Middle Ear Effusion, Attention, and the Development of Child Behavior Problems

Abstract

Objective: Much interest centers on whether middle ear effusion (MEE) early in life has lasting developmental consequences. It was hypothesized that episodic loss of hearing acuity associated with MEE results in a deficit in attention, a core factor in the development of child behavior problems, and that impaired attention is related to behavior problems during the early years of childhood. Method: This was a prospective study of a large sample of children (n = 698) that was representative of the local population in terms of socioeconomic and ethnic characteristics. The children were recruited at birth and were monitored with regular home visits for 3 years to check for the presence of MEE. Assessment of attention occurred at 2, 3, 5, and 7 years. Behavior problems were assessed at 3, 5, and 7 years. Results: The results did not support the hypothesis that children with greater duration of MEE experience greater attention deficits and more behavior problems than children with a shorter duration of MEE. Structural Equation Modeling parameter estimates resulted in no support for the primary hypothesis. Correlational analyses also did not support the hypothesis. Attention and behavior problems were related significantly. Conclusions: Our negative findings call into question the results of previous studies relating MEE to behavior and attention problems, studies that may have been biased by small, non-representative samples and retrospective designs that lacked careful documentation of MEE.

Assessment and Treatment of Behavioral Disorders in Children with Hearing Loss: A Systematic Review

“…Regarding OME, a large longitudinal cohort study with the Child Behavior Checklist in a group of children found no association between hearing loss and behavioral problems. 41 This was also reported by Minter et al 43 However, a large cohort study with a similar level of evidence used Rutter’s Behavior Scale and the Connors’ Hyperactivity Index and found an association between OME and hyperactive, antisocial, and neurotic behavior. 42 This study was significantly limited by a crude assessment of OME through subjective parental report of suspected/confirmed hearing loss and purulent ear drainage.…”

“…[28][29][30][31][32][33][34][35][36][37][38][39][40] Eight studies assessed behavior among DHH children who had otitis media with effusion (OME) or minimal/unilateral hearing loss ( Table 3). [41][42][43][44][45][46][47][48] Of the 36 articles, 2 studies also explored interventional methods for this population. 49,50 The included studies occurred from 1985 to 2015 and took place in the United States, Taiwan, New Zealand, Australia, Spain, India, the United Kingdom, Turkey, the Netherlands, Germany, and Canada.…”

“… 41‐48 A range of behavioral assessment instruments was used in these studies. Regarding OME, a large longitudinal cohort study with the Child Behavior Checklist in a group of children found no association between hearing loss and behavioral problems 41 . This was also reported by Minter et al 43 However, a large cohort study with a similar level of evidence used Rutter's Behavior Scale and the Connors’ Hyperactivity Index and found an association between OME and hyperactive, antisocial, and neurotic behavior 42 .…”

“…Eight studies were identified that examined behavioral problems among children with either OME or minimal/unilateral hearing loss ( Table 3). [41][42][43][44][45][46][47][48] A range of behavioral assessment instruments was used in these studies. Regarding OME, a large longitudinal cohort study with the Child Behavior Checklist in a group of children found no association between hearing loss and behavioral problems.…”

Switch Attention to Listen

“…Interestingly, all the participants in our experimental group reported a history of recurrent otitis media. While the data does not speak directly to any definitive links with OME, it may be that due to the transient disruptions in hearing associated with recurrent OME3940 the experimental group may have learnt to allocate most of their cognitive resources to selectively focus attention on expected information and the remaining resources are insufficient for them to switch their attention to any unexpected stimulus. Future studies are needed to evaluate this hypothesis.…”