August 1997
---
Children with tympanotomy tubes have similar developmental
milestones as those without.
WASHINGTON, D.C. — A recent study found that children with a clinical diagnosis of otitis media with effusion (OME) and hearing loss make significant gains in language and behavior in the 12 months after tympanotomy tube insertion. However, after controlling for differences in baseline severity, tube insertion does not appear to result in a developmental path that differs from that of healthy control children.
"Our study showed that language and behavior improve in children, often quite dramatically, following tympanotomy tube insertion. The biggest improvement occurs immediately after the tube insertion, but these improvements cannot be attributed to the tubes themselves because the developmental trajectory seemed similar for cases and controls once we controlled for baseline severity of behavior and language problems," Melissa Wake, MD, said here at the recent meeting of the Pediatric Academic Societies.
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To determine whether tympanotomy tubes would lead to improvements in language and behavior, 74 children 3 to 5 years of age with persistent clinical bilateral OME and hearing loss were prospectively studied. These were children who consecutively underwent tympanotomy tube insertion at the Royal Children's Hospital in Melbourne, Australia. Children were excluded from the study if they had other conditions related to language and behavior.
In addition, 59 healthy community controls matched for age and sex were included in the study. The mean age of children in both groups was 4.5 years.
"I believed that tympanotomy tube insertion would lead to improvements in language and behavior in these children. I also felt that it was likely that children having the tubes inserted would have worse language skills and behavior than healthy children," Wake said.
Using the Child Behavior Checklist, the children's mothers and fathers independently rated the children's behavior. Teachers and day care providers also rated the children's behavior using the Teacher/Caregiver Report Form, which is a new version of the Child Behavior Checklist. The children's behavior was measured at 0, 2, 6, and 12 months after tube insertion.
Language was assessed at 0, 6, and 12 months. "Assessments included receptive (TACL-R); expressive (BLT-2, morphologic rules and semantic knowledge); and articulation (GFr)," Wake said.
Disease severity was assessed at the time of tube insertion using audiometry.
"At baseline, cases rated worse than controls in all aspects of language and behavior. By 12 months, cases had improved to resemble controls on all variables other than GFr and BLT-morph, for which slight differences persisted," she said.
"After controlling for baseline differences for each measure, neither case status nor severity of hearing loss contributed to change in any variable other than a very slight contribution of case status change in mothers' Child Behavior Checklist scores," she added.
"The profiles of both groups come much closer together by 6 months and remain parallel out to at least 12 months," Wake said.
For more information:
- Wake M, Oberklaid F. Predictors of language and behavioral outcome following tympanotomy tube insertion in preschool children. Presented at the Pediatric Academic Societies' meeting. May 2-6. Washington, DC.
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