“…Despite the above cautions, the high prevalence of OME raises educational policy issues. Signal‐to‐noise ratios in classrooms are often poor, with high levels of background noise and insufficient teacher intervention to ensure audibility of their own or a child's voice (Blake & Busby, 1994; Shield & Dockrell, 2004). Despite the fact that children affected by OME show a particular deficit for understanding speech in noise (Jerger, Jerger, Alford, & Abrams, 1983; MRC Multi‐centre Otitis Media Study Group, 2004), we have been unable to find other recent policy literature linking the problems of ambient noise and OME, or directly addressing teachers' knowledge of OME and its more subtle signs.…”