Comparative Analysis of Speech Outcomes in South Korean Preschoolers With Unilateral Congenital Aural Atresia Against a Norm-referenced Standard.

OBJECTIVE

This study aims to assess speech development, including receptive and expressive language, as well as articulation, in South Korean preschoolers with unilateral congenital aural atresia (CAA) compared with their peers with normal hearing.

MATERIALS AND

METHODS

A retrospective review of medical records was conducted for preschoolers diagnosed with unilateral CAA at a single tertiary institution between January 2020 and December 2022. Excluding 12 children without speech evaluation and 4 with bilateral hearing loss, 67 subjects were enrolled. Raw scores from the Urimal-Test of Articulation and Phonology (U-TAP), assessing articulation abilities, were converted to z-scores against the normal standard. Similarly, raw scores from the Receptive and Expressive Vocabulary Test (REVT) and the Sequenced Language Scale for Infants (SELSI), evaluating vocabulary abilities, were transformed into z-scores for comparison with U-TAP. Receptive and expressive language abilities were compared using the percentile parameter.

RESULTS

The average age at the time of the visit was 40.32±19.89 months, with 40 males (59.7%) and 27 females (40.3%), indicating male predominance. Affected ears were more prevalent on the right side (47 patients, 70.1%) than the left side (20 patients, 29.9%). U-TAP z-scores for the majority of 67 subjects were below 0, averaging -2.23±2.37. Spearman correlation analysis revealed a nonlinear relationship between age (in months) and U-TAP z-scores (correlation coefficient: 0.089, P-value: 0.432), suggesting no significant correlation between age and articulation. A pairwise comparison of REVT/SELSI and U-TAP z-scores showed higher receptive language scores than articulation abilities (P-value <0.0001). The average REVT/SELSI z-score was -0.09±1.70, indicating that vocabulary scores were largely within the normal range. In addition, the average percentile of expressive language (40.14±37.44) was significantly lower than that of receptive language (56.25±33.40) (P-value <0.005).

CONCLUSION

When comparing speech parameters in patients with unilateral CAA, it was observed that receptive language abilities were mostly within the normal range. In addition, expressive language abilities were lower than receptive language abilities. The articulation abilities of preschoolers with unilateral CAA enrolled in this study were significantly inferior to those of their normally developing age-matched peers. Hence, preschoolers with unilateral CAA require careful monitoring of language development and appropriate intervention, including bone conduction hearing aids and articulation therapy, when necessary.