Otitis Media in Infancy and Intellectual Ability, School Achievement, Speech, and Language at Age 7 Years

Teele, David W.; Klein, Jerome O.; Chase, Catharine M.; Menyuk, Paula; Rosner, Bernard

doi:10.1093/infdis/162.3.685

Cited by 346 publications

(204 citation statements)

References 18 publications

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“…Thus, we excluded studies 5,[33][34][35][36][37][38] in meta-analyses that were in an age grouping that would contain data from only 1 or 2 cohorts (eg, only 2 correlation studies examined OME and receptive language in infancy). Eleven age groupings remained with at least 3 studies on a particular outcome and were available for meta-analyses: 1) infancy: receptive language versus hearing loss (correlation studies); 2) infancy: expressive language versus hearing loss (correlation studies); 3) preschool: receptive language versus OME (correlation studies); 4) preschool: receptive language versus OME (group studies); 5) preschool: expressive language versus OME (correlation studies); 6) preschool: expressive language versus OME (group studies); 7) preschool: vocabulary comprehension (Peabody Picture Vocabulary Test [PPVT]) 39 versus OME (correlation studies); 8) preschool: vocabulary comprehension (PPVT) 39 versus OME (group studies); 9) preschool: expressive vocabulary (number of different words [NDW]) versus OME (correlation studies); 10) preschool: expressive syntax (mean length of utterance [MLU]) versus OME (correlation studies); and 11) preschool: speech versus OME (group studies).…”

Section: Study Selectionmentioning

confidence: 99%

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

Roberts¹,

Rosenfeld

Zeisel³

2004

Pediatrics

211

153

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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.

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Section: Study Selectionmentioning

confidence: 99%

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

Roberts¹,

Rosenfeld

Zeisel³

2004

Pediatrics

211

153

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“…Hearing threshold appears to depend partly upon history of otitis media in childhood (15). Furthermore, history of otitis media is associated with poor performance in language and academic areas during childhood (16,17), behavioral problems during childhood (17), and behavior and language during adolescence (18). As such, we were careful to consider the degree of otitis media in our study of the effects of hearing level on the four areas described.…”

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confidence: 99%

Variation in the Normal Hearing Threshold Predicts Childhood IQ, Linguistic, and Behavioral Outcomes

Welch

Dawes

2007

Pediatr Res

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Childhood hearing level varies considerably within the range considered normal. Four classes of outcome were investigated for associations with hearing thresholds in this range: ability to identify speech in noise, neurocognitive ability, linguistic ability, and behavior. The research was conducted in a general population cohort of 711 children with mean hearing threshold of 15 dB HL or better. Some outcomes: speech in noise, intelligence, and certain linguistic abilities, were predicted in both boys and girls; effects were stronger in girls. In girls only, poorer hearing predicted worse behavior. These effects remained after statistical control for childhood socioeconomic status and otitis media. Variability in normal hearing, due to causes other than otitis media, is associated with the listening, language, and neurocognitive abilities of children, and the behavior of girls. We suggest that these effects may be present for three reasons, cochlear insults, neurodevelopmental factors, and psychological factors. We discuss how these may interact to produce the effects observed. T he conventional cut-off for normal-range hearing in children is 15 dB HL (1); which includes 97% (711/734) of the general population sample assessed here. This includes a wide range of actual hearing abilities, and how it relates to psychosocial consequences in humans is unclear (2). Hitherto, research has concentrated on effects in people with relatively large hearing losses, with little attention paid to the effects of variability within the normal range. We investigated four areas for which we hypothesized effects of hearing level in normally hearing children. Identification of signals in noise.A relation between puretone detection and identification of signals in noise has been demonstrated in minimally hearing-impaired children (3). Variation in normal hearing may be due to vulnerable structures involved in the cochlear active process (4). Children with poorer normal hearing may be less able to identify signals in noise due to slight deterioration in these systems.Neurocognitive ability. Assessment of hearing threshold measures performance on a psychoacoustical task in which general neurocognitive ability might play a part, so variation in threshold might be related to IQ. Furthermore, a body of research has related sensory processing, in terms of inspection time, with IQ (5-7). Thus, there may be a relation between hearing and IQ.Linguistic ability. Children with minimal hearing impairment perform less well on tests of educational performance, particularly in areas related to language (8). Furthermore, those with poor linguistic abilities perform less well on tests of acoustic frequency and temporal resolution (9,10). These findings are with stimuli requiring a high degree of processing (11), however, simple detectability may contribute to the effects shown.Behavior. Little research has investigated behavioral concomitants of variation in hearing in children. In deaf people, there may be effects with depression and interp...

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“…While OM is only very rarely associated with mortality, the morbidity associated with OM is significant. Hearing loss is the most common complication of OM (4,25,31) with behavioral, educational, and language development delays being additional consequences of earlyonset OM with effusion (26,31,49). The socioeconomic impact of OM is also great, with direct and indirect costs of diagnosing and managing OM exceeding $5 billion annually in the United States alone (1,8,27,31).…”

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confidence: 99%

Partial Analysis of the Genomes of Two Nontypeable Haemophilus influenzae Otitis Media Isolates

et al. 2004

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In 1995, The Institute for Genomic Research completed the genomic sequence of a rough derivative of Haemophilus influenzae serotype d, strain KW20. This sequence, though extremely useful in understanding the basic biology of H. influenzae, has yet to provide significant insight into our understanding of disease caused by nontypeable H. influenzae (NTHI), because serotype d strains are not generally pathogens. In contrast, NTHI strains are frequently mucosal pathogens and are the primary pathogens of chronic otitis media as well as a significant cause of acute otitis media in children. Thus, it is of great importance to further understand their biology. We used a DNA-based microarray approach to identify genes present in a clinical isolate of NTHI that were absent from strain Rd. We also sequenced the genome of a second NTHI isolate from a child with chronic otitis media to threefold coverage and then used an array of bioinformatics tools to identify genes present in this NTHI strain but absent from strain Rd. These methods were complementary in approach and results. We identified, in both strains, homologues of H. influenzae lav, an autotransported protein of unknown function; tnaA, which encodes tryptophanase; as well as a homologue of Pasteurella multocida tsaA, which encodes an alkyl peroxidase that may play a role in protection against reactive oxygen species. We also identified a number of putative restriction-modification systems, bacteriophage genes and transposon-related genes. These data provide new insight that complements and extends our ongoing analysis of NTHI virulence determinants.

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Otitis Media in Infancy and Intellectual Ability, School Achievement, Speech, and Language at Age 7 Years

Cited by 346 publications

References 18 publications

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

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

Variation in the Normal Hearing Threshold Predicts Childhood IQ, Linguistic, and Behavioral Outcomes

Partial Analysis of the Genomes of Two Nontypeable Haemophilus influenzae Otitis Media Isolates

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