Ear Infections, Hearing Loss, and Speech Development

What is Otitis Media?

Otitis media, also simply referred to as a middle ear infection, is inflammation in the middle ear (the area behind the eardrum) that is usually associated with the buildup of fluid. When infection occurs, the condition is called "acute otitis media." This is when a cold, allergy, or upper respiratory infection, and the presence of bacteria or viruses, lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube (the tube from the back of the ear to the mouth). Fluid can remain in the ear for weeks to many months. 

Otitis media is the most frequently diagnosed disease in infants and young children.

75% of children experience at least one episode of otitis media
by their third birthday.
Almost 1/2 of these children will have
three or more ear infections during their first 3 years of life.

Why is Otitis Media So Common in Children?

Children are more susceptible to ear infections because of the location of their ear canal. Until the age of 6 or 7 years, a child’s Eustachian tube is small and horizontal, making it susceptible to fluid build-up and blockages due to large adenoids and infections. As the skull matures and grows, the Eustachian tube becomes more vertical in position and more natural drainage takes place.

Otitis Media and Hearing Loss

All children with middle ear infection or fluid have some degree of hearing loss. Generally, the type of hearing loss associated with ear infections is temporary. 

The average hearing loss in ears with fluid is 24 decibels (the level of a very soft whisper). At this level of hearing loss, soft sounds, such as "S" and "Sh" may not be heard. Thicker fluid can cause much more loss, up to 45 decibels (the range of conversational speech).

Hearing loss becomes a bigger issue when otitis media occurs over and over again, and damage to the eardrum, bones of the ear, or even the hearing nerve can occur and cause a more permanent, sensorineural hearing loss.

Otitis Media and Speech Development

Essentially, a child experiencing hearing loss from middle ear infections will hear muffled sounds and misunderstand speech rather than incur a complete hearing loss. Even so, the consequences can be significant.

Communication development is at its peak from 12 months through four years of age. Children learn speech and language from listening to other people talk. Fluctuating hearing loss during that time interferes with learning speech and language. Similar words may sound the same. They may not hear final consonants, past tense, and plural word endings. Therefore, they may not learn how to say words properly. 

Otitis media without infection presents a special problem because symptoms of pain and fever are usually not present. Therefore, weeks and even months can go by before parents suspect a problem. During this time, the child may miss out on some of the information that can influence speech and language development, especially during the formative preschool years.

When to Seek Help

Ear infections require immediate attention, most likely from a pediatrician or otolaryngologist (ear doctor). If your child has frequently recurring infections and/or chronic fluid in the middle ear, additional specialists, such as an audiologist or speech-language pathologist, should be consulted.

Children experiencing recurring ear infections or fluid build-up should be closely monitored for any signs of speech and language delay. It has been reported that 1/3 of children receiving therapy for speech and language delay have a reported history of recurrent ear infections. Prevention, early recognition, and treatment of ear infections is important.

If you have any questions, wish to speak with Dr. Cameron and/or Dr. Garber about your concerns, or wish to make an appointment to have your child tested for hearing loss, please contact us.