Impact of recurrent otitis media on middle ear function, hearing, and language

doi:10.1016/S0022-3476(88)80659-0

The Journal of Pediatrics

Volume 113, Issue 3, September 1988, Pages 581-587

https://doi.org/10.1016/S0022-3476(88)80659-0 Get rights and content

Whether recurrent oftitis media in infants and young children is followed by delayed language development was addressed by following 210 normal subjects longitudinally through the first 2 years of life with pneumatic otoscopy and tympanometry performed at every physician encounter. Otitis accounted for 26% of the medical visits. One hundred fifty-six of these children had speech and hearing evaluation at 2 years of age. Thirty percent of the children with recurrent otitis media had a mild or moderate hearing loss. However, after miltiple speech and language tests, we could not identify a delay in language acquisition in the otitis-prone children. At 3 to 4 years old, 36 children, including nine with a hearing loss at 2 years of age, were retested; all nine had normal hearing. Recurrent otitis media induced a temporary decrease in hearing sensitivity demonstrable at 2 years of age, which appeared to resolve as the children mature and which was not assoclated with delay in language acquisition.

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Cited by (47)

Otitis media, the quality of child care, and the social/communicative behavior of toddlers: A replication and extension
2005, Early Childhood Research Quarterly
The purpose of this study was to examine the effects of otitis media (OM) and the quality of child care on the social and communicative behaviors of toddlers, using a cumulative risk framework that included moderation. The study followed 72 children who began child care in infancy. Both process and structural aspects of the quality of 11 child care centers were measured and children received weekly ear examinations from the time they entered child care. At 24 months of age children were observed in their classrooms during free play when they were well. Children in the chronic OM, low quality care group exchanged more negative gestures with peers, initiated less verbally to teachers and peers and were talked to less by teachers and peers in comparison to all other children. The results suggest the importance of the moderating effect of the quality of child care in understanding the effects of OM on social/communicative development.
Pediatricians' opinions about otitis media and speech-language-hearing development
2004, Journal of Communication Disorders
Twenty-five pediatricians responded to a confidential survey about their opinions on the relationship between otitis media and children’s speech-language-hearing status. Results found that pediatricians did not necessarily agree that otitis media has an impact on speech-language-hearing development. Pediatricians reported that an early otitis media onset (birth to age 2) affects speech-language development, but they also reported that parents and daycare environments could mitigate any otitis media effect. Pediatricians reported a possible otitis media impact on hearing status, but they did not necessarily agree that an otitis media history required referral for audiological testing. Clinical implications are discussed for collaboration among pediatricians, speech-language pathologists, and audiologists.
(1) The reader will become familiar with pediatricians’ opinions about the impact of otitis media on speech-language development. (2) The reader will become familiar with strategies to support interdisciplinary collaboration between pediatricians, speech-language pathologists, and audiologists.
The effect of otitis media and daycare quality on mother/child bookreading and language use at 48 months of age
2002, Journal of Applied Developmental Psychology
The purpose of this study was to understand the effect of quality of childcare and experience with otitis media (OM) early in life on mother/child bookreading and language use at 48 months of age. Forty-one children were followed from daycare entry in the first year of life until 4 years of age. Weekly health screenings from daycare entry until 4 years of age were performed by a nurse and physician to assess OM. Half the children were classified as chronic OM and half as nonchronic OM. Half the children were in low-quality care and half in high-quality care, but there were no SES confounds with quality of care. Children who had chronic OM and were in low-quality care spoke half as many words and different words during bookreading, answered fewer abstract questions correctly, and were rated more poorly on language use by their teachers than the other three groups of children.
Early surgery compared with watchful waiting for glue ear and effect on language development in preschool children: A randomised trial
1999, Lancet
Otitis media with effusion (OME) is the most common cause of hearing loss in children and is generally treated by elective surgery. We compared in children with persistent OME the effect on speech and language development of immediate surgery (ventilation-tube insertion) and watchful waiting before surgery.
We did a randomised controlled trial with masked outcome assessment in Bristol Children's Hospital, Bristol, UK. We included 186 children born between April 1, 1991, and Dec 31, 1992, who had confirmed bilateral OME and bilateral hearing impairment of 25–70 dB of at least 3 months' duration. Children were randomly assigned surgery within 6 weeks (n=92), or 9 months of watchful waiting (n=90), after which bilateral tube insertion was done if required. We assessed hearing loss, expressive language, and verbal comprehension at 9 months and 18 months.
At 9 months, standardised scores for expressive language and verbal comprehension differed between groups with marginal significance after adjustment for baseline differences (p=0·04 and p=0·028, respectively). At 9 months, verbal comprehension and expressive language skills in the watchful-waiting group were 3·24 months behind those in the early-surgery group. The watchful-waiting group was delayed on these two measures compared with their age-expected levels. 18 months after randomisation, 85% of children in the watchful-waiting group had received surgery and groups did not differ significantly.
There is some benefit from ventilation-tube insertion for expressive language and verbal comprehension but the timing of surgery is not critical.
Changing perspectives on otitis media: Diagnosis, risk factors, management, and prevention
1998, Seminars in Pediatric Infectious Diseases
This review summarizes recent information on the diagnosis, epidemiology, management, and prevention of otitis media, focusing on practical implications for pediatric clinicians and researchers. New perspectives are offered on the following four clinically important aspects of otitis media: (1) use of tympanometry in diagnosis, (2) sociodemographic risk factors, (3) management, and (4) methods of prevention. The limited positive predictive value of tympanometry in infants and young children and the uncertain validity of research in which tympanometry alone is used for diagnosing middle-ear effusion are discussed. New evidence indicates that by far the most important sociodemographic risk factors for otitis media are low socioeconomic status and repeated exposure to large numbers of other children, whether at home or in a child care facility. The rising prevalence of multiplyresistant strains of Streptococcus pneumoniae, a phenomenon promoted by extensive antimicrobial usage, makes it advisable to curtail antimicrobial treatment to the extent possible without risking avoidable morbidity or avoidable tube placement. Concerning prevention, curtailing the use of antimicrobials for prophylaxis is recommended and alternative clinical approaches are reviewed.
Analysis of risk factors of non-dry ear after radical mastoidectomy for otitis media
2023, Revista de Psiquiatria Clinica

