loss, Conductive / Q000150:complications / Q000175:diagnosis*; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007805:Language Development Disorders / Q000150:complications / Q000175:diagnosis*; D008297:Male; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D012720:Severity of Illness Index