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Updated: Jul 17, 2026

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
Association of early bilateral middle ear effusion with language at age 5 years
D P McCormick1, C D Baldwin, J S Klecan-Aker
1University of Texas Medical Branch, Galveston, TX 77555-1119, USA. david.mccormick@utmb.edu
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 (Carrow Elicited Language Inventory) and articulation (Goldman-Fristoe Articulation). Children's ability to discriminate speech sounds in a quiet environment (Carrow 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.
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