FETAL ALCOHOL SYNDROME : Hearing, Speech, Language, and Vestibular Disorders - 08/09/11

Doi : 10.1016/S0889-8545(05)70359-4

Michael W. Church, PhD ^a,^b, Ernest L. Abel, PhD ^a,^c
^a Departments of Obstetrics and Gynecology (MWC, ELA)
^b Otolaryngology (MWC), Audiology and Communication Disorders (MWC)
^c Psychology (ELA), Wayne State University School of Medicine, Detroit, Michigan

Résumé

Maternal alcohol abuse during pregnancy is associated with several alcohol-related birth effects.^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références} A pattern of these birth effects consisting of prenatal or postnatal growth retardation or both, craniofacial anomalies, and nervous system defects^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références, 26Jones K.L., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy Lancet 1973 ; 1 : 999-1001 [cross-ref]

Cliquez ici pour aller à la section Références, 46Rosett H. A clinical perspective of the fetal alcohol syndrome Alcohol Clin Exp Res 1980 ; 4 : 119-122 [cross-ref]

Cliquez ici pour aller à la section Références} is called fetal alcohol syndrome (FAS)^{26Jones K.L., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy Lancet 1973 ; 1 : 999-1001 [cross-ref]

Cliquez ici pour aller à la section Références} or, more recently, fetal alcohol abuse syndrome.^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références} The incidence of FAS in the United States is about 2 cases per 1000 population; the incidence among children born to heavy drinkers is about 4%.^{1Abel E.L. An update on incidence of FAS: FAS is not an equal opportunity birth defect Neurotoxicol Teratol 1995 ; 17 : 437-443 [cross-ref]

Cliquez ici pour aller à la section Références}

Mental retardation and other neurodevelopmental disorders such as hyperactivity, distractibility, short attention span,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références} poor judgment, impulsivity, poor social skills,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références, 40Olson H.C., Feldman J., Streissguth A.P. Neuropsychological deficits and life adjustment in adolescents and adults with fetal alcohol syndrome Alcohol Clin Exp Res 1992 ; 16 : 380

Cliquez ici pour aller à la section Références} poor visual and auditory memory,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références} and sensory problems involving ocular,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références, 54Stromland K. Ocular abnormalities in the fetal alcohol syndrome Acta Ophthalmol 1985 ; 63 (suppl 171) : 1-50

Cliquez ici pour aller à la section Références, 55Stromland K., Pinazo-Duran M.D. Optic nerve hypoplasia: Comparative effects in children and rats exposed to alcohol during pregnancy Teratology 1994 ; 50 : 100-111 [cross-ref]

Cliquez ici pour aller à la section Références} auditory,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références, 9Church M.W., Abel E.L., Kaltenbach J.A., et al. Effects of prenatal alcohol exposure and aging on hearing function in the rat: Preliminary observations Alcohol Clin Exp Res 1996 ; 20 : 172-179 [cross-ref]

Cliquez ici pour aller à la section Références, 10Church M.L., Eldis F. Correlations between craniofacial, hearing, and language disorders in the Fetal Alcohol Syndrome Alcohol Clin Exp Res 1997 ; 55 : 57

Cliquez ici pour aller à la section Références, 11Church M.W., Eldis F., Blakley B.W., et al. Hearing, speech, language, vestibular and dentofacial disorders in the Fetal Alcohol Syndrome (FAS) Alcohol Clin Exp Res 1997 ; 21 : 227-237 [cross-ref]

Cliquez ici pour aller à la section Références, 12Church M.W., Gerkin K.P. Hearing disorders in children with Fetal Alcohol Syndrome: Findings from case reports Pediatrics 1988 ; 82 : 147-154

Cliquez ici pour aller à la section Références, 13Church M.W., Holloway J.A. The effects of prenatal alcohol exposure on postnatal development of the brainstem auditory evoked potential in the rat Alcohol Clin Exp Res 1984 ; 8 : 258-263

Cliquez ici pour aller à la section Références, 40Olson H.C., Feldman J., Streissguth A.P. Neuropsychological deficits and life adjustment in adolescents and adults with fetal alcohol syndrome Alcohol Clin Exp Res 1992 ; 16 : 380

