Download Otitis Media and Temporary Conductive Hearing Loss

OTITIS MEDIA AND TEMPORARY
CONDUCTIVE HEARING LOSS
How will this impact my child’s
speech and language development?
It aims to help you
understand what otitis
media and a conductive
hearing loss is, and the
effects it can have on
a child’s speech and
language development.
This booklet also provides
tips and strategies to
help develop your child’s
speech and language.
This booklet is a guide
for parents of young
children who have
been diagnosed with a
temporary conductive
hearing loss likely caused
by otitis media.
TYPES OF OTITIS MEDIA
Inflammation of the middle ear is called “otitis media”.
Temporary conductive hearing loss occurs when sound is obstructed through the external ear, middle ear or both.
There are different types of middle ear infections that may lead to temporary conductive hearing loss such as:
Otitis media with effusion is inflammation
of the middle ear that involves the
presence of fluid in the normally air-filled
middle ear space. This fluid may occur
with or without an active infection.
Diagram courtesy
of Healthy Hearing
Acute otitis media is a middle ear
infection of recent onset, accompanied
by signs of infection, e.g. fever and pain.
Chronic otitis media is otitis media of
more than 3 months duration with or
without perforation of the ear drum.
FACTS ABOUT OTITIS MEDIA
2
1
OME can be caused by bacterial or viral
infections of the upper respiratory tract. Certain
individual factors make a child more susceptible
to OME, e.g. congenital abnormalities such as
cleft palate, genetic conditions such as Down
Syndrome, dairy intolerance, allergies, problems
with adenoids or tonsils, swimming in public
swimming pools, attendance at child care,
and exposure to passive smoking.
Otitis media can occur when the Eustachian tube that connects the middle ear to
the back of the throat is not working properly. The Eustachian tube opens to allow
the air pressure between the middle ear and the environment to stay the same. If
the Eustachian tube fails, normal pressure is not maintained in the middle ear and
fluid can be secreted into the middle ear space. Over time this fluid can become
infected with bacteria and/or viruses. This can cause pain, fever and hearing loss.
3
4
About 85% of children
will experience at least
one episode of otitis
media by the time they
start school.
5
Otitis media is
the most common
cause of temporary
hearing problems
in babies and
young children.
The younger a child is when
the first episode of otitis
media occurs, the greater the
likelihood of recurrent and
severe episodes.
6
A conductive hearing loss typically
accompanies otitis media because the middle
ear problem prevents sound from being
adequately “conducted” through the middle
ear space to the inner ear. During an episode
of otitis media, a child’s degree of hearing loss
may fluctuate.
The first 5 years of life is a critical time for
speech and language development. If hearing
loss related to otitis media occurs or reoccurs
during this critical period it may impact on your
child’s speech and language development.
IMPACT ON SPEECH
AND LANGUAGE
DEVELOPMENT
Children with temporary hearing loss may
present with the following:
Difficulty hearing
everything that is said
accurately, especially
in noisy environments.
Difficulty hearing softer
speech sounds such
as, ‘p’, ‘t’, ‘v’, ‘sh’ and
‘j’, accurately.
Difficulty hearing well
over a distance.
Difficulty learning
in a noisy school
classroom.
Difficulty paying
attention for periods
of time.
Difficulty overhearing
conversations.
Children may have difficulty picking up language
spontaneously and incidentally. This may lead to:
•Fewer words in their vocabulary
•Difficulty producing well-formed phrases
or sentences
•Difficulty breaking words down into their individual sounds. This skill is important for spelling and reading skills.
HOW TO
PROVIDE A GOOD
LANGUAGE MODEL
Direct your child’s
attention to sound
Keep background
noise low
Use specific
vocabulary in
short sentences
Speak when close
to your child
Use clear
speech
Use an unhurried
speech rate
Set time aside to
talk and play with
your child
16 TOP OF THE CHART
TIPS FOR ENCOURAGING
YOUR CHILD’S LANGUAGE
AND LISTENING
1. THE MORE WE GET TOGETHER
Keep your child close to your side and get down to your
child’s level so that you can make eye contact. By being
within 1 metre of your child when talking will give your child
the best opportunity to hear and understand what you are
saying. If your child’s ear infection is only in one ear, try to
direct your speech towards their “good” ear.
2. HUSH-A-BYE BABY
Be aware of background noise and distractions, as your
child will have a reduced ability to `tune in’ to your voice
when there are other sounds competing for his/her attention.
Try to turn off the TV or radio and shut windows when you
play or talk with your child.
3. I HEAR THUNDER
Draw your child’s attention to sounds in the environment by
pointing to your ear when a sound is near. Take your child
to the source of the sound and tell your child what made the
sound, e.g. “We heard the dog barking”.
4. HEY JUDE
Get your child’s attention before speaking to him/her. You
can do this by saying your child’s name, moving closer or
gaining eye contact.
