The association between otitis media in early childhood with later behaviour and attention problems: A longitudinal pregnancy cohort

Altamimi, Ali Ah; Robinson, Monique; McKinnon, E.; Alenezi, Eman M.A.; Veselinović, Tamara; Choi, Robyn; Brennan‐Jones, Christopher G.

doi:10.1016/j.ijporl.2023.111545

Cited by 7 publications

(7 citation statements)

References 29 publications

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“…Previous investigations of behavioural outcomes in the same cohort revealed that behavioural problems were present in the rOM group at ages 5 and 8, which indicates a continuation of problems since early childhood. 8 Conjointly, these findings suggest that the cumulative history of OM since early childhood is likely a significant contributor to the behavioural problems observed at 10 years of age, which has also significantly impacted children's cognitive and educational outcomes. The mechanism through which an early history of OM can lead to later behavioural problems is poorly understood and is likely influenced by various environmental and genetic factors not assessed in this study.…”

Section: Discussionmentioning

confidence: 89%

“…For example, previous studies that explored the relationship between a history of recurrent and/or persistent OM and behavioural problems reported increased internalising (i.e., inner‐directed) and externalising (i.e., outer‐directed) behavioural problems with emotional, social, attention, and hyperactivity being amongst the most commonly reported problems. 3 , 4 , 5 , 6 , 7 , 8 These problems persisted into the early adolescent years, suggesting a potential long‐term impact even when any OM‐related symptoms have presumably resolved. However, the limitations and methodological designs in previous studies do not provide sufficient evidence to support the relationship between OM and behavioural problems, the extent of these problems, and whether they are of clinical significance.…”

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confidence: 99%

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Recurrent otitis media and behaviour problems in middle childhood: A longitudinal cohort study

Altamimi,

Robinson,

Alenezi

et al. 2023

J Paediatrics Child Health

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AimTo investigate the long‐term effects of early‐life recurrent otitis media (OM) and subsequent behavioural problems in children at the age of 10 years.MethodsData from the Raine Study, a longitudinal pregnancy cohort, were used to categorise children into those with three or more episodes of OM (rOM group) and those without a history of recurrent OM in the first 3 years of life (reference group). The parent report Strengths and Difficulties Questionnaire was used to assess child behaviour at the age of 10 years. Parental questionnaires were used to report past and present diagnoses of various mental health and developmental conditions, including attention, anxiety, depression, learning, and speech‐language problems. Multiple linear and logistic models were used to analyse the data and were adjusted for a fixed set of key confounding variables.ResultsThe linear regression analysis revealed significant, independent associations between a history of recurrent OM and higher Strengths and Difficulties Questionnaire scores, including total, internalising, externalising, emotional, attention/hyperactivity and peer problems subscales. Logistic regression analyses revealed an independent increased likelihood for children in the rOM group to have a diagnosis of attention, anxiety, learning and speech‐language problems.ConclusionChildren at 10 years of age with an early history of recurrent OM are more likely to exhibit attentional and behavioural problems when compared to children without a history of recurrent OM. These findings highlight the association between early‐life recurrent OM and later behavioural problems that may require professional allied health‐care interventions.

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Section: Discussionmentioning

confidence: 89%

mentioning

confidence: 99%

Recurrent otitis media and behaviour problems in middle childhood: A longitudinal cohort study

Altamimi,

Robinson,

Alenezi

et al. 2023

J Paediatrics Child Health

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“…26,27 Children who experience recurrent OM during this period can face many challenges including, hearing loss, intermittent pain, disturbed sleep patterns, increased school absenteeism and can be at a greater risk of developmental delays. 4,7,16,26,28,29 Thus, the significant burden that recurrent and persistent episodes can have on children, accompanied by caregivers' fear and uncertainty, can result in increased parental worry and stress. 10,15 Furthermore, several studies have indicated that children with recurrent and persistent OM in the first few years of life experience reduced quality of life and a poor disease-specific functional health status.…”

Section: Discussionmentioning

confidence: 99%

“…6 Children with OM often endure pain, sleep disturbances, and hearing impairment and may also face developmental problems and poor quality of life. 4,[7][8][9] As such, the persistence and recurrence of OM can be a source of concern and a considerable burden on caregivers and families.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Early‐Life Recurrent Otitis Media in Children on the Psychological Well‐Being of Caregivers

