Chronic Middle Ear Disease and Auditory Perceptual Deficits

Abstract

Data are presented indicating a correlation between chronic recurrent otitis media of early childhood and in increased likelihood of subsequent auditory processing deficits in a group of children referred for evaluation of impaired learning. Helpful appendices are added for a better understanding a central auditory processing skills.

The Psychological, Educational and Auditory Sequelae of Early, Persistent Secretory Otitis Media

“…A prevalence of conductive hearing loss in 20-25% of children in these groups is reported, compared with approximately 10% abnormal hearing thresholds in control groups (Masters & Marsh, 1978;Freeman & Parkins, 1979). As many as 46 % of children referred for poor school performance have been found to have histories of CSOM (Gottlieb, Zinkus & Thompson, 1980). These figures should be interpreted cautiously, since there are a number of factors, including adverse birth history and home environment, which predispose children both to CSOM and to poor school achievement.…”

Parental Stress and Parent-rated Child Behavior in Relation to Otitis Media in the First Three Years of Life

“…Most previously reported studies relating parentchild stress and/or children's behavior to the children's previous experience with otitis media have had retrospective 1,7,8,[13][14][15] or cross-sectional 2,6,10 designs, and most have considered only children Ͼ3 years of age. [2][3][4]5,7,8,10,[12][13][14][15] The cross-sectional studies have, of necessity, related behavioral measures only to concurrent and not to past experience with otitis media, and thus provide little insight into possible lasting, long-term relationships.…”

“…[2][3][4]5,7,8,10,[12][13][14][15] The cross-sectional studies have, of necessity, related behavioral measures only to concurrent and not to past experience with otitis media, and thus provide little insight into possible lasting, long-term relationships. The retrospective studies have been limited by their inherently questionable ascertainment of both the presence and the absence of otitis media throughout time.…”

“…In the first of these, a retrospective study of 213 8-to 9-year-old children who were referred because of poor school performance or suspected develop- mental delays and who represented "a broad socioeconomic background," Gottlieb and colleagues 13 found that the prevalence of behavior problems, based on ratings by examiners, parents, and teachers, did not differ significantly between children with, and without a history of recurrent or chronic otitis media during "early childhood." In 2 later studies involving a birth cohort of New Zealand children, Silva and colleagues 2,10 compared 47 who were found on examination at age 5 years to have bilateral OME with 355 who were found at that age to be otologically normal.…”

“…The problems reported have included stress in the mother-child relationship, 1 restlessness and fidgetiness, 2 destructive behavior, 2 frequent disobedience, 2 impaired task orientation in the classroom, 2-4 inattention, short attention span and/or distractibility, 2,4 -6 attention deficit hyperactivity disorder, 7,8 dependence, 2,3 restricted social interaction, 9 suboptimal social behavior, 6 unpopularity with other children, 2 and behavior problems. 10 On the other hand, other investigators have found no significant associations between persistent or recurrent otitis media early in life and measures of attention, 11,12 cooperation, 11 or behavior, [12][13][14] or the presence of attention deficit hyperactivity disorder, 15 later in childhood. Unfortunately, the studies forming the basis for these various reports have all lacked or been deficient in one or more of the following key features: prospective design; representative study population; avoidance of selection bias; adequate sample size; accurate ascertainment of the presence or absence of otitis media; well grounded assessment measures; and acknowledgment of the distinction between association and causality.…”