Speech and Language Development in Children with Congenital Infections: Findings from a Specialized Hearing Health...

Congenital infections remain a significant public health concern worldwide, contributing to developmental delays that may compromise speech, language, and cognitive development. These infections can lead to sensorineural hearing loss (SNHL), further affecting communication and neurodevelopment. This study aimed to assess speech, language, and developmental milestones in children with congenital infections, with and without SNHL, at a specialized auditory diagnosis and rehabilitation center.

This cross-sectional observational study included 55 children with laboratory-confirmed congenital infections caused by pathogens in the TORCHS group (toxoplasmosis, other including syphilis and human immunodeficiency virus [HIV], rubella, cytomegalovirus [CMV], herpes simplex, and syphilis), diagnosed at a reference center in São Paulo, Brazil. Phoniatric assessment involved detailed clinical history-taking to identify risk factors for hearing loss. Standardized evaluations included observational assessments and the Denver Developmental Screening Test II. The mean age of participants was 30 months.

Of the 55 children, 67.3% had syphilis and 18.2% had CMV, with smaller proportions diagnosed with HIV, toxoplasmosis, rubella, or coinfections. SNHL was identified in 30.9%, predominantly profound (58.8%). Nearly half (49.1%) failed neonatal hearing screening, 38.2% were born prematurely, and 30.9% had low birth weight. CMV was strongly associated with SNHL (80% of CMV cases; p < 0.001), and children with SNHL showed significantly greater delays in language and developmental domains (p < 0.001). Developmental assessments identified delays in expressive language (43.6%), receptive language (34.5%), and nonverbal communication (23.6%). Denver II screening revealed significant delays, especially in the language domain.

These findings underscore the need for multidisciplinary early intervention strategies to mitigate developmental risks and support long-term outcomes.