06/08/2025
🧠 Clinical Observation Series
Possible Link Between Allergic Rhinitis, Hearing/Language Delay, and Autism-like Features in Children
Observer: Dr. Mirza Shahzad Akhter, Pulmonologist
Location: Dera Ghazi Khan, Pakistan
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🔍 Background Observations
Over the past several months, 14 families with strong histories of allergic conditions (including bronchial asthma and allergic rhinitis) have presented with children diagnosed with autism spectrum disorder (ASD). In 2 of these children, deafness was also reported. These families often reported that their children had:
Delayed or absent speech
Poor eye contact
Behavioral isolation
Nasal congestion or mouth breathing since early infancy
Further discussion with a local psychotherapist working with autistic children revealed that almost all of her patients also had chronic nasal symptoms, though these were often untreated or ignored.
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🧪 Recent Clinical Case (July 2025)
One such family visited the clinic 20 days ago. Both parents had asthma and allergic rhinitis. They brought three siblings (ages 2–6 years; 1 female, 2 males) with the following features:
Complete silence, no verbal communication
Responded only to visual commands
ENT specialist, after audiometry, diagnosed hearing loss and recommended hearing aids for all three
However, physical exam and history revealed signs of allergic rhinitis:
Nasal obstruction
Mouth breathing
Daytime fatigue
Poor sleep pattern
Dr. Shahzad initiated treatment for allergic rhinitis including:
Intranasal steroids
Antihistamines
Environmental allergen avoidance
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🔄 Follow-up after 20 Days
Children began producing vocal sounds
Began looking at faces when spoken to
Seemed more aware and interactive
No longer appeared behaviorally "deaf"
This suggests that chronic nasal blockage and allergic inflammation may have:
Impaired auditory input (possibly mimicking deafness)
Suppressed speech development
Contributed to autism-like features
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💡 Hypothesis
Chronic nasal obstruction due to allergic rhinitis in early childhood may:
Disrupt auditory feedback critical for speech development
Mimic ASD or hearing loss
Be underdiagnosed in children with neurodevelopmental or behavioral disorders
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🧭 Next Steps
Formal documentation of more such cases
Possible collaboration with ENT, psychiatry, and speech therapy teams
Initiate pilot research or case series publication
Conduct allergy and nasal airway screening in children with speech delay or autism diagnosis
