What is the evidence re: Otitis Media and its effect on language development?

Thursday, January 21, 2021

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Otitis Media with Effusion (OME) is recognised as one of the most prevalent childhood illnesses. OME is described as an inflammation in the middle ear that is usually associated with a build-up of fluid. When this occurs several times a year, it is referred to as recurrent otitis media (ROM) (Casby, 001).


There is extensive and emerging research surrounding the connection between ROM (with associated hearing loss) and speech-language development. Although multitudes of research findings and explanations exist, a consensus about the impact of ROM on speech-language development has not yet been reached.


Although the evidence base in the literature is inconclusive, there is a general consensus that hearing is the primary avenue for language learning, social communication and interaction, and education. Almost any hearing loss has a negative impact on language learning and academic development (Madell, 18, p.). Therefore if hearing loss occurs within the first years of a child¡¦s life (during the period of pre- and early verbal development) it is likely to effect auditory processing, later communication development skills and academic achievement and hence place the child at risk for lowered speech-language outcomes (Boswell, 1).


Numerous studies are prospective and hence considered the optimal design for studies. However, with the exception of a few, most present variable results and are less conclusive about the relationship between ROM and language development. In contrast, others are restricted by their retrospective nature presenting methodological flaws, yet provide conclusive evidence that OME has a marked negative effect on speech-language development. It is noted that many studies vary considerably due to a number of factors (sample size, socio-economic status (SES), lack of valid and reliable measures of hearing.


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The following studies provide evidence of a relationship between ROM and speech-language development;


„h Friel-Patti & Finitzo (10) (prospective study) „³ relationship between OME and language is mediated by hearing.


„h Shriberg, L., Friel-Patti, S. Flipsen, P., & Brown, R. (000) „³ ¡§OME and associated elevated hearing levels increase the risk for lowered speech-language outcomes at years of age¡¨ (Shriberg et al., 000)


„h Groenen, P. Crul, T,. Maassen, B. & Van Bon, W. (16) „³ ¡§children with OME experience demonstrate a greater mean ¡§just noticeable difference¡¨ (JND) than children without early OME experience.¡¨ (p.4)


„h Paradise. J, et al. (000) „³ persistent early-life MEE causes slight impairments of receptive language and verbal aspects of cognition.


„h Shriberg, L., Kertoy, M.K., Katcher, M.L., & Block, M.G. (000) „³ study supports a positive relationship between ROM and speech development


In contrast, the following found a negative correlation between ROM and speech-language development;


„h Paul, R., Lynn, F. & Lohr-Flanders, M. 1 „³ no differences in expressive language outcomes in either group that could be firmly attributed to a history of ROM.


„h Grievink, E. Peters, S, Van Bon, W, & Schilder. A. (1). „³ a history of OME was present amongst - 4 year-old children, but did not have a negative consequence for language performance at 7 years of age.


It is evident that the current literature on ROM and language development is overflowing with reports of inconclusive findings. Therefore, the argument still remains unpersuasive as to whether ROM (with associated hearing loss) has long-term consequences on speech-language development.


Possible implications of this evidence for Speech Pathologists


The possibility of ROM and its associated hearing loss introduces new responsibilities for health professionals, particularly Speech Pathologists (SP). The SP may be the first point of contact and although they may be unable to provide caregivers with conclusive evidence regarding the impact that ROM has on speech-language development, they are able to contribute in the areas of;


„h Diagnosis and referrals,


„h information provision (emphasise to the family the importance of hearing for communication and increase awareness and education)


„h monitoring (changes in responsiveness to sounds) (Boswell, 1, p.15)


If the SP ensures hearing is tested it can be accepted / eliminated as a contributing factor to speech-language development.


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