The influence of chronic persistent otitis media with effusion on language development of 2- to 4-year-olds

doi:10.1016/0165-5876(88)90080-8

International Journal of Pediatric Otorhinolaryngology

Volume 15, Issue 3, September 1988, Pages 253-261

https://doi.org/10.1016/0165-5876(88)90080-8 Get rights and content

Abstract

Literature is not conclusive about the effect of otitis media with effusion (OME) on language development in children. As part of a large epidemiological study on OME in preschool children, language development was measured in 52 children with known history of bilateral OME and in 13 children without OME. The test Reynell Developmental language scales-revised (RDLS-r) was performed by one speech therapist under standard conditions. Verbal comprehension scores were not or only slightly reduced in OME children. Expressive language, however, was significantly lower than the standard with the effect being larger when the OME had lasted for a longer period. This is one of the first prospective studies that confirms the hypothesis of an effect of persistent bilateral middle ear effusion on language development.

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Cited by (58)

A longitudinal evaluation of hearing and ventilation tube insertion in patients with primary ciliary dyskinesia
2016, International Journal of Pediatric Otorhinolaryngology
Citation Excerpt :
Even though spontaneous hearing improvement can be expected in most cases, it is not justified to wait until school age for this to occur. Decreased hearing is shown to impair speech development and to negatively affect the quality of life in non-syndromic patients [23–26]. OME can be managed with hearing aids or surgically with VT insertion.
Primary ciliary dyskinesia (PCD) is an autosomal recessive genetic disease, which primarily manifests with oto-sino-pulmonary symptoms. Otitis media with effusion (OME) is common from early childhood. The existing literature on OME management in PCD is conflicting.
The goals of the present study were firstly to evaluate the long-term hearing in PCD patients and secondly to determine the influence of ventilation tube (VT) insertion on hearing and postoperative otorrhoea.
A longitudinal retrospective study extracting the hearing level (pure tone average (0.5, 1, 2, 4 kHz, PTA)) and tympanometry from the medical records. Furthermore, the patient files were reviewed for VT insertion and postoperative otorrhoea. Postoperative otorrhoea was defined prolonged when it lasted for four weeks or longer.
Fifty-seven patients were identified in a 30-year period, age 2–72 years, and 278 audiometries were evaluated. The median number of audiometries per patient was 3 (range 1–29) and the median follow-up was 60 months (range 0–351 months). The mean PTA was 34 dB HL in patients below six years of age and improved significantly (p < 0.0001) with age. VT insertion improved hearing; however, 48% of patients with VT insertion experienced prolonged otorrhoea.
In this study of PCD patients the hearing improved as a function of age as well as following VT insertion. However, VT insertion was also associated with prolonged otorrhoea.
The assessment of hearing organ of school children in Upper Silesia region
2009, International Journal of Pediatric Otorhinolaryngology
Citation Excerpt :
The majority, however, is in the range of 5–10%, which has also been confirmed by our own studies [6,7]. Paedo-audiologists commonly stress that hearing loss in school children poses a substantial obstacle for proper development and education [8,9]. In order to minimise the adverse influence of hearing disorders, it is justified to carry out screening examinations of hearing, which enable early detection of pathologies of ears, which usually have few symptoms, and are oftentimes either not noticed or underestimated by the close surroundings of the child.
Because at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a research programme. An important advantage of this study is the assessment of hearing in children from Upper Silesian region, a top ranking region in Europe in industrialisation and environmental pollution.
In the selected population of primary school children in the province of Silesia, hearing loss occurred in 6% of the examined pupils; in schools located in urban areas it was higher than in schools from rural areas.
In the group of children aged 6–10 years conductive hearing loss occurred significantly more frequently, than main cause of that hearing loss was Eustachian tube dysfunction.
The obtained results testify about the society being hardly aware of the problems related to hearing loss, which stresses the necessity of conducting screening examinations of hearing organ in children at school age, as well as improving the health care and prevention in that respect.
Quality of childcare and otitis media: Relationship to children's language during naturalistic interactions at 18, 24, and 36 months
2007, Journal of Applied Developmental Psychology
The purpose of this study was to examine the relationship between the quality of childcare and experience with otitis media (middle ear disease) as they relate to children’s early naturalistic language development. Sixty children were followed longitudinally from childcare entry in the first year of life until three years of age. Half the children were in higher quality childcare and half in lower quality childcare, but parent demographics, like education and income, were not associated with the quality of the childcare. Experience with otitis media was monitored weekly in the childcare setting. Naturalistic language samples were collected at 18, 24, and 36 months of age and coded for a variety of syntactic, morphological and semantic markers of language development. Results suggested that children in higher quality care were more advanced on most of the measures of language, especially at 24 and 36 months of age. Children in lower quality care became progressively further behind the children in higher quality care on all language measures. This was especially true for vocabulary, with children in higher quality care having double the number of different words by 36 months as compared to the children in lower quality care. There were no main effects or interactions for experience with otitis media over the first three years.
