HEARING, LANGUAGE, SPEECH, VESTIBULAR, AND DENTOFACIAL DISORDERS IN FETAL ALCOHOL SYNDROME

Fetal alcohol syndrome (FAS) is characterized by congenital anomalies traditionally associated with hearing disorders. The present study sou ght to (a) evaluate possible central hearing loss; (b) verify and exte nd previous observations on sensorineural and conductive hearing losse s; (c) evaluate possible vestibular disorders; (d) examine the relatio nships between hearing, speech, language, vestibular, and dentofacial disorders in FAS patients; and (e) evaluate the influence of patient a ge, race, and gender on the expression of these morbidities. A biracia l group of 22 FAS patients (aged 3 to 26 years) were evaluated by stan dard 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 ot itis 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 functio n, all (100%) were significantly impaired. Among the patients tested f or speech and language ability, 18 of 20 (90%) had speech pathology, 1 6 of 21 (76%) had expressive language deficits, and 18 of 22 (82%) had receptive language deficits. Hearing, speech, and language deficits w ere not influenced by age, race, or gender. On the vestibular tests, a ll performed within normal limits with the possible exception of one c hild (n = 6). High incidences of dentofacial, temporomandibular joint, ocular, cardiac, and skeletal disorders were observed. Race and gende r tended to influence dental malocclusion class. Two subjects exhibite d autistic tendencies. In conclusion, new and important findings inclu ded a high prevalence of sensorineural, conductive, and central hearin g deficits, the persistence of otitis proneness into adulthood, the ex istence of temporomandibular joint disorders, and the possible influen ce of gender or race on dental malocclusions. Such disorders can contr ibute to the learning, behavioral, and emotional difficulties seen in FAS patients and warrant early, aggressive intervention.