PEDIATRICS Vol. 106 No. 4 October 2000, pp. 725-735
Otitis Media in Early Childhood in Relation to Preschool Language and School Readiness Skills Among Black Children
Received Jul 23, 1999; accepted Jan 7, 2000.
, §,
,
From * Frank Porter Graham Child Development Center;
Department of Pediatrics; § Division of Speech and Hearing Sciences,
Department of Allied Health Sciences; Departments of Psychology and
¶ Psychiatry; and the # School of Nursing, University of North Carolina
at Chapel Hill, Chapel Hill, North Carolina.
Objective. To examine whether otitis media with effusion (OME) and associated hearing loss (HL) during the first 5 years of life were related to children's language skills during the preschool years and to school readiness skills at entry to kindergarten.
Methods. In a prospective study, the ears of 85 black children primarily from low-income families and recruited from community-based childcare programs were repeatedly examined from 6 months to 5 years of age for the presence of OME and from 6 months to 4 years of age for HL when well and ill with OME. Assessments were made annually of the children's child-rearing environments at home and in childcare, and children's language skills between 3 and 5 years of age and readiness skills in literacy and math were evaluated at entry into kindergarten.
Results. Children had either bilateral or unilateral OME ~30.4% and HL 19.6% of the observation time. OME and associated HL were significantly positively correlated with some measures of expressive language at 3 and 4 years of age; however, these direct relationships were no longer significant when the child's gender, socioeconomic status, maternal educational level, and the responsiveness and support of the home and childcare environments were also considered. Further, both OME and HL were moderately correlated with school readiness skills at entry to school, with children having more OME scoring lower in verbal math problems and with children with more HL scoring lower in math and recognizing incomplete words. These associations continued to remain significant even after partialing out the child and family background factors.
Conclusions. There was not a significant relationship between children's early OME history or HL and language skills during the preschool years. However, children with more frequent OME had lower scores on school readiness measures. These associations were moderate in degree, however, and the home environment was more strongly related to academic outcomes than was OME or HL. These results should be interpreted cautiously when generalizing to other populations. Key words: otitis media, language, hearing loss, school readiness skills, children.
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