Association of early bilateral middle ear effusion with language at age 5 years

Objective.- This study tested the hypothesis that children with early persistent middle ear effusion (MEE) are at risk for later language deficit. Method.- We recruited 698 newborns and monitored them for MEE every 2 to 4 weeks at home until age 3 years. Language skills were assessed on 294 subjects at age 5, while controlling for 8 demographic and environmental factors. Language outcomes at age 5 years were studied as a function of duration of bilateral MEE from birth to age 3 years. Results.- A significant relation was found between duration of bilateral MEE and speech sound sensitivity (Carroty Elicited Language Inventory) and articulation (Goldman-Fristoe Articulation). Children's ability to discriminate speech sounds in a quiet environment (Carroty Auditory Visual Abilities Test) was less affected by early prolonged MEE in homes that provided more cognitive stimulation. Conclusions.- These exploratory results indicate that prolonged early MEE may predispose children to language deficits at age 5 years. The language deficits are of small magnitude and may or may not be clinically significant. Language stimulation at home may protect against some of the effects of prolonged MEE.