Hearing, Language, Speech, Vestibular, and Dentofacial Disorders in Fetal Alcohol Syndrome

Abstract

Fetal alcohol syndrome (FAS) is characterized by congenital anomalies traditionally associated with hearing disorders. The present study sought to (a) evaluate possible central hearing loss; (b) verify and extend previous observations on sensorineural and conductive hearing losses; (c) evaluate possible vestibular disorders; (d) examine the relationships between hearing, speech, language, vestibular, and dentofacial disorders in FAS patients; and (e) evaluate the influence of patient age, race, and gender on the expression of these morbidities. A biracial group of 22 FAS patients (aged 3 to 26 years) were evaluated by standard hearing, speech, language, and vestibular tests. Dentofacial and other malformations were also assessed. Of the 22 FAS patients, 17 (77%) had intermittent conductive hearing loss due to recurrent serous otitis media that persisted from early childhood into adulthood, whereas 6 (27%) had sensorineural hearing loss in addition to the conductive hearing loss. Among the 12 patients tested for central hearing function, all (100%) were significantly impaired. Among the patients tested for speech and language ability, 18 of 20 (90%) had speech pathology, 16 of 21 (76%) had expressive language deficits, and 18 of 22 (82%) had receptive language deficits. Hearing, speech, and language deficits were not influenced by age, race, or gender. On the vestibular tests, all performed within normal limits with the possible exception of one child (n = 6). High incidences of dentofacial, temporomandibular joint, ocular, cardiac, and skeletal disorders were observed. Race and gender tended to influence dental malocclusion class. Two subjects exhibited autistic tendencies. In conclusion, new and important findings included a high prevalence of sensorineural, conductive, and central hearing deficits, the persistence of otitis proneness into adulthood, the existence of temporomandibular joint disorders, and the possible influence of gender or race on dental malocclusions. Such disorders can contribute to the learning, behavioral, and emotional difficulties seen in FAS patients and warrant early, aggressive intervention.

Intervention for individuals with fetal alcohol spectrum disorders: Treatment approaches and case management

“…The effect of alcohol on a developing fetus place individuals with prenatal alcohol exposure at increased risk for a range of medical problems, including cardiac problems, skeletal defects, sensory deficits, and dental problems [Church et al, 1997;Autti-R€ am€ o et al, 2006]. Other research has documented that children with FASDs are hospitalized more frequently than nonexposed children [Kvigne et al, 2004].…”

Speech development delay in a child with foetal alcohol syndrome

“…Studies of people with FAS showed significant weakening of the central auditory [13] in all patients (100%). As it is apparent from the above tests that delayed speech development in case of children with FAS is a result of central auditory processing disorder [14], as well as damage to conductive hearing, receiving, or a mixed one.…”

An innocent victim (fetal alcohol syndrome)

“…Subjects with this syndrome, present with a high prevalence of dental anomalies and speech pathologies that frequently require early intervention 5 . A high rate of temporo-mandibular joint disorders has also been reported 5 .…”

“…-The majority of these children have disorders in the ENT area and vestibular dysfunction is common 5 …”