View all citing articles on Scopus

¹

Supported in part by Contract No. NO1 AI 02645 from the National Institute of Allergy and Infectious Diseases and by Grant No. 5MO-1RR00095 from the Vanderbilt Clinical Research Center. Support for preparation of this article was provided by a grant from the Robert Wood Johnson Foundation.

The opinions, conclusions, and proposals herein are those of the authors and do not necessarity represent the views of the Foundation.

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SupplementImpact of recurrent otitis media on middle ear function, hearing, and language1

Int J Pediatr Otorhinolaryngol

Acute suppurative otitis media

Pediatrics

Otitis media in infancy: tympanometric findings

Pediatrics

Medical intelligence. Current concepts in otolaryngology: otitis media in children: to treat or not to treat?

N Engl J Med

Persistence of middle-ear effusion after acute otitis media in children

N Eng J Med

Otitis media during early life: how hazardous to development? A critical review of the evidence

Pediatrics

Audiometry and tympanometry in relation to middle-ear effusions in children

Laryngoscope

Effects of conductive hearing loss: fact or fiction

J Speech Hear Disord

Persistent middle ear effusions: natural history and morbidity

Pediatr Infect Dis

Otitis media in infants and children

Pediatrics

Social class and mental illness: a community study

Clinical studies of pneumococal vaccines in infants. I. Reactogenicity of two polyvalent polysaccharide vaccines

Rev Inf Dis

Clinical studies of pneumococcal vaccines in infants. II. Efficacy and effect on nasopharyngeal carriage

Rev Infect Dis

Clinical experience with impedance audiometry

Arch Otolaryngol Head Neck Surg

Epidemiology of otitis media in children

Ann Otol Rhinol Laryngol

Supplement
Impact of recurrent otitis media on middle ear function, hearing, and language1