Prevalence of Hearing Loss in Children Presenting With Speech and Language Delay at the Kenyatta National Hospital

Abstract

Background: Speech and language skill acquisition is essential to a child’s development. Failure to meet the expected speech and language milestones appropriate for age constitutes a delay and has negative implications on the child’s psychosocial and educational wellbeing. The causes of speech and language delay are multifactorial with hearing loss contributing significantly to the pathology. Objective: To determine the prevalence of hearing loss in patients aged 18months -12 years presenting with speech and language delay at the Kenyatta National Hospital during a 12- month study period. Study design and setting: This was a descriptive cross-sectional study conducted at the Speech Therapy unit of Kenyatta National Hospital. Study Population: Children aged 18 months to 12years presenting with speech and language delay. Methodology: Patients referred to the Ear Nose and Throat department with a diagnosis of speech and language delay and met the inclusion criteria were recruited into the study. Recruitment of participants was done using convenience sampling and data captured in a structured data collection sheet. The participants biodata was recorded and a focused history and examination conducted, with an emphasis on otoscopy. Children below four years had their hearing thresholds assessed by Auditory Brainstem Response audiometry and above four years by Pure Tone Audiometry. Tympanometry was done on all participants . Data management and analysis: .Data was collected using a questionnaire and compiled on an excel spreadsheet. Data was preprocessed and analyzed using the R statistical language (version 4.30 R core team 2023) Demographics and patient characteristics were non-parametric and summarized as medians and interquartile ranges (IQR). Measures of association of the categorical variables such as hearing loss and Otitis media with effusion were established using Chi squares, P values and 95% confidence intervals. P values of 0.05 were considered statistically significant. Results: There was a hearing loss prevalence of 72.9% in speech and language delayed participants in the Kenyatta National Hospital. The median age of participants was 4.0 (3.35,5.00) with statistically equal male and female distribution. Mild (23.72%) and severe 13 (18.24%) were most commonly found hearing losses. The distribution of other hearing losses was moderate (15.25%), Moderately severe (6.77%) and profound (3.38%).Type of hearing loss was not determined. Otoscopic and tympanometry features of Otitis Media with Effusion were not statistically significant. Conclusion and Recommendations: There was a hearing loss prevalence of 72.9% in speech and language delayed participants with the most common thresholds being mild and severe. There is need to screen all children with speech or language delay for hearing loss