Strategies for Children with Persistent Middle Ear Effusion

Strategies for Children with Persistent Middle Ear Effusion.If fluid is in the middle ear and the ear is not infected, it is called otitis media with effusion (OME).

OME may occur in two ways. One way is if the fluid in the middle ear is slow to clear out after an ear infection. OME may also occur without any infection if the Eustachian tube is not properly working. When it works properly, this tube brings air to the middle ear. Young children and children with cleft palate or Down syndrome may have more problems with OME.

The presence of fluid in the middle ear reduces the middle ear's ability to conduct sound. The eardrum and middle ear bones cannot vibrate as they should, making sound seem "muffled." This temporary hearing loss may contribute to speech and/or language delay or other developmental delays. Therefore, children with temporary hearing problems due to OME would benefit from attention to listening, language and learning conditions.

Below are strategies to help your child continue to listen and learn during this period of temporary hearing loss.

  • Get down to the child's eye level when talking.
  • Talk about familiar things in the child's environment (pets, toys) and interests.
  • Talk with the child during mealtimes, baths and throughout the day.
  • Play interactive games, such as pat-a-cake, with the child to encourage talking.
  • Ask simple questions and pause for the child to respond.
  • Respond to what the child is talking about immediately and with interest.
  • Add to what the child is saying by using more words.

Help Children Hear and Understand Your Speech

  • Get within three feet of the child before speaking.
  • Get the child's attention before speaking.
  • Face the child and speak clearly with a normal tone and normal loudness.
  • Use visual cues, such as moving your hands and showing pictures, in addition to using speech.
  • Seat the child near adults and children who are speaking.
  • Speak clearly and repeat important words, but use natural speaking tones and pattern.
  • Check often to make sure the child understands what is being said.
  • Stand still when talking to the child to decrease distractions.
  • Praise the child for talking even if the speech is unclear.
  • Take the child lots of places (library, supermarket, the park) and talk about what you see.
  • Say the names of the things the child sees or plays with and describe things that happen.
  • Talk with the child about what he did and will do, why things happen, and feelings.
  • Encourage the child to talk to other children.

Decrease Background Noise

  • Turn off unnecessary music and TV in the background.
  • Fix noisy appliances, such as heaters or air conditioners.
  • Limit play with noisy toys.
  • Encourage teachers to create quiet areas, such as dividers for small group play and reading.
  • Close windows and doors when it is noisy outside.

Roberts, J.E.; Rosenfeld, R.M.; and Zeisel, S.A.: Otitis media and speech and language: a meta-analysis of prospective studies. Pediatrics, 113(3 Pt 1): e238-48, 2004.


Last Updated 05/2013