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Otological and habilitative management of children with Down syndrome
D G Pappas1, C Flexer, L Shackelford
1Pappas Ear Clinic, Birmingham, AL 35233.
Insights
Early, aggressive intervention for hearing loss in infants with Down syndrome can lead to age-appropriate oral language development. This approach addresses common ear issues and utilizes auditory-verbal therapy for better communication skills.
Area of Science:
- Pediatric audiology
- Developmental pediatrics
- Speech-language pathology
Background:
- Children with Down syndrome frequently experience conductive hearing loss due to external auditory canal (EAC) stenosis, cerumen impaction, serous otitis media (SOM), and cholesteatoma.
- Hearing loss significantly impacts spoken communication skills in children with Down syndrome, often hindering them below their cognitive potential.
- Assertive management strategies are crucial for addressing hearing impairments in this population.
Purpose of the Study:
- To present an aggressive, multidisciplinary treatment model for infants with Down syndrome during their first year of life.
- To evaluate the impact of this model on oral language development.
- To compare language outcomes between infants receiving early intervention and those who do not.
Main Methods:
- Implementation of a multidisciplinary treatment model including EAC reconstruction, amplification technology, and speech/language intervention.
- Emphasis on auditory-verbal (A/V) therapy as a core component of the intervention.
- A pilot study comparing language development in two groups of infants with Down syndrome: one receiving early aggressive treatment (Group A) and a control group (Group B).
Main Results:
- Infants in Group A, who received the aggressive early intervention, demonstrated age-appropriate oral language development.
- This suggests a positive correlation between the early multidisciplinary approach and improved communication outcomes.
- The findings highlight the potential of proactive management in mitigating the effects of hearing loss on language acquisition.
Conclusions:
- An aggressive, multidisciplinary treatment model initiated in the first year of life is effective in promoting age-appropriate oral language development in infants with Down syndrome.
- Auditory-verbal therapy, combined with audiological and surgical interventions, plays a vital role in this success.
- Early and assertive management of hearing loss is essential for optimizing spoken communication skills in children with Down syndrome.
Abstract:
It has been well-established that children with Down syndrome experience a high incidence of persistent conductive hearing loss because of their predisposition to stenosis of the external auditory canal (EAC), cerumen impaction, serous otitis media (SOM), and cholesteatoma. Because this hearing problem may be a primary cause of the spoken communication skills in these children being far below their cognitive ability, assertive management is required. The authors present an aggressive multi-discipline treatment model that is instituted during the first year of life in an infant with Down syndrome. Reconstruction of the EAC, amplification technology, and speech/language intervention that emphasizes auditory-verbal (A/V) therapy are discussed. In a pilot study, we compared the language development of six infants with Down syndrome who received aggressive treatment during their first year of life (group A) to six infants who did not (group B). The results showed age-appropriate oral language development for the infants in group A.