Seattle Times Medical Reporter

Most children escape several bouts with childhood’s second most-common illness, otitis media, without permanent hearing or speech problems. But some may experience subtle difficulties, a leading researcher says.

“The goal of our research is to determine which children are most at risk for problems,” Says Dr. Judith Gravel, associate professor of audiology at Albert Einstein College of Medicine in New York City. “Most will not be affected, but a small portion will.”

Otitus media, most often referred to as an ear infection, is an inflammation and fluid buildup of the middle ear. It is second only to the common cold as the most common illness affecting preschool children. Half of all children have had a least one episode by age 1, and one-third have repeated episodes from age 1 to 3.

Children most at risk for problems are those who have many episodes, severe infections, or fluid present three months or longer. In an ongoing research study at Albert Einstein (called the Bronx ChHEARs Project), children who visited the doctor at least four times for otitis media in their first year were the most likely to have temporary hearing problems. But, no one really knows yet just how much illness will cause long-term damage, Gravel told a seminar yesterday at the American Speech-Language-Hearing Association annual meeting in Seattle. About 10,000 speech and hearing experts are attending the meeting at the Washington State Convention and Trade Center through tomorrow.

Gravel said otitis media muffles sounds during the critical years when children are developing language. When infants have infections in their first year, they are more likely to have more as toddlers.

The infections may muffle speech, so the child may have a distorted perception of correct speech sounds. This can lead to impaired language development in the early years, although most problems correct themselves by first grade, Gravel said.

Gravel said subtle long-term problems that occur with children include:

Inability to listen well when there is background noise. It’s harder for them to “target” the sounds they’re supposed to be listening to.
Behavior problems may occur because of inattentiveness. They are unable to stay focused on the classroom task at hand.
Reading difficulties may occur because language is learned through speech. Thus, a child may not be able to read aloud or understand a word beginning or ending in “f,” a sound that is more difficult than others to hear.
Speech itself sometimes is affected. But most often, that is corrected by school age.

Otitis media can be sneaky, causing fluid buildup without apparent pain to the child. Gravel said it’s important for parents to be watchful for subtle symptoms such as inattentiveness, listening to television at a louder than usual level, misunderstanding directions, listlessness, unexplained irritability or pulling and scratching at the ears.