Glue Ear and Speech and Language Development

Glue Ear, Grommets, and Speech and Language Development

Verbal communication begins with babies listening to adults and children around them talking, and practicing verbalisations through babbling.  Many children develop ear infections during their early years, which may compromise their hearing at a time of rapid speech and language development. While the odd ear infection may not impact their communication development, frequent ear infections may reduce the amount of speech and language that the child is able to hear, and therefore acquire. 

What is Otitis Media (OM)?
Otitis media (OM) is an infection of the middle ear (a cavity directly behind the eardrum, which is usually filled with air) (Hirst & Neill, 2013). During OM, the eustachian tube (a tube between the middle ear and the back of the nose) may be unable to equalise pressure in the middle ear and drain fluids. A build-up of pressure in the middle ear may pull the eardrum inwards or push it outwards, compromising it’s abilities to vibrate (Hendry, Farley & McLafferty, 2012; Justice, 2010; Robb & Williamson, 2016). The function of the middle ear may be further compromised by a build-up of fluid behind the eardrum (Glue ear, or Otitis Media with Effusion), preventing the eardrum and the hearing bones (ossicles) from vibrating effectively (Vennik & Williamson, 2014). 

Glue Ear and Grommets:
Grommets are tiny man-made tubes which go through the ear drum. This creates a hole in the eardrum which can help to relieve pressure in the middle ear, and drain any fluid which has built up. The insertion of grommets may immediately improve a child’s hearing, as the release of pressure and removal of fluid will allow the eardrum and hearing bones to vibrate again (Robb & Williamson, 2016). If left in, grommets may reduce the incidence and impact of further ear infections for at least six months post insertion (McDonald, Langton Hewer & Nunez, 2008).  

Hearing the Sounds of Speech:
Speech sounds occur at different frequencies. A child with mild hearing loss may be able to hear most sounds, but may miss out on hearing several higher frequency speech sounds (e.g. p, k, f, th, s). This is likely to make it difficult for them to develop these sounds, and discriminate between some words e.g. cool vs pool, free vs three, fight vs kite. 

Speech and Language Delay:
Children who present with a speech and/or language delay may benefit from some support in developing their communication skills. Children who present with recurrent OM may benefit from an assessment session with a Speech and Language therapist. 

References:
Hendry, C., Farley, A., & McLafferty, E. (2012). Anatomy and physiology of the senses. Nursing Standard, 27(5), 35-42. 

Hirst, S., & Neill, S. (2013). Treatment of acute otitis media in childhood. Practice Nursing, 24(8), 407-410.

Justice, L. M. (2010). Communication sciences and disorders: A contemporary perspective. Boston, MA: Allyn & Bacon.

McDonald, S., Langton Hewer, C. D., & Nunez, D. A. (2008). Grommets (ventilation tubes) for recurrent acute otitis media in children. The Cochrane Database of Systematic Reviews, 4(3), 1192-1207

Robb, P. J., & Williamson, I. (2016). Otitis media with effusion in children: Current management. Paediatrics and Child Health, 26(1), 9-14

Vennik, J., & Williamson, I. (2014). An overview of the symptoms and management of glue ear. British Journal of School Nursing, 9(7), 335-338.

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