The American Speech-Language-Hearing Association (ASHA) describes otitis media as “an inflammation in the middle ear (the area behind the ear drum) that is usually associated with a buildup of fluid. The fluid may or may not be infected.” The difficulty with otitis media is that the symptoms, severity, frequency and length vary. Certain special-need populations are more prone to otitis media.
Symptoms of acute otitis media include earache, irrational behavior and fever. Otitis media with effusion (fluid) often represents no symptoms, but can cause temporary hearing loss. Chronic or recurring otitis media may display a variety of symptoms. It is not uncommon for 4 or 5 back-to-back occurrences to happen in a six-month period.
Speech and language pathologists have been concerned with otitis media for year. Hearing loss accompanying otitis media can range from negligible to as high as 50 dB. The effects of hearing loss on speech and language development are well known. Children learn speech and language from listening to others speak. Research as revealed that infants need more intensity than adults to discriminate sounds and be able to reproduce them. Very young children with otitis media are, therefore, at greater risk for delays in speech and language development because the hearing loss associated with otitis media may not be considered “mild” by using the above standards.
Another reason for concern with otitis media is its fluctuating nature: inconsistent auditory input makes it especially tough for the child during the sensitive period of speech and language development.
It is important that children receive medical treatment as soon as possible for otitis media. Consult your pediatrician for your initial concerns. She/He may refer you to an Ear-Nose-Throat (ENT) Specialist. Antibiotics and pressure equalization tubes have been options for treatment, especially with special-need populations. If hearing loss is present, it is recommended that a complete hearing evaluation, including tympanometry (a measure of pressure in the middle ear cavity) be obtained and tracked. This is especially important for chronic otitis media, which can cause fluctuating hearing loss. For this reason, school hearing screenings do not always detect the child with otitis media. Depending on the day, the child may pass the screening at the typical 25 dB hearing level. Children with special needs would benefit from complete audiological evaluations every six months.
The preschool years are critical for laying a firm foundation of speech and language skills. If the child is not communicating at age-appropriate levels, later development may be affected, including the necessary skills for academics. It is best to identify and treat delays as soon as one suspects difficulty. Doctors and speech-language pathologists are trained to diagnose and treat these problems, as well as assist parents in being good models for speech and language development. Concerned about whether your child uses age-appropriate speech? Contact me at AAC on the Lakeshore for consultation and evaluation.