Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study

Abstract

We examined the association between otitis media (OM) and educational attainment in a retrospective population cohort of Western Australian children who participated in the grade 3 National Assessment Program—Literacy and Numeracy in 2012 (N = 19,262). Literacy and numeracy scores were linked to administrative hospital and emergency department data to identify secondary care episodes for OM. Results of multivariate multilevel models showed that children with OM episodes had increased odds of poor performance on literacy and numeracy tests, compared to children without OM episodes (46–79% increase in odds for Aboriginal children; 20–31% increase in odds for non-Aboriginal children). There were no significant effects found for age at the first episode, nor for OM episode frequency (all ps > 0.05). Regardless of the timing or frequency of episodes, children with OM episodes are at risk of poor literacy and numeracy attainment. Aboriginal children with OM appeared to be particularly at risk of poor literacy and numeracy achievement. Intervention to reduce the prevalence of otitis media in young children, and early treatment of OM, are important for limiting the negative effects on academic outcomes.

Early onset of otitis media is a strong predictor of subsequent disease in urban Aboriginal infants: Djaalinj Waakinj cohort study

“…While larger longitudinal studies are needed, our results highlight the feasibility of and need for early ear health assessments in infants living in urban areas, given the generally asymptomatic nature of OM in infancy. Prompt management is then needed to reduce the likelihood of long‐term hearing loss and potential developmental, social, behavioural, educational outcomes and economic consequences 4–6,15 . Twenty of the 125 study participants are known to have had grommets inserted before 3 years of age, a further indication of the disease burden and need for services.…”

“…Prompt management is then needed to reduce the likelihood of long‐term hearing loss and potential developmental, social, behavioural, educational outcomes and economic consequences. 4 , 5 , 6 , 15 Twenty of the 125 study participants are known to have had grommets inserted before 3 years of age, a further indication of the disease burden and need for services. The proportion of infants with OM in our urban Aboriginal cohort is somewhat lower than in the Goldfields 20 years ago (35% at 2 months in this study vs. 44% in the KOMRP) 8 and lower than that reported recently in remote Northern Territory communities, where only 20% had normal ears bilaterally at 4 months of age.…”

“…In 2009, the estimated annual cost for treatment of OM in Australia was $100–$400 million 2 . When OM and its suppurative complications are not treated adequately, the associated conductive hearing loss can result in delays in speech and language development which may affect school performance, socio‐economic circumstances and quality of life in adulthood 1,3–5 . Australian Aboriginal and/or Torres Strait Islander children continue to experience severe, persistent and unacceptably high rates of OM from a young age 4 .…”

“… 2 When OM and its suppurative complications are not treated adequately, the associated conductive hearing loss can result in delays in speech and language development which may affect school performance, socio‐economic circumstances and quality of life in adulthood. 1 , 3 , 4 , 5 Australian Aboriginal and/or Torres Strait Islander children continue to experience severe, persistent and unacceptably high rates of OM from a young age. 4 OM in early life is frequently asymptomatic 6 , 7 ; hence parents may not be aware that their child has the disease until hearing loss, delayed speech or poor balance are observed.…”