Cliquez ici pour aller à la section Références} and possibly vestibular problems^{11Church M.W., Eldis F., Blakley B.W., et al. Hearing, speech, language, vestibular and dentofacial disorders in the Fetal Alcohol Syndrome (FAS) Alcohol Clin Exp Res 1997 ; 21 : 227-237 [cross-ref]

Cliquez ici pour aller à la section Références, 14Clarren S.K. Recognition of fetal alcohol syndrome JAMA 1981 ; 245 : 2436-2439

Cliquez ici pour aller à la section Références, 29Kyllerman M., Aronson M., Sabel K.-G., et al. Children of alcoholic mothers: Growth and motor performance compared to matched controls Acta Paediatr Scand 1985 ; 74 : 20-26 [cross-ref]

Cliquez ici pour aller à la section Références, 37Nordemar H. Alcohol and ultrastructural changes in the developing inner ear Acta Otolaryngol 1988 ; 105 : 75-81 [cross-ref]

Cliquez ici pour aller à la section Références} are among the most devastating results of maternal alcohol abuse during pregnancy. Because normal postnatal development of higher central nervous system (CNS) structures is critically dependent on normal sensory function, impairment of sensory function can be conceived of as a form of sensory deprivation.

Studies of the developing visual and auditory systems clearly indicate that sensory deprivation during a critical period of postnatal maturation can compromise normal maturation of neural synapses, dendritic arborization and spinal development, myelination, neuronal cell size, cell number, and the organization of visual^{43Riesen A.H. Effects of stimulus deprivation on the development and atrophy of the visual sensory system Am J Orthopsychiatry 1960 ; 30 : 23-36

Cliquez ici pour aller à la section Références, 58Wiesel T.N. Postnatal development of the visual cortex and the influence of environment Nature 1982 ; 299 : 583-592 [cross-ref]

Cliquez ici pour aller à la section Références} and auditory structures^{57Webster D.B., Webster M. Neonatal sound deprivation affects brainstem auditory nuclei Arch Otolaryngol 1977 ; 103 : 392-396

Cliquez ici pour aller à la section Références} in laboratory animals and humans.

During postnatal development, critical periods exist during which stimulation is processed optimally. Once this period has passed, stimulation has a progressively diminished influence on development. In humans, this critical period for hearing and language development occurs during the first 2 or 3 years of life.^{38Northern J.L., Downs M. Hearing in Children Baltimore: Williams & Wilkins (1984).

Cliquez ici pour aller à la section Références} A hearing impairment during this period, even in an otherwise normal child, is tantamount to sensory deprivation and can result in permanent speech, language, and cognitive deficits; distractibility; hyperactivity; and impaired academic performance similar to that exhibited by individuals with FAS.^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Cliquez ici pour aller à la section Références, 26Jones K.L., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy Lancet 1973 ; 1 : 999-1001 [cross-ref]

Cliquez ici pour aller à la section Références, 38Northern J.L., Downs M. Hearing in Children Baltimore: Williams & Wilkins (1984).

Cliquez ici pour aller à la section Références, 46Rosett H. A clinical perspective of the fetal alcohol syndrome Alcohol Clin Exp Res 1980 ; 4 : 119-122 [cross-ref]

Cliquez ici pour aller à la section Références}

This review focuses on the developmental effects of alcohol on the auditory system. The vestibular system is also examined, because it shares several embryologic, anatomic, and functional similarities with the auditory system, and because the inner ear and eighth cranial nerve contain the peripheral pathways of both these senses. Speech and language deficits are surveyed because they are both highly dependent on auditory function.

Le texte complet de cet article est disponible en PDF.

Plan

HEARING DISORDERS

Delayed Auditory Maturation

Sensorineural Hearing Loss

Conductive Hearing Loss and Recurrent Serous Otitis Media

Central Hearing Disorders

VESTIBULAR DISORDERS

SPEECH AND LANGUAGE DISORDERS

Language Disorders

Speech Disorders

RELATIONSHIPS BETWEEN CRANIOFACIAL AND COMMUNICATION DISORDERS

CONCLUSION AND COMMENTS

Address reprint requests to Michael W. Church, PhD, Fetal Alcohol Research Center, 275 East Hancock Avenue, Detroit, MI 48201
This work was supported by grants P5O AA 07606 from the National Institute on Alcohol Abuse and Alcoholism and RO1 DA 05536 from the National Institute on Drug Abuse and various research grants from Wayne State University.