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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Past history of otitis media and balance in four-year-old children
M L Casselbrant1, J M Furman, E M Mandel
1Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, PA 15213, USA.
Insights
A history of recurrent middle ear effusion (MEE) in young children can negatively impact their vestibular and balance function, even without an active infection. Early intervention for MEE may be crucial for long-term development.
Area of Science:
- Pediatric Vestibular Function
- Childhood Auditory Health
Background:
- Recurrent or persistent middle ear effusion (MEE) is common in early childhood.
- The long-term effects of MEE on neurodevelopmental outcomes, particularly vestibular and balance function, require further investigation.
Purpose of the Study:
- To establish normative data for vestibular and balance tests in 4-year-old children.
- To assess the impact of a history of MEE on these functions in the absence of concurrent MEE.
Main Methods:
- A cohort of 71 four-year-old children with documented MEE history was evaluated.
- Tests included otoscopy, tympanometry, audiometry, and vestibular/balance assessments (rotational and posturography).
- Children were grouped based on a history of recurrent/persistent MEE (≥10% cumulative time with MEE).
Main Results:
- Children with a history of MEE showed significantly lower average gain to a rotational stimulus compared to those without MEE history (0.44 vs. 0.57, P = .007).
- No other significant differences in vestibular or balance measures were found between the groups.
Conclusions:
- A history of recurrent or persistent MEE can affect vestibular and/or balance function in 4-year-olds, even when not actively infected.
- The potential long-term consequences of MEE on these functions warrant consideration in early intervention strategies.
Objectives/Hypothesis:
To obtain normative data for a population of children 4 years of age with respect to standard vestibular and balance test protocols and to determine, in the absence of concurrent middle ear effusion (MEE), the possible changes caused by a history of recurrent or persistent MEE.
Study Design:
Comparative studies of the results of vestibular and balance tests in a cohort of young children with and without a history of MEE.
Methods:
Seventy-one children, 4 years of age, with a well-documented history since early infancy regarding the presence or absence of MEE were evaluated using pneumatic otoscopy, tympanometry, audiometry, and vestibular and balance (rotational and moving platform posturography) tests. For the results of the vestibular and balance tests, comparisons were made between the group of 31 children (43.7%) without and the group of 40 children (56.3%) with a history of recurrent or persistent MEE, when a positive disease history was defined as at least a 10% cumulative percentage of time with MEE between early infancy and time of testing.
Results:
When compared with children with a negative history of significant MEE, children with a positive history had a lower average gain to a rotational stimulus of 0.1 Hz, 150 degrees/s (0.57 vs. 0.44; P = .007). There were no significant differences between groups with respect to other measures.
Conclusions:
These results suggest that a history of recurrent or persistent MEE affects the vestibular and/or balance function of 4-year-old children when tested in the absence of a concurrent episode of MEE. The possible sequelae of the disease should be weighed in future considerations of early intervention for MEE.
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Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and key...