Language Delay In Children Research Articles

Association between Motor and Language Skills Development in Children with Autism Spectrum Disorder: A Scoping Review

ABSTRACT An emerging body of literature suggests that early motor skills may be a key predictor of language development in children with autism spectrum disorder (ASD). However, characteristics of subject groups, targeted skill areas and their assessment tools, and methodological approaches significantly vary across existing studies. This scoping review aimed to map out the associative nature of motor and language skills among children with ASD according to different age groups and ancillary attributes by investigating empirical studies published in the past 20 years. We searched research articles published in peer-reviewed journals between January 2000 and December 2020 using PsycINFO, PubMed, and ERIC. A total of 11 studies were selected and analysed using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Available evidence indicates that despite a lack of agreement among available instruments for skills assessments, there exists a positive relationship between motor and language development in that early motor skills predict the rate of both receptive and expressive language development in children with ASD. More studies on such relationship in later childhood and adolescence are warranted to provide practical implications of motor and/or language delay in children with ASD and further timely intervention development.

Identifying Risk Factors of Speech and Language Delay on Children

Speech and language delay are usually found in various disorders such as mental retardation, hearing impairment, psychosocial, autism, receptive aphasia and cerebral palsy and speech organ disorders. Retrospective research at Dr. Kariadi Hospital found that children aged 13 months to 60 months with complaints of speech problems that were subjected to an objective audiometric examination showed that 79.1% had hearing loss. This research aims to determine the relationship of risk factors with speech and language delays in children. This research was conducted in April 2020 using the cross-sectional with suspicion of late speaking who were examined by Brain evoked response audiometry (BERA) at Dr Kariadi Hospital Semarang. Researchers assessed the delay with the Languange evaluation Scale Trivandum (LEST) questionnaire. Researchers analyzed the data with chi-square test, fisher’s exact. The sample was 80 patients with the mean age was 22.35 months. Mostly in men (67.5%). The most common risk factor was hearing impairment. Hearing impairmentwas associated with speech and language delay. Economic status and bilingual were not associated with speech and language delay in children.

Patterns of social interaction in families of children with Expressive Language Delay

There are two types of languages one is receptive and the other one is expressive. The lack in sufficient social interaction of parents with their children although normal in all developmental milestones causes a delay in their expressive language.Objective: The objective of the present study was to determine the different patterns of soial interaction used by families that are responsible for the development of Expressive Language Delay in children. Methods: Comparitive Cross sectional survey was used for this study. The parents of 100 children from Lahore, of which 50 were parents of normally speaking children and 50 were parents of children with expressive language delay was taken as sample. These parents were asked to fill the questionairre accordingly that consists of different statements regarding their social patterns used by them to interact with their children. Results: Results indicated that there were significant differences with a p-value of 0.01 between the patterns used by parents of normally speaking children than those of expressive language delayed children. The mean values of excessive screen time of children with expressive language delay and normally speaking were 1.9600 and 4.0200 with standard deviations of 1.22824 and 0.84491 respectively. There were also insignificant differences with the p-value <0.01 in habits including reading picture books, using simple sentences and abrupt response to new things happen of parents with normally speaking children than with the parents of expressive language delayed children. Conclusion: It is concluded that there is a difference between interactional patterns of parents of children with expressive language delay than those with normally speaking children that are the main causes of developemnt of expressive language delay in these children.

