Abstract

Mohamed Abdelmalek*, Maryem E. Ismail, Hana M. Badi and Wesal I. Abolefa

ABSTRACT

Aim of study: The purpose of this study was to assess the percentage of hearing-impaired children in a group of phenotypically healthy children presenting with speech-language delay. This will help in the early diagnosis of hearing loss, allowing proper management to be instituted as early as possible. Methods: The study was conducted by evaluating 80 children in Misurata medical center with delayed speech with a mean age of two and half years up to 15 years. The guardians of these children were requested to answer a questionnaire. History of the child's morbidity pattern and the risk factors for speech delay were recorded. The child's developmental milestones were assessed and dysmorphic babies were excluded from our study. All children in our study underwent a thorough audiological examination consisting of clinical examination and auditory brainstem responses (ABRs) testing. Results: In our study, we found 17 patients (21.25 %) of all patients with delayed speech have hearing impairment. According to our findings, the children were classified into 3 groups; those with normal hearing levels (group I, 63 children, 78.75%), sensorineural hearing loss (group II, 14 children, 17.5.9%) and conductive hearing loss (group III, 3 children, 3.75% of those with sesorineural hearing loos, 12 patients was bilateral and two unilateral of those with conductive hearing loss, two patients was unilateral and one bilateral. In group II, 10 children suffered from profound hearing loss in both ears, 2 from severe, 1 had profound hearing loss in one ear and 1 severe No child had mild sensorineural hearing loss.) % All patients with hearing impairment are males (100 %). 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 of those hearing impairment (17 children , sensorineural and conductive), 7 children their family had concern that their child had hearing problem, the others 10 no. Conclusion: 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. The results of this study highlight the importance of establishing and adopting low-cost procedures such as screenings to identify children at risk of developing language and/or hearing disorders in early childhood. Intact hearing in the first few years of life is vital to language and speech development. Hearing loss at an early stage of development may lead to profound speech delay. Hearing loss may be conductive or sensorineural. Conductive loss is commonly caused by otits media with effusion, malformations of the middle ear structures and atresia of the external auditory canal. Sensorineural hearing loss may result from intrauterine infection, Kernicterus, ototoxic drugs, bacterial meningitis, hypoxia and intracranial hemorrhage.