The role of otitis media in the development of expressive language disorder.

Abstract

The role of otitis media (OM) was investigated in a group of preschool children with a rigorously defined language impairment: developmental expressive language disorder (ELD). No differences in the frequency, duration, or timingof medically documented episodes of OM were found between 65 ELD and 50 normal children. However, longitudinal analyses with the ELD children revealed a relation between OM and expressive language improvement. The strongest positive predictor of language improvement between 2 and 3 years of age was the amount of time spent with OM between 12 and 18 months of age. These findings suggest that children with ELD represent 2 etiological populations depending on a history of OM. When ELD is influenced strongly by OM during a critical period for the development of expressive language, improvement is highly likely. However, in the absence of such a history, the causes of ELD are likely to be more central and long-lasting. The absence of between-groups differences, coupled with the predictive power of OM history within the ELD group, suggests either that another factor interacts with OM to cause ELD or that OM depresses development for all children.Otitis media (OM), or inflammation of the middle ear, is a common disease of infancy and early childhood. Approximately 50% of all children experience at least one episode of OM during the 1st year of life, and by 3 years of age, approximately two thirds of all children experience at least one episode; one third of all children experience three or more episodes of OM prior to age 3 (Howie, 1980;Teele, Klein, & Rosner, 1980. During the acute phase of OM, children may experience pain, fever, and other overtly expressed symptoms. OM is typically associated with fluid in the ear (effusion) that persists after the acute phase of the infection has passed (Bluestone, 1984;Marchant et al, 1984;Teele et al., 1980Teele et al., ,1984. The occurrence of OM is often associated with conductive hearing loss of a transient nature and may lead to chronic auditory impairment (Bess, 1983;Fria, Cantekin, & Eicher, 1985; Wright etal., 1988).Several studies have found a relation between an early history of OM and later problems in language development. For instance, Teele et al. (1984) followed a cohort of 205 children from birth to 3 years of age. The presence of OM was periodically assessed by otoscopic examination. Tests of speech and

Practitioner Review: Early Developmental language Delay: What. If Anything. Should the Clinician Do About It?

“…However, the evidence does not support such a relation for specific language delay. In our sample of 91 normal children and 93 two-year-olds with specific expressive delay there were no differences that approached significance on birth weight, rates of prematurity, or obstetric complications (Wliitehurst et al 1992). Likewise, found that neither pre-nor perinatal problems distinguished two-year-olds with specific language delay from normally developing controls.…”

Markers for persistent specific expressive language delay in 3–4‐year‐olds

“…), socio‐economic status (SES) (Paul and Fountain ), gestural communication (Thal and Tobias ), and the presence of otitis media (Lonigan et al . ). Multiple factors may be involved.…”

Outcomes of Early Language Delay

“…In a follow-up of the same sample, the researchers considered whether otitis media might act as a nongenetic risk factor for early language delay. They found that children with early expressive language delay did not differ from controls in the frequency, duration, or timing of episodes of otitis media, but history of middle ear disease between 12 and 18 months of age predicted expressive language improvement in the language delayed group (Lonigan, Fischel, Whitehurst, Arnold, & Valdez-Menchaca, 1992). They concluded that the population of children with language delay may contain a mixture of two etiological groups.…”