Altamimi,

Robinson,

Alenezi

et al. 2023

The Laryngoscope

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AimChildren with early‐life recurrent otitis media (OM) will often endure pain, sleep disturbances, and other developmental setbacks that impact the surrounding family system. The aim of this study was to investigate the psychological well‐being and family functioning of caregivers of children with early‐life recurrent OM (rOM).MethodsData from a longitudinal pregnancy cohort were used to categorize children into two groups: those with a history of recurrent OM (rOM group) and those without a history of rOM (reference group) by the age of 3 years. The psychological well‐being of caregivers and the family functioning status were assessed using the Affect Balance Scale and the General Functioning Scale of the McMaster Family Assessment Device (FAD‐GF), respectively, at the three‐, five‐, and eight‐year follow‐up appointments. Multiple linear regression models were used to analyze the data and were adjusted for potential confounding variables.ResultsThere were significant associations between having a child with an early history of rOM and the Affect Balance Scale of caregivers for the negative affects subscale at the three‐ (p < 0.001) and five‐ (p = 0.018) year follow‐ups, and the Affect Balance subscale at the three‐year (p = 0.007) and the five‐year follow‐ups (p = 0.047). There were no significant associations measured during the 8‐year follow‐up period for the FAD‐GF.ConclusionThe findings of this study further highlight the impact of caring for a child with rOM in early childhood on caregivers' psychological well‐being in the first five years of a child's life. The impact, however, did not appear to influence the longer‐term functioning of the family as a whole.Level of EvidenceLevel 3 Laryngoscope, 2023

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“…Children with a history of recurrent and persistent OM with or without ventilation tube insertion (the primary surgical procedure for OM) have been found to experience a wide range of behavioral problems that can persist into early adolescent years. 7 , 8 Examples of behavioral problems include social and emotional difficulties, increased anxiety, as well as attention and hyperactivity problems. 7 , 9 …”

Section: Introductionmentioning

confidence: 99%

The Impact of Waiting Times on Behavioral Outcomes for Children with Otitis Media: Results from an Urban Ear, Nose, and Throat Telehealth Service

Altamimi,

Robinson,

Alenezi

et al. 2023

Telemedicine Reports

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Aim: Children with otitis media (OM) experience long waiting times to access Australia's public hospitals due to limited capacity. The aim of this article is to utilize an Ear, Nose, and Throat (ENT) telehealth service (the Ear Portal) to examine whether delayed access to specialist care is associated with poorer behavioral outcomes for children with OM. Methods: Participants in the study included 45 children who were referred to ENT specialists due to recurrent and persistent OM. Children were triaged as semiurgent with a target time-to-assessment of 90 days or nonurgent with a target time-to-assessment of 365 days. The behavioral outcomes of children were assessed using the parent report Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics and adjusted multiple linear regression models were used to compare children who received access to the service within the time-to-assessment target of their triage category (“on-boundary”; n = 17) and outside the time-to-assessment target (“off-boundary”; n = 28). Spearman correlation analysis was used to explore the relationship between the internalizing, externalizing, and total SDQ scores as a function of waiting times in days. Results: Borderline or abnormal SDQ scores ranged from 24.4% to 42.2% across the study participants. The regression analysis showed a statistically significant association between the off-boundary group and higher scores (i.e., poorer) on the peer, emotional, conduct, internalizing, and total problems subscales. Further, lengthy waiting times were significantly correlated with higher internalizing problems. These findings indicate that longer waiting times may lead to poorer behavioral outcomes for children with OM. Clinical Trial Registration: (ACTRN1269000039189p). Conclusion: Children with recurrent and persistent OM referred to ENT outpatient care were found to have significantly more behavioral difficulties if their waiting times exceeded the recommended timeframes for their triaged referrals. Additionally, they experienced more internalizing problems that correlated with longer waiting times. This highlights the calls for alterations in current clinical practice given the lengthy waiting times in Australia's public hospitals.

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The association between otitis media in early childhood with later behaviour and attention problems: A longitudinal pregnancy cohort

Cited by 7 publications

References 29 publications

Recurrent otitis media and behaviour problems in middle childhood: A longitudinal cohort study

Recurrent otitis media and behaviour problems in middle childhood: A longitudinal cohort study

The Impact of Early‐Life Recurrent Otitis Media in Children on the Psychological Well‐Being of Caregivers

The Impact of Waiting Times on Behavioral Outcomes for Children with Otitis Media: Results from an Urban Ear, Nose, and Throat Telehealth Service

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