Despite Glue Ear (Otitis Media) affecting approximately 80% of children under the age of 7 years, there is very limited research about the condition in how it effects children and young people in schools. It is a continuum condition so some children have one or two episodes but for others it results in permanent hearing loss and continues into adulthood. Knowledge about the condition in teachers seems to be confined to its potential impact on phonic acquisition. Its implication on behaviour, social skills and the need for teachers to differentiate is largely overlooked.
Let me try to answer your question.
Otitis media with effusion (OME or SOM) is common in children especially in 1-3 years old attending day-care. They often have a flue/cold with running nose in most of the year, ecept in the summer. When the have their running nose, many of them also have OME and a conductive hearing loss of about 9-10 dB (ref1).
Most of the children have no other symptoms of their OME, but some wil develop an AOM with pain and fever. The professionels in the day cares often did not experience any change in the child. And often the periode with OME is short, a few weeks or months (ref 2).
Whitch children need treatment? I have tried answering that question in a paper a few years ago (ref 3).
I have also been involved in developing a listen in noise test for screening fx day care children for significant difficulties hearing word in noisy surroudings (www.galkertesten.dk) ref 4 - and new paper are hopfully in progress.
ref. 1 Cochrane reveiw: Grommets for hearing loss associated with OME in children Lous J et al. 2005 - and a new edition in 2010 with GG Browning as first author.
ref 2 Filleau-Nikolajsen M, Lous J. Prospective tympanometry in 3-year-old children: a study of the sponaneus course of tympanometry type in a nonselected population. Arch Otolaryngol 1979;105:461-6.
ref3. Lous J. Which children would benefit most from ventilation tubes (grommets)? A personal evidencebased review. Int J Ped Otorhinolaryngolo 2008; 72 731-6.
ref.4 Williamson I, Sheridan C, Galker E, Lous J. A video-based performance in noise test ... Int J Ped Otorhinilaryngol 1999; 49: 127-33.
The main reason for the limited intervention/ interest (as you have put it) in children with glue ear is that it is a self limiting condition & as the child grows the middle ear effusion will often spontaneously resolve. In those children with speech and language difficulties impacting school performance (including behavioural difficulties), early referral to an ENT surgeon/ paediatric audiologist for assessment for intervention is useful.
Thank you both for your answers. I am completing a PhD in the experience of young people who have had the condition from under 5 years and continue to do so. I am interested the way in which it impacts their lives and that of their mothers'. I think your paper on hearing in noise, Dr Jorgen sounds very interesting. From my own work I would suggests that there is more to the behavioural impact than teachers often recognise. There is evidence that suggests that although it can impact social skills, many teacher attribute this to other causes, because they have limited understanding of medical conditions.
Comment to Jeena and Carmel
The children I have studied were in principel normal children either 3 years old or 7 years old - and in these childre conduktiv hearing loss have been of short duration. It is quit another thing when you are talking about many moths or years duration. In that case treatment with grommet is indicated.
In Denmark we have the opposit problem, many children are treated with grommet after only a duration of few weeks even our old guideline recommend 3 months of wachfull waiting befor insertion og grommets. Yours Jørgen Lous
Would you always recommend grommets? I have been talking and reading and some people seem to consider that hearing aids may be helpful, particularly if the child's problem is more to do with hearing loss from Glue Ear rather than ear infections. I agree that to treat under 3 months would be better as an exceptional circumstance. My research suggests that there is not enough thought given to the continuum aspect of the condition.
Yes some are talking about hearing aid, but I have not seen a study on that with succes.
My personal view is: if no symptoms and the summer is comming up to 6 month wait and see is OK. If the child have social or language problems and bilateral fluid in the middle ear - then grommets are indicated her and now.
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