Association of Hair Zinc Level with Cognitive and Language Delays in Children Aged 9–24 Months Old

Background: The delay in cognitive and language development can be caused by multifactor, including chronic deficiency of micronutrient, zinc. Level of zinc serum is influenced by food intake which can cause bias. There are inconsistencies in previous studies between zinc levels and the development caused by differences of sample or subjects. This study using hair as sample in analyzing the association between zinc level on cognitive and language delays in children aged 9-24 months old. AIM: To find out that low hair zinc level is associated with delayed of cognitive and language development in children 9-24 months old. Method: This analytical observational study with case-control design. Case group consisted of 69 children with cognitive and language development delays, based on CAT/CLAMS scores < 85 subjects aged 9-24 months meanwhile the control group consist of 69 children with normal cognitive and language development. Chi-square test was used to assess the association between zinc levels and the incidence of cognitive and language delays. Multivariate analysis was performed by logistic regression. Results: Univariate analysis showed no association between low zinc level and delayed of cognitive and language development in children aged 9-24 months (OR 1.263; 95% CI 0.64-2.46; p=0.495). Logistic regression was performed for other variables and screen time > 2 hours and lack of stimulation were risk factors for cognitive and language development delays (adjusted OR 2.78; 95% CI 1,284-6.058; p=0.010 and adjusted OR 3.96; 95% CI 1.833-8.581; p<0.001). Conclusion: There is no relationship between low hair zinc level and delays in cognitive and language development in children age 9-24 months, but there is an association between screen time more than two hours per day and lack of stimulation with delays in cognitive and language development in children 9-24 months 24 months.

Risk factors identification of speech and language delay in children in a tertiary level hospital: A pilot study

Difficulties in the development of speech and language in children are considered as a common paediatric disability and it may have long-lasting effects on social skills, behavior, emotion, education and employment. There are several factors associated with speech and language delay in children which are very crucial to identify for raising awareness among parents as well as for the professional to provide early intervention by looking into them. The aim of this study is to identify risk factors of speech and language delay in children less than 6 years of age within the period of one year in a tertiary level hospital of Bangladesh. A cross-sectional study conducted with 150 children with primary speech and language delay and their parents who attended for speech and language therapy at Outdoor Patient (OPD) of Institute for Paediatric Neurodisorder and Autism (IPNA) in Bangabandhu Sheikh Mujib Medical University (BSMMU) for one year of period. This study found that the aspects being male gender, parental age, use of electronic devices, gestational age at birth, low birth weight and child’s attention problem are most common risk factors of speech and language delay in children. These findings help to monitoring the children who have these risk factors and that should draw the attention for early screening, assessment and intervention.

Risk factors identification of speech and language delay in children in a tertiary level hospital: A pilot study

Risk factors identification of speech and language delay in children in a tertiary level hospital: A pilot study

External risk factors associated with language disorders in children

Background Children with language delay have deficits in the ability to learn and use language, either expressive and/or receptive despite otherwise normal development. Language delay could be influenced by either internal factors (within the child) and external factors (from the environment). Timely identification and modification of these risk factors can allow early intervention to reduce child disability and are associated with better long-term outcomes.
 Objective To identify possible risk factors related to language delay in children, such as bilingualism, socioeconomic status, maternal and caregiver education level, use of digital media, absence of story reading sessions, breastfeeding patterns, siblings, parenting methods, and maternal occupation.
 Methods This observational, analytic study included 102 children aged 24-36 months from four daycare centers in Manado, North Sulawesi, selected by cluster random sampling. Parents were interviewed to gather demographic information of child age, gender, presence of older siblings, maternal occupation, socioeconomic status, maternal/caregiver educational level, use of digital media, absence of story reading sessions, breastfeeding patterns, parenting methods, and bilingual environment. Children’s language development was assessed by the Capute Scales.
 Results Multivariate analysis revealed 2 factors significantly associated with increased risk of language delay; namely absence of storybook reading (OR=0.16; 95%CI 0.03 to 0.72; P=0.017) and bilingualism (OR=12.58; 95%CI 1.57 to 100.81; P=0.017).
 Conclusion Story reading sessions is associated with decreased risk of language delay, shile bilingualism is associatd with increased risk of language delay.

