Why do infants pull their ears?

Çakabay, Taliye; Bezgin, Selin Üstün; Tarakçıoğlu, Mahmut Cem; Koçyiğit, Murat; Keskineğe, Bilge Serin; Örtekin, Safiye Giran; Özdemir, Mustafa

doi:10.1016/j.anl.2019.02.009

Cited by 2 publications

(5 citation statements)

References 8 publications

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“…The finding that most reviewed guidelines recommend enquiring about parent/caregiver observation led to a non-systematic citation and key-word library and Google Scholar search for studies relating to efficacy of this activity [ 60 – 65 ]. A review of these studies using the GRADE approach found low certainty of evidence.…”

Section: Resultsmentioning

confidence: 99%

Development of the national consensus statement on ear health and hearing check recommendations for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: systematic scoping review and e-Delphi

Harkus,

Marnane,

O’Keeffe

et al. 2024

BMC Prim. Care

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Background Early detection of long-term, often asymptomatic, middle ear infection in young Aboriginal and Torres Strait Islander children is more likely to be achieved when ear health and hearing checks are routinely undertaken in primary healthcare. Evidence consistently demonstrates the adverse impacts of this condition on the development and wellbeing of children and their families. We aimed to develop feasible, evidence- and consensus-based primary healthcare recommendations addressing the components and timing of ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years, not already known to have, nor being actively managed for, ear and hearing problems. Methods A 22-person working group comprising Aboriginal and Torres Strait Islander and non-Indigenous members from the primary healthcare, ear, hearing, and research sectors provided guidance of the project. A systematic scoping review addressed research questions relating to primary health ear health and hearing checks for Aboriginal and Torres Strait Islander and other populations at increased risk of persistent ear health problems. Twelve primary studies and eleven guidelines published between 1998 and 2020 were identified and reviewed. Quality and certainty of evidence and risk of bias ratings were completed for studies and guidelines. In the absence of certain and direct evidence, findings and draft recommendations were presented for consensus input to a 79-member expert panel using a modified e-Delphi process. Recommendations were finalised in consultation with working group members and presented to expert panel members for input on considerations relating to implementation. Results Overall, the quality, certainty, and directness of evidence in the studies and guidelines reviewed was low. However, the findings provided a basis and structure for the draft recommendations presented during the consensus-building process. After two e-Delphi rounds, seven goals and eight recommendations on the components and timing of Ear Health and Hearing Checks in primary healthcare for young Aboriginal and Torres Strait Islander children were developed. Conclusions The systematic scoping review and consensus-building process provided a pragmatic approach for producing strong recommendations within a reasonably short timeframe, despite the low quality and certainty of evidence, and paucity of studies pertaining to primary healthcare settings.

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Section: Resultsmentioning

confidence: 99%

Development of the national consensus statement on ear health and hearing check recommendations for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: systematic scoping review and e-Delphi

Harkus,

Marnane,

O’Keeffe

et al. 2024

BMC Prim. Care

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“…Accuracy of caregiver-reporting of signs and symptoms as a predictor of OM varies widely. [22][23][24][25] Parent/ carer concern correctly identifies children with OM 17-83% of the time, and correctly identifies children without OM 36-93% of the time. 23 Consensus statement is also low (sensitivity, 6.0-19.7%), with positive predictive values of 22.0-82.1%.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…Summary of evidence. Accuracy of caregiver‐reporting of signs and symptoms as a predictor of OM varies widely 22‐25 . Parent/carer concern correctly identifies children with OM 17–83% of the time, and correctly identifies children without OM 36–93% of the time 23 .…”

Section: Recommendationsmentioning

confidence: 99%

“…[28][29][30][31][32][33] Rationale for recommendation. Although parent/carer concern does not reliably predict ear health [22][23][24]34 and hearing status, 26,27 it should routinely be enquired about during checks because, when concern is expressed, a proportion of parents/carers will be correct. 30,35 Following up on parent/carer concerns acknowledges the importance of their observations and advocacy for their child's health and wellbeing, and increases the likelihood that parents/carers feel respected and listened to.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…No recommendations were developed relating to signs and symptoms: OM presents with a wide range, both ear‐specific and general, 1,24,28,34,36 and one common subtype is largely asymptomatic 37 …”

Section: Recommendationsmentioning

confidence: 99%

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Routine ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: a national consensus statement

Harkus,

Marnane,

O'Keeffe

et al. 2023

Medical Journal of Australia

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SummaryThis consensus statement provides new recommendations for primary care assessment of ear health and hearing status of young Aboriginal and Torres Strait Islander children who are not known to have, or are not being actively managed for, ear health and hearing problems. Any child identified with otitis media should be actively managed. This national consensus statement extends existing treatment and management guidelines.Main recommendations Undertake checks at least 6‐monthly, commencing at 6 months until 4 years of age, then at 5 years. Undertake checks more frequently in high risk settings for children under 2 years, when acceptable to families, or in response to parent/carer concerns. Ask parents/carers about concerns, signs, and symptoms; check children's listening and communication skills; and assess middle ear appearance and mobility. Otoacoustic emissions testing is suggested when equipment is available, primary health practitioners have capability and confidence to use the equipment, and there is local preference for its use. Video otoscopy is suggested for health promotion purposes, and/or for sharing images with other health practitioners. Audiometry should be done as per existing guidelines: when there are parent/carer concerns, signs of persistent/recurrent otitis media, or when listening and communication development is not yet on track. Changes in management as a result of this statement Key practice changes include routine use of tympanometry, and listening and communication skills checklists. Implementation will require access to equipment and training; clear information on immediate, practical actions for families; timely pathways to referral services; and a change management process that shifts perception and tolerance of otitis media and its impacts and raises expectations that Aboriginal and Torres Strait Islander children can have healthy ears and hearing.

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Why do infants pull their ears?

Cited by 2 publications

References 8 publications

Development of the national consensus statement on ear health and hearing check recommendations for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: systematic scoping review and e-Delphi

Development of the national consensus statement on ear health and hearing check recommendations for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: systematic scoping review and e-Delphi

Routine ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: a national consensus statement

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