Ear Infections  

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February 9, 2004

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Ear Infections (Otitis Media)

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  Links     Ear infections are medically referred to as otitis media.  It is the most common childhood disease, peaking in incidence in the first two years of life.  Otitis media is the general term for a continuum of diseases of the middle ear including:
  • Inflammation of the middle ear,
  • Infection of the middle ear,
  • Fluid behind the middle ear, and
  • Chronic fluid and/or infection

The incidence of otitis media in children in the U.S. is estimated to be about 35 to 40% in the first year of life.  In the first three years of life, 75% of children will have experienced at least one episode of otitis media.

Children who experience their first episode of otitis media at an early age are at 2 to 8 times greater risk for developing chronic or recurrent otitis media.  It is estimated that between 5 and 20% of children have recurrent otitis media.  Many children experience 'silent' otitis media with no obvious symptoms.  They are sometimes diagnosed on well-baby visits.  It is a common misperception that ear infection always causes pain.  Pediatricians use guidelines to determine treatment.

Cognitive and academic consequences of otitis media have been identified.  Some studies have shown that children with otitis media in early childhood are at risk for experiencing language delays, for repeating kindergarten, and for having phonological deficits that may interfere with learning to read.  However, it is important to note that many variables contribute to the aforementioned deficits and there was no study that concluded that otitis was the sole cause.  There has been growing concern about the possibility that a child who has recurrent otitis media may also experience language delays.  Many of the grammatical markers fall at the end of words such as -s, -ed, -er, and they are uttered with lower volume and less vocal stress.  It is these sounds that will not be accurately perceived if a child has otitis media and which could affect their acquisition in the child's speech.  Speech and language screenings should be done if a child is identified as having language delay, particularly if there is a history of recurrent otitis media.

If your child appears to hear better on some days, is a mouth breather, snores when sleeping, has asthma and/or allergies, and has frequent upper respiratory problems (head colds, runny nose, red eyes) then you should consider having your child's hearing tested by an audiologist.  Audiological evaluations can be done on infants as well as older children.  Pediatric audiologists may use several techniques to test the hearing of very young children and there are some tests that provide information about the ear that do not require the child to respond.

For more information about otitis media, see this online NIH tutorial. Please note, the tutorial contains sound files and some visual media which may take a long while to download on a dialup connection.  It may also require the downloading of a browser plug-in, Macromedia Flash.

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