The Effect of Premature Births on Language Delay in Children: A Meta-Analysis

Background: Child development problems are problems that need attention. A child can experience developmental delays in one or more developmental domains. It usually occurs in infants who born prematurely. In Indonesia, data from the Ministry of Health states that there are 675,700 premature infants in Indonesia. This study aimed to examine the effect of premature births on language delay in children using a meta-analysis Subjects and Method: This was a systematic review and meta-analysis. The articles used in this study were obtained from several databases including PubMed, Wiley, Springer Link, Elsevier, BMC Pediatrics and Google Scholar. The articles used in this study were those published from 2000-2020. The article search was carried out by considering the eligibility criteria defined using the PICO model. The population in the study were children with intervention in the form of babies born prematurely, the comparison was that babies born at term, the outcome was language delay. The keywords for searching articles are as follows: (preterm OR "short gestational ages" OR SGA OR premature) AND "language delay" AND child AND observational AND aOR. The articles included in this study are full text articles with an observational study design. Articles were collected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3. Results: A total of 8 articles from the Americas, Europe, Asia and Australia were reviewed in this study. The meta-analysis combining 8 cohort studies concluded that preterm infants caused language delay in children 1.65 times as much as non-nomal children (aOR= 1.65, 95% CI= 1.11 to 2.44, p= 0.010). Conclusion: Infants born prematurely experience delays in language development. Keywords: premature birth, language development delay Correspondence: Alfiani Vivi Sutanto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: alfianivivi85@gmail.com. Mobile: 085799253- 568.

Assessment of speech and language delay in children up to 6 years using Trivandrum development screening chart and language evaluation scale Trivandrum

Assessment of speech and language delay in children up to 6 years using Trivandrum development screening chart and language evaluation scale Trivandrum

Children with speech delay – A retrospective chart review

Introduction: Speech delay is a common problem in children less than 6 years. The reported prevalence of language delay in children two to seven years of age ranges from 2.3 to 19%. Various psychiatric disorders may manifest as speech delay in the early period. Usually, these children are initially seen by the primary care physician who gives reassurances and often fails to refer them to a psychiatrist. In these cases, the children miss out on the specialised assessment that they require and consequent help. Therefore, it is essential to evaluate each child with speech delay. Early identification and starting appropriate therapy as early as possible is very important for good clinical long term outcome. In this context, this study was carried out to investigate socio-demographic and other factors associated with speech delay. Materials and Methods: A retrospective study design was used to collect data from case files of children aged less than 6 years who were referred to the psychiatric OPD for speech delay between May 2015 and May 2017. Their socio-demographic details, antenatal, perinatal and postnatal details, medical comorbidities, psychological assessment reports such as developmental and social quotient were collected and evaluated. Results: In our study, speech delay was predominant in male child, middle and low socioeconomic status, semi-urban population & nuclear family. Mild deficits in developmental and social functioning was found according to DST and VSMS. Conclusion: This study’s findings may prove relevant to therapists when planning comprehensive and effective treatment for such children. Keywords: Speech delay, Specific developmental disorders of speech and language, Pervasive developmental disorders, Mental retardation.

Preverbal Production and Early Lexical Development in Children With Cochlear Implants: A Longitudinal Study Following Pre-implanted Children Until 12 Months After Cochlear Implant Activation.

Studies have shown that children vary in the trajectories of their language development after cochlear implant (CI) activation. The aim of the present study is to assess the preverbal and lexical development of a group of 20 Italian-speaking children observed longitudinally before CI activation and at three, 6 and 12 months after CI surgery (mean age at the first session: 17.5 months; SD: 8.3; and range: 10–35). The group of children with CIs (G-CI) was compared with two groups of normally-hearing (NH) children, one age-matched (G-NHA; mean age at the first session: 17.4 months; SD: 8.0; and range: 10–34) and one language-matched (G-NHL; n = 20; mean age at the first session: 11.2 months; SD: 0.4; and range: 11–12). The spontaneous interactions between children and their mothers during free-play were transcribed. Preverbal babbling production and first words were considered for each child. Data analysis showed significant differences in babbling and word production between groups, with a lower production of words in children with CIs compared to the G-NHA group and a higher production of babbling compared to the G-NHL children. Word production 1 year after activation was significantly lower for the children with CIs than for language-matched children only when maternal education was controlled for. Furthermore, latent class growth analysis showed that children with CIs belonged mainly to classes that exhibited a low level of initial production but also progressive increases over time. Babbling production had a statistically significant effect on lexical growth but not on class membership, and only for groups showing slower and constant increases. Results highlight the importance of preverbal vocal patterns for later lexical development and may support families and speech therapists in the early identification of risk and protective factors for language delay in children with CIs.

Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia.

Background: Speech and language therapy is typically initiated reactively after a child shows delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth.We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).

Maternal interactive beliefs and style as predictors of language development in preterm and full term children.

Previous research has shown that the quality of mother-child interactions between pre-term children and their mothers tends to be poorer than that of full-term children and their mothers (Forcada-Guex, Pierrehumbert, Borghini, Moessinger & Muller-Nix, 2006). Mothers of pre-term children are less responsive and more intrusive in interactions with their children than mothers of full-term children (Forcada-Guex et al., 2006; Ionio, Lista, Mascheroni, Olivari, Confalonieri, Mastrangelo, Brazzoduro, Balestriero, Banfi, Bonanomi, Bova, Castoldi, Colombo, Introvini & Scelsa, 2017; Laing, McMahon, Ungerer, Taylor, Badawi & Spence, 2010). The current research explored differences between mothers of pre-term and full-term children in terms of interactive beliefs and style, and the potential for language development to be differentially predicted by maternal interactive beliefs and styles in pre-term versus full-term children. Independent t-tests were conducted to compare pre-term and full-term groups in relation to the measures of maternal interactive beliefs and styles. A series of multiple regression analyses were then performed separately for each group to examine the shared and unique contributions of maternal interactive beliefs and styles on full-term versus pre-term children's language development. The results showed that mothers of pre-term children were more intrusive-directive than mothers of full-term children; in contrast, mothers of full-term children were more responsive and supportive-directive in interactions with their children. Moreover, predictors of language development were different in full-term versus pre-term children; in full-term children, maternal supportive beliefs and responsiveness were significant predictors of language development evaluated by both the Bayley Scales of Infant and Toddler Development and the MacArthur Communicative Development Inventory; in the pre-term group, maternal supportive and directive beliefs, as well as supportive and intrusive directiveness, were significant predictors, with the latter being negatively associated with language development indicators. This research can shed light on how to prevent language delay in children and improve mother-child interactions that contribute to language development, which may in turn improve language development in vulnerable children, children born pre-term in particular.

Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia

Background: Speech and language therapy is typically initiated reactively after a child shows delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).

Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia

Background: Speech and language therapy is typically initiated reactively after a child starts showing delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).

Early intervention intensity and language outcomes for children using cochlear implants

ABSTRACTMeasurement of optimum treatment efficacy to address language delays in children using cochlear implants is difficult, but important, to promote evidence-based treatments and reduce treatment inequities. This exploratory retrospective study investigated associations between; frequency of early intervention (weekly, fortnightly, monthly); total dose (calculated in hours over a year); and child involvement in family activities on language outcomes for 42 pediatric cochlear implant recipients enrolled in aural/oral programs. Parents who attended the Cochlear Implant Clinic completed the Family and Educational Characteristics Questionnaires (FamEd-Q) at each post-operative review, and their children completed formal language assessments. Family and child demographic characteristics were collated. Children whose parents reported lower doses (in hours) of early intervention demonstrated better expressive language skills than children who received more intervention, but this result was confounded by other underlying differences between groups regarding age-at-first-implant and cognitive function. Additionally, children from families with greater relative socio-economic advantage tended to receive more frequent intervention sessions. Of practical significance, greater levels of child involvement in family activities were associated with higher child language scores.

