Pervasive developmental delay in children presenting as possible hearing loss

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 hearin g function and language ability often uncovers an underlying developmental disorder satisfying criteria for diagnosis on the spectrum of autism and pe rvasive developmental delay (PDD), The otolaryngologist has a unique opport unity 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 Depart ment of Otolaryngo logy for possible hearing loss identified 15 children who were later diagno sed with PDD. Results: Fifteen children initially referred for beaming eval uation were subsequently identified with a diagnosis of PDD. Males outnumbe red females 4 to 1, with the average age of referral being 2 years, One thi rd of the patients displayed middle ear disease that improved with PE tube placement, One third of the patients showed brainstem conduction dysfunctio n 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 i n their early identification and appropriate referral for therapy.