HEARING, SPEECH, LANGUAGE, AND VESTIBULAR DISORDERS IN THE FETAL ALCOHOL SYNDROME - A LITERATURE-REVIEW

Fetal alcohol syndrome (FAS) is characterized in part by mental impair ment, as well as craniofacial and ocular anomalies. These conditions a re traditionally associated with childhood hearing disorders, because they all have a common embryonic origin in malformations of the first and second branchial arches, and have similar critical periods of vuln erability to toxic insult. A review of human and animal research indic ates that there are four types of hearing disorders associated with FA S. These are: (1) a developmental delay in auditory maturation, (2) se nsorineural hearing loss, (3) intermittent conductive hearing loss due to recurrent serous otitis media, and (4) central hearing loss. The a uditory and vestibular systems share the same peripheral apparatuses ( the inner ear and eighth cranial nerve) and are embryologically and st ructurally similar. Consequently, vestibular disorders in FAS children might be expected. The evidence for vestibular dysfunction in FAS is ambiguous, however. Like other syndromes associated with craniofacial anomalies, hearing disorders, and mental impairment, FAS is also chara cterized by a high prevalence of speech and language pathology. Hearin g disorders are a form of sensory deprivation. If present during early childhood, they can result in permanent hearing, language, and mental impairment. Early identification and intervention to treat hearing, l anguage, and speech disorders could therefore result in improved outco me for the FAS child. Specific recommendations are made for interventi on and future research.