Otitis media in early childhood in relation to preschool language and school readiness skills among black children

Objective. To examine whether otitis media with effusion (OME) and associat ed hearing loss (HL) during the first 5 years of life were related to child ren's language skills during the preschool years and to school readiness sk ills at entry to kindergarten. Methods. In a prospective study, the ears of 85 black children primarily fr om low-income families and recruited from community-based childcare program s 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 O ME. Assessments were made annually of the children's child-rearing environm ents 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 similar to 30.4% a nd HL 19.6% of the observation time. OME and associated HL were significant ly positively correlated with some measures of expressive language at 3 and 4 years of age; however, these direct relationships were no longer signifi cant when the child's gender, socioeconomic status, maternal educational le vel, and the responsiveness and support of the home and childcare environme nts were also considered. Further, both OME and HL were moderately correlat ed with school readiness skills at entry to school, with children having mo re 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 fa mily background factors. Conclusions. There was not a significant relationship between children's ea rly OME history or HL and language skills during the preschool years. Howev er, children with more frequent OME had lower scores on school readiness me asures. These associations were moderate in degree, however, and the home e nvironment was more strongly related to academic outcomes than was OME or H L. These results should be interpreted cautiously when generalizing to othe r populations.