Early Middle Ear Effusion and School Achievement at Age Seven Years
2006, Ambulatory Pediatrics
This study tested the hypothesis that children with early persistent middle ear effusion (MEE) are at risk for later deficits in academic performance.
We recruited 698 newborns and monitored them for MEE every 2 to 4 weeks at home until age 3 years. At age 7 years, it was possible to obtain school data for 226 children. Tests included the Iowa Tests of Basic Skills or the Stanford Achievement tests, the Woodcock Reading Mastery Tests, and the Woodcock-Johnson Tests of Achievement.
There was no significant relationship between early MEE and measures of school achievement as shown by correlations or multiple regression. Differences between extreme MEE groups were not significant. School achievement was strongly associated with ethnicity, home environment, and socioeconomic status.
Early persistent MEE does not appear to affect achievement in school at age 7 years.
Hearing assessment in pre-school children with speech delay
2006, Auris Nasus Larynx
The purpose of this study was to detect any underlying hearing loss among the healthy pre-school children with speech delay.
76 children, aged from 1 to 5 years, underwent a thorough audiological examination consisting of tympanometry, free field testing, otoacoustic emission recordings and auditory brainstem responses (ABRs). If hearing was normal, then they were evaluated by a child neurologist–psychiatrist.
According to our findings, the children were classified into 3 groups; those with normal hearing levels (group I, 52 children, 68.4%), sensorineural hearing loss (group II, 22 children, 28.9%) and conductive hearing loss (group III, 2 children, 2.6%). In group I, speech delay was attributed to pervasive developmental disorder (PDD), which represents high-functioning autistic children (37 cases). Other causes were specific language impairment (SLI)-expressive (3 cases), bilingualism (2 cases), and unknown etiology (10 cases). More than half (59%) of the children diagnosed with PDD evidenced significant language impairment limited to more than two words. Children with SLI-expressive and bilingualism used a maximum of two words. In group II, 13 children suffered from profound hearing loss in both ears, 3 from severe, 3 had profound hearing loss in one ear and severe in the other, 2 from moderate, and 1 had moderate in one ear and severe in the other. No child had mild sensorineural hearing loss. The children with profound hearing loss in at least one ear had total language impairment using no word at all (10 cases), or a maximum of two words (6 cases). When hearing loss was moderate to severe, then the speech vocabulary was confined to several words (more than two words—6 cases). Only two children suffering from conductive hearing loss both presented with complete lack of speech.
A great number of healthy pre-school children with speech delay were found to have normal hearing. In this case, the otolaryngologist should be aware of the possible underlying clinical entities, especially of psychiatric nature. The children with profound sensorineural hearing loss exhibited more severe speech delay than those with moderate to severe. Regardless of etiology, the early identification and intervention contribute to positive outcome in this critical period of childhood for language development.
Otitis media and academic achievements
2001, International Journal of Pediatric Otorhinolaryngology
Objective: This is a study of whether there are any long-term differences in academic achievements between children with and without observed or treated middle ear disease in a population with a stable long-standing treatment policy. Methods: A birth cohort of 2156 children was previously studied through a questionnaire to the parents at 4 years of age, follow-up after audiometric screening at 4, 7, 11 and 14 years of age, and study of records from all Ear, Nose and Throats departments in the area; 2095 of these still lived in the area and received academic grades on leaving the ninth year of the state school system. We have compared these grades, and the choice of high school course for children with different experiences of otitis media. Results: A history of treatment for bilateral secretory otitis media was correlated to minor group difference in the mean of grades, but not to any significant difference in the individual grades or in the choice of further studies. Having many episodes of acute otitis before the age of four was uncorrelated to lower grades and to less tendency to continue with theoretical studies. Conclusions: No harmful effect of middle ear disease could be shown in a large sample, suggesting that Swedish children do not suffer long-term effects on learning from otitis media.

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Research paperThe influence of chronic persistent otitis media with effusion on language development of 2- to 4-year-olds

Abstract

Reynell Taalontwikkelingstest, Dutch Form and Instruction

Auditory processing abilities in children with previous middle ear effusion

Ann Otol.

Acute and recurrent acute otitis media

Consequences of unremitting middle-ear disease in early life. Otologic, audiologic and developmental findings in children with cleft palate

N. Engl. J. Med.

Clinical experience with impedance audiometry

Arch. Otolaryngol.

Physical and behavioral aspects of middle ear disease in school children

J. School Health

Design features in the assessment of language development in children with otitis media

Ann. Otol. Rhinol. Laryngol.

Effect of persistent otitis media on language development

Ann. Otol. Rhinol. Laryngol.

Effects of hearing loss from early recurrent otitis media on speech and language development

Effects of hearing loss on speech and language in the postbabbling stage

Research paper
The influence of chronic persistent otitis media with effusion on language development of 2- to 4-year-olds