5. SHE’LL BE COMING ‘ROUND
THE MOUNTAIN
Talk about what you and your child are doing, looking at or
experiencing. Simplify your language to keep the sentences
short, but specific and complete, e.g. “Put the block on the
truck” instead of “Put it on”. Talk about things happening in
the here and now.
6. THE WHEELS ON THE BUS
Children need to hear the same word many times before
they will remember it or use it themselves, so repeat, repeat,
repeat!!!
7. YOU ARE MY SUNSHINE
12. ROUND AND ROUND THE GARDEN
Consistently respond to your child’s communication
attempts and always reward attempts for talking, even if
they are incorrect.
Expand your child’s language by modelling new words or
adding another word to your child’s utterance, e.g. “car” can
become “yes, it’s a big truck”.
8. DO-RE-MI
13. WE ALL STAND TOGETHER
Grab your child’s listening attention by using an interesting,
sing-song voice with lots of intonation.
Set time aside every day to talk and play with your child.
9. PAT-A-CAKE
Create the need to talk by pausing for longer than usual.
While you are often able to anticipate or identify your child’s
needs, wait until he/she attempts to communicate before
responding.
10. FOLLOW THE LEADER
Follow your child’s lead and talk about things that interest
him/her. Provide your child with support in understanding
through visual cues such as using gesture.
11. SIMON SAYS
Copy any sounds that your child makes and then model
new sounds for your child to listen to and copy. Take turns
copying each other’s speech.
14. HEAD AND SHOULDERS, KNEES
AND TOES
Use normal, unexaggerated mouth movements when you
talk to your child. Also speak at a normal volume, but
slightly slower.
15. THE SOUND OF MUSIC
Use singing and action songs to focus your child’s attention
and help with his/her understanding and memory. Use it to
have FUN together!
16. ONCE UPON A TIME
Share a book with your child every day. Books are a fun way
of encouraging your child to listen to your voice and learn
about new words and ideas.
BIRTH – 3 MONTHS
4 – 6 MONTHS
7 MONTHS – 1 YEAR
1 – 2 YEARS
HEARING AND UNDERSTANDING
Responds to loud noises
Looks to the direction of sound
Likes games such as peek-a-boo
Smiles in response to a voice
Responds to changes in
the pitch of your voice
Turns to look in the direction
of sounds
Reacts to toys that make sounds
When you speak they listen
Pays attention to music
Recognises some common words
(e.g. cup)
Quiets to the sound of your voice
Sucking behaviour changes in
response to sound
Beginning to respond to requests
Can point to pictures in a
book when named
Can point to a few body
parts when asked
Follows simple commands
and understands simple questions
Listens to simple songs & stories
TALKING
Makes happy sounds
Different crying sounds
for different needs
Smiles in response to seeing
your face
Babbling starting to sound
more like speech (p, b ,m present)
Vocal when excited or unhappy
Makes gurgling sounds in
play and when left alone
Babbling is made up of
both short and long sounds
e.g.”tata, bibibibibibi”
Uses speech to gain & maintain
attention
Imitates speech sounds
Has 1 or 2 words but they may not
be clear to an unfamiliar adult
More words are said every month
Uses some 1-2 word
questions e.g. “where kitty?”
Puts 2 words together
e.g. “more cookie”
Uses many different consonant
sounds at the start of words
2 – 3 YEARS
3 – 4 YEARS
4 – 5 YEARS
HEARING AND UNDERSTANDING
Understands opposite meanings
(“big-little,” “up-down,” “go-stop”)
Able to hear you when you call them from a
different room
Listens to a short story and is able to answer
simple questions about it
Can follow two-step directions
(e.g. “Get the book and put it on the table”)
Able to hear the television or radio at the same
loudness level as other family member
Is able to hear and understand most of what is
said in school and at home
Understands simple “who?,” “what?,” “where?”
questions
TALKING
Has a word for almost everything
Uses 2-3 word “sentences” to talk about and ask
for things
Understood by familiar listeners most of the time
Will ask for or direct attention to objects by
naming them
Talks about things they do at school or
at friends’ homes
Usually talks without repeating syllables
or words
Usually understood by people outside the family
Uses a lot of sentences that have
4 or more words
Sounds clear like other children
Uses sentences which give a lot of
detail (e.g. “I like to read my books”)
Uses adult-like grammar
Tells stories which stay on topic
Communicates easily with others
Says most sounds correctly except
a few, like, l, s, r, v, z, j, ch, sh, th
IF YOU HAVE ANY CONCERNS REGARDING
YOUR CHILD'S SPEECH AND LANGUAGE
DEVELOPMENT PLEASE DISCUSS IT WITH A
HEALTH CARE PROFESSIONAL SO THAT A
REFERRAL TO A SPEECH PATHOLOGIST
CAN BE INITIATED.
SARAH BRITTON, SARAH BORDEN,
SHAHIRA JAMANI, MEAGAN JORDAN,
HUMMA KHAN, KIRSTY KNIGHT, SEMELE WONG.
© 2012 MATER MISERICORDIAE HEALTH SERVICES BRISBANE LIMITED ACN 096 708 922