Evaluating speech dysfunction in patients with congenital cytomegalovirus - A multicenter retrospective study.

OBJECTIVE: Despite the known impact of congenital cytomegalovirus (cCMV) on hearing, implications on speech have been understudied. In the absence of hearing loss, 2% of cCMV patients may still develop speech and language impairment. This study will describe demographics of cCMV patients, rates of speech therapy referral, and speech dysfunction within two of North Carolina's largest health systems. STUDY DESIGN: A retrospective chart review study. SETTING: Two academic medical centers. METHODS: A multisite retrospective chart review of patients was performed to identify cCMV patients. 69 patients were identified, 20 from Duke University Medical Center and 49 from University of North Carolina Health Systems. Data obtained from medical records included patient demographics, referrals, and speech dysfunction. RESULTS: Of 69 patients, 34 (49.3%) had evidence of speech dysfunction. Most patients (44.9%) were found to have a constitutional speech delay, an umbrella term used in this study to signify that a provider or speech-language pathologist reported speech dysfunction within the medical chart. Out of all cCMV patients, 9 of the 34 (26.5%) showed evidence of speech dysfunction in the presence of normal hearing. 88.2% of patients with speech dysfunction were referred to speech therapy by an SLP, with 79.4% attending a session and 61.8% having medical chart descriptions of improved speech. CONCLUSION: This is the largest US-based study on cCMV speech outcomes, with findings suggesting a higher rate of speech dysfunction than previously reported, including a higher rate of speech delay in those without a diagnosed hearing loss. Speech therapy initiation averaged within the 1-3-year early intervention American Speech-Language-Hearing Association recommendation. Recommendations to receive early speech evaluation referrals, regardless of hearing loss, may enhance outcomes in this population.

Duke Scholars

Author Eileen Margolies Raynor Pediatric Otolaryngology

Author Kristal Mills Riska Communication Sciences