Elsevier

Ambulatory Pediatrics

Volume 1, Issue 2, March–April 2001, Pages 87-90
Ambulatory Pediatrics

Association of Early Bilateral Middle Ear Effusion With Language at Age 5 Years

https://doi.org/10.1367/1539-4409(2001)001<0087:AOEBME>2.0.CO;2Get rights and content

Objective.— This study tested the hypothesis that children with early persistent middle ear effusion (MEE) are at risk for later language deficit.

Method.— We recruited 698 newborns and monitored them for MEE every 2 to 4 weeks at home until age 3 years. Language skills were assessed on 294 subjects at age 5, while controlling for 8 demographic and environmental factors. Language outcomes at age 5 years were studied as a function of duration of bilateral MEE from birth to age 3 years.

Results.— A significant relation was found between duration of bilateral MEE and speech sound sensitivity (Carrow Elicited Language Inventory) and articulation (Goldman-Fristoe Articulation). Children's ability to discriminate speech sounds in a quiet environment (Carrow Auditory Visual Abilities Test) was less affected by early prolonged MEE in homes that provided more cognitive stimulation.

Conclusions.— These exploratory results indicate that prolonged early MEE may predispose children to language deficits at age 5 years. The language deficits are of small magnitude and may or may not be clinically significant. Language stimulation at home may protect against some of the effects of prolonged MEE.

Section snippets

Subjects

The study population and methods were described previously.16, 17, 18, 19 During the period from 1984 to 1989, we recruited 698 children from 3 local newborn nurseries. Parents signed an informed consent. Exclusionary criteria included neonatal complications, craniofacial anomalies, lack of a telephone, the fact that English was not the primary language spoken in the home, or plans to move from the area in the next 5 years. Subjects with evidence of sensorineural deafness at any age were

Sample Characteristics and Attrition

Of the 698 infants enrolled at birth, 294 children were available for language assessment at age 5 years. Subjects were 56% Caucasian, 30% African American, and 14% Hispanic (English-speaking only). The mean score for SES was 37.4, which is at the mean for a random sample of the population of the United States. The mother's intelligence (Shipley) mean score of 50 (standard deviation = 10.1) is also typical of the normative sample for this instrument. There were no differences by gender or

DISCUSSION

We found a direct relationship between duration of bilateral MEE before age 3 years and children's understanding of grammar or speech sound sensitivity (CELI) and articulation (Goldman-Fristoe) at age 5 years. These results applied to all children in the sample, regardless of gender and ethnicity. These exploratory results are consistent with the findings of Abraham et al9 and Paden et al,10 although their assessments were conducted with younger children. We also found subtle associations

ACKNOWLEDGMENTS

Mary J. Owen, MD, and Virgil M. Howie, MD, initiated and carried out the planning, data collection, and early data analysis for this project. A more detailed version of this paper (with results for time with middle ear effusion) is available from the first author, and a more complete discussion of the statistical characteristics of the study population can be found in Johnson et al.16 This project was funded in part by the National Institute of Child Health and Human Development, grant HD20988.

REFERENCES (32)

  • RobertsJE et al.

    Otitis media in early childhood and later language

    J Speech Hearing Res

    (1991)
  • AbrahamSS et al.

    Early otitis media and phonological development at age 2 years

    Laryngoscope

    (1996)
  • PadenEP et al.

    Predictors of phonologic inadequacy in young children prone to otitis media

    J Speech Lang Disorders

    (1987)
  • GravelJS et al.

    Listening and language at 4 years of age: effects of early otitis media

    J Speech Hearing Res

    (1992)
  • TeeleDW et al.

    Otitis media with effusion during the first three years of life and development of speech and language

    Pediatrics

    (1984)
  • ModyM et al.

    Speech perception and verbal memory in children with and without histories of otitis media

    J Speech Lang Hearing Res

    (1999)
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    Presented in part at the Sixth International Symposium on Recent Advances in Otitis Media, Ft. Lauderdale, Fla, June 1995; at the the Society for Research in Child Development, Washington, DC, April 1997; and at the Pediatric Academic Societies Annual Meeting, Washington, DC, May 1997.

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