Otitis Media and Speech and Language: A Meta-analysis of Prospective Studies

Abstract

ABSTRACT. Objective. Considerable controversy surrounds whether a history of otitis media with effusion (OME) in early childhood causes later speech and language problems. We conducted a meta-analysis of prospective studies to determine: 1) whether a history of OME in early childhood is related to receptive language, expressive language, vocabulary, syntax, or speech development in children 1 to 5 years old and 2) whether hearing loss caused by otitis media in early childhood is related to children's receptive language or expressive language through 2 years of age.Methods. We searched online databases and bibliographies of OME studies and reviews for prospective or randomized clinical trials published between January 1966 and October 2002 that examined the relationship of OME or OME-associated hearing loss in early childhood to children's later speech and language development. The original search identified 38 studies, of which 14 had data suitable for calculating a pooled correlation coefficient (correlational studies) or standard difference between parallel groups (group studies). Random-effects meta-analysis was used to pool data when at least 3 studies had usable data for a particular outcome.Results. We performed 11 meta-analyses. There were no significant findings for the analyses of OME during early childhood versus receptive or expressive language during the preschool years in the correlation studies. Similarly, there were no significant findings for OME versus vocabulary, syntax, or speech during the preschool years. Conversely, there was a significant negative association between OME and preschoolers' receptive and expressive language (lower language) (0.24 and 0.25 standard difference, respectively) in the group studies. Additionally, hearing was also related to receptive and expressive language in infancy (3%-9% of variance).Conclusions. Our results indicate no to very small negative associations of OME and associated hearing loss to children's later speech and language development. These findings may overestimate the impact of OME on outcomes, because most studies did not adjust for known confounding variables (such as socioeconomic status) and excluded data not suitable for statistical pooling, especially from methodologically sound studies. Although some OME language differences were detectable by meta-analysis due to increased statistical power, the clinical relevance for otherwise healthy children is uncertain. Pediatrics 2004;113:e238 -e248. URL: http: //www.pediatrics.org/cgi/content/full/113/3/e238; otitis media, childhood, meta-analysis, speech, language.

Conductive Hearing Loss Induced by Experimental Middle-Ear Effusion in a Chinchilla Model Reveals Impaired Tympanic Membrane-Coupled Ossicular Chain Movement

“…Moreover, Turcanu et al (2009) The presence of an MEE is not necessarily indicative of the presence of a CHL-implications for long-term hearing impairments due to chronic CHL Although most children experience multiple bouts of OME during early childhood, it is less clear whether OME typically presents with a corresponding CHL. This distinction is critical, as the mere presence of OME alone without associated CHL would not be expected to result in long-term hearing deficits (Roberts et al 2004). However, OME that has been clinically documented to coincide with a corresponding CHL has been shown to result in altered auditory physiology and auditory behavior in a majority of cases (for review, see Whitton and Polley 2011); children with these conditions have a high likelihood of developing persistent hearing deficits.…”

“…On the other hand, clinically, OME might be present (as indicated by tympanometry and visual inspection), but the CHL could be negligible. Thus, children with chronic OME should ideally receive hearing tests to determine the presence and magnitude of an MEEinduced CHL (Roberts et al 2004). …”

Surgical Treatments for Otitis Media With Effusion: A Systematic Review

“…1,3,4 Despite the high prevalence of OME, its long-term impact on child developmental outcomes, such as speech, language, intelligence, and hearing remain disputed. 5 A recent systematic review of the natural history of OME found mixed evidence regarding the impact of OME in early childhood on later developmental outcomes. 2 Lacking clear evidence that OME influences children' s development, clinicians struggle with decision-making for this common condition.…”

Uso de chupeta: história e visão multidisciplinar

“…Since otitis is more frequent during the first year of life, studies have demonstrated that its relapse may cause, to a larger or shorter extent, speech development delay or problems. 48 Thus, with regard to speech, pacifiers are, at the same time, used to consolidate sucking and coordinate suckingswallowing-breathing and considered a negative habit.…”