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Pervasive developmental delay in children presenting as possible hearing loss
1Department of Pediatric Otolaryngology, Columbia-Presbyterian Medical Center, Babies and Children's Hospital of New York, New York 10032-3784, USA.
Insights
Pediatric hearing evaluations can identify children with autism spectrum disorder (ASD) and pervasive developmental delay (PDD). Early identification by otolaryngologists aids in timely intervention for developmental delays.
Area of Science:
- Pediatric Otolaryngology
- Developmental Pediatrics
- Audiology
Background:
- Children with delayed language and social skills by age 2 are often referred for hearing evaluations.
- Otolaryngologists play a key role in identifying potential developmental disorders.
Observation:
- A retrospective review identified 15 children diagnosed with PDD among those referred for hearing loss.
- The majority of identified children were male, with an average referral age of 2 years.
Findings:
- One-third of patients had middle ear disease responsive to PE tube placement.
- Another third exhibited auditory brainstem conduction dysfunction.
Implications:
- Language and communication deficits in children with developmental delays may be misattributed to hearing loss.
- Otolaryngologists and audiologists are crucial for early identification and referral of children with autism and PDD.
Objective/Hypothesis:
Children who fail to develop adequate language skills and/or appropriate social skills by age 2 years often are referred to the department of otolaryngology for otolaryngologic examination and evaluation of possible hearing deficits. Discovering a gross disparity between hearing function and language ability often uncovers an underlying developmental disorder satisfying criteria for diagnosis on the spectrum of autism and pervasive developmental delay (PDD). The otolaryngologist has a unique opportunity to identify these autistic children and initiate their evaluation and management.
Study Design:
Retrospective review.
Methods:
Review of charts of children referred over the past 4 years to the Department of Otolaryngology for possible hearing loss identified 15 children who were later diagnosed with PDD.
Results:
Fifteen children initially referred for hearing evaluation were subsequently identified with a diagnosis of PDD. Males outnumbered females 4 to 1, with the average age of referral being 2 years. One third of the patients displayed middle ear disease that improved with PE tube placement. One third of the patients showed brainstem conduction dysfunction on auditory brainstem evoked response testing.
Conclusions:
Children with developmental delays, especially higher functioning ones, may present with a myriad of language and communication deficits that are often mistakenly attributed to hearing loss. Otolaryngologists and audiologists can assist in their early identification and appropriate referral for therapy.