1. Chronic Otitis Media and Language Delay By: Laura Kee

2. What is Chronic Otitis Media? An inflammation of the middle ear (the area behind the ear drum) Usually associated with a build-up of fluid, which may or may not be infected (ASHA kidsource) Duration can vary widely from a few days to months (Casby, 2001)

3. Common Symptoms Earaches (child complains of ear hurting) Drainage of the ear Fever Rubbing or pulling at the ears Irritability Poor sleep (Roberts and Zeisel, 2000)

4. Common Symptoms Using gestures rather than speech Talking less than usual or using unclear speech Different response to speech and everyday sounds Frequently needs to have directions and information repeated Difficulty keeping balance, running, or jumping Turning up the TV or radio louder than usual (Ontario Association…, 1988)

5. How common is Chronic Otitis Media? It is the single most frequent finding during physician office visits of young children (Casby, 2001) 50-75% of children have at least one episode by one year of age (Roberts, 1997) 10-20% of children will have otitis media three or more times, with fluid lasting an average of one month each time (Roberts and Zeisel, 2000) For school children, an estimated 5 million school days are missed every year due to Otitis Media (ASHA KidSource)

6. Why is it so common with children? Eustachian tube is smaller and more nearly horizontal in children than in adults Therefore, it can be more easily blocked by infections and other conditions (ASHA KidSource)

7. Do children ever outgrow this? The eustachian tube changes in size and angle (ASHA KidSource) Growth periods for the eustachian tube occur at around age 4, again at age 7, and lastly at around puberty (UCSD…, 2000)

8. How can Otitis Media cause a hearing loss? Three tiny bones in the middle ear carry sound vibrations from the eardrum to the inner ear When fluid is present in the middle ear, vibrations are not transmitted efficiently and sound energy is lost Because of this, some speech sounds may be muffled or inaudible (ASHA KidSource)

9. Is this hearing loss permanent? Generally, this type of hearing loss is only temporary. When Otitis Media occurs over and over again, damage to the eardrum, the bones of the ear, or the auditory nerve can occur. This would cause a permanent hearing loss. (ASHA KidSource)

10. How can this hearing loss cause a language delay? Children learn speech and language by interacting with people around them (Roberts & Zeisel, 2001). If a hearing loss exists, the child is not able to get the full benefits of language learning experiences, due to lack of exposure (ASHA KidSource). This is because the fluid in the middle ear may muffle sound, making it harder to hear and understand speech (Roberts & Zeisel, 2001). Critical delays in speech and language can occur as a result (ASHA KidSource).

11. What can I do if I am concerned about my child’s language development? Talk to your child’s healthcare provider Talk to a speech- language pathologist. An SLP specializes in diagnosis and treatment of speech and language disorders (picture from Roberts and Zeisel, 2000)

12. References 1.Questions and Answers about Otitis Media, Hearing and Language Development (n.d.). ASHA KidSource Online. Retrieved August 8, 2002, from http://kidsource.com/ASHA/otitis.html http://kidsource.com/ASHA/otitis.html 2.Roberts J., Zeisel S. (2000, July 1). Ear Infections and Language Development. Guide- Non-Classroom Use. Abstract retrieved August 8, 2002, from ERIC database. 3.Ear Infections and Speech and Language Development (1988). Ontario Association for Families of Children with Communication Disorders. Retrieved August 8, 2002, from http://www.cyberus.ca/~oafccd/factshee/fact24.htm http://www.cyberus.ca/~oafccd/factshee/fact24.htm

13. 4. Roberts, K. (1997). A Preliminary Account of the Effect of Otitis Media on 15-Month-Old’s Categorization and Some Implications for Early Language Learning. Journal of Speech, Language, and Hearing Research, 40, 508-518. 5.Acute Otitis Media (2000). UCSD Ototlaryngology- Head and Neck Surgery. Retrieved August 8, 2002, from http://www- surgery.ucsd.edu/ent/DAVIDSON/Pathway/AcutOtit.h tmhttp://www- surgery.ucsd.edu/ent/DAVIDSON/Pathway/AcutOtit.h tm 6.Casby, M. (2001, February). Otitis Media and Language Development: A Meta-Analysis. American Journal of Speech-Language Pathology. Abstract retrieved August 12, 2002, from Academic Search Elite database.