Language delays in children with prenatal exposure to HIV and antiretroviral therapy

Language delays in children with prenatal exposure to HIV and antiretroviral therapy

Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia

Background: Speech or language therapy is typically initiated reactively after a child starts showing delays. Infants with classic galactosemia (CG), an inborn error of metabolism with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the BBC from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were developmental milestones in communication, motor, and cognition. Outcomes in the treatment cohort were compared to typical children and the control child and to typically developing children represented in test norms and cases described in the literature . The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, and three had higher communication and personal-social skills, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12th February 2019).

S14-05 SESSION 14: FACIOCRANIOSYNOSTOSIS – PART III LANGUAGE OUTCOMES IN A RETROSPECTIVE STUDY OF CHILDREN WITH TCF12 MUTATIONS, A SINGLE CENTRE STUDY

Introduction: TCF12 mutations are a recent finding in craniosynostotic conditions, predominantly found in coronal synostosis. It accounts for 1% of all craniosynostosis and 17% of non syndromic bicoronal synostosis. As there is very little in the literature reporting on the speech and language outcomes of this group of children, it was felt important to analyse this subgroup of children and report on their language skills. This will help with their multi disciplinary management and parental explanations of associated risks. Methods: A retrospective review was carried out of receptive and expressive language skills in children, who met the criteria for diagnosis of TCF12 mutations; who attend Alder Hey Children’s Hospital Craniofacial Unit, Liverpool, UK. Patients’ medical and speech therapy notes were analysed, including any standardised testing carried out or informal assessment data gathered. In the absence of this data, information was gathered from telephone consultation. Results: 13 subjects met the inclusion criteria as having a positive diagnosis of TCF12 mutations from Sanger sequencing. M-F ratio was M6-F7. Within this cohort, 4 subjects presented with Left coronal synostosis, 4 with Right coronal synostosis, 4 with bicoronal synostosis and one subject had sagittal synostosis. Analysis was divided into 2 sub groups, <24months and >3years. In the first subgroup, 32% (n=4) presented with a delay in either their receptive and/or expressive language skills, whilst this number was 27% (n=3) in the older sub group. Only 11 subjects were included in the second data collection point, as 2 subjects were not yet at the minimum age required. Further analysis is to be done looking at type of synostosis and language delay and also on surgical intervention. Conclusion: This study shows that there is an increase in speech and language delay in children who have TCF12 mutations, greater than that found in the general population. It is an area that requires further investigation and this study represents a single centre report on a population hitherto not widely published on and is a preliminary study to a wider, 4 centre study, currently in progress.

A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever.

.The neglected tropical diseases Zika, Ebola, and Lassa fever (LF) have all been noted to cause some degree of hearing loss (HL). Hearing loss is a chronic disability that can lead to a variety of detrimental effects, including speech and language delays in children, decreased economic productivity in adults, and accelerated cognitive decline in older adults. The objective of this review is to summarize what is known regarding HL secondary to these viruses. Literature for this review was gathered using the PubMed database. Articles were excluded if there were no data of the respective viruses, postinfectious complications, or conditions related to survivorship. A total of 50 articles were included in this review. Fourteen articles discussing Zika virus and subsequent complications were included. Across these studies, 56 (21.2%) of 264 Zika-infected individuals were found to have HL. Twenty-one articles discussing Ebola virus and subsequent complications were included, with 190 (5.7%) of 3,350 Ebola survivors found to have HL. Fifteen additional articles discussing LF and subsequent complications were included. Of 926 individuals with LF, 79 (8.5%) were found to have HL. These results demonstrate a relationship between HL and infection. The true prevalence is likely underestimated, however, because of lack of standardization of reporting and measurement. Future studies of viral sequelae would benefit from including audiometric evaluation. This information is critical to understanding pathophysiology, preventing future cases of this disability, and improving quality of life after survival of infection.