Glue Ear and Speech Development

One of the questions speech therapists always ask during initial assessment is:

Does your child have a history of ear infections?

Why?

Because ear infections, depending on how bad they are, how long they last and how often they occur, can impact speech and language development in children.

What is glue ear?

Glue ear (otitis media with infusion) is a very common infection in children, most often associated with ear infections. Basically, it is when the middle ear (behind the eardrum) fills up with sticky fluid – thus, glue ear. It can affect one or both ears.

Essentially, for our ears to work effectively, our middle ears (the space behind the eardrum) should be filled with air. This is helped by the Eustachian Tube, connecting the middle ear to the back of our throats and helping drain fluid when there is a build up. When soundwaves from the outer ear hit the ear drum, the vibrations from the eardrum set off the tiny bones (ossicles) in the middle ear, which then send the signal on to the inner ear.

So when the middle ear is filled with sticky fluid, it is hard for both the eardrum and the ear bones to pass the signal from the outer ear through to the inner ear.

The result: hearing loss.

In most cases this is temporary; often the glue ear will resolve itself within a few weeks.
Your GP or ENT will usually monitor for a few months, before deciding whether intervention such as grommets is needed.

If the glue ear is persistent and occurs over and over again, it can lead to long-term hearing loss which will affect your child’s speech and language development.

How does glue ear affect speech and language?

The overall impact on speech and language development depends on the severity of the hearing loss from the glue ear. What they hear is likely to be muffled. They may not be able to hear higher frequency sounds like p, k, f, s, t.

A child’s speech develops by them imitating what they hear.

If they cannot hear specific sounds:

These sounds will not develop without support. For example, stop might become “doh”.
They might have difficulty discriminating between words – like cake vs take; this could delay their vocabulary development.

If they are not hearing all the words in your sentences:

They will not be using those words themselves in their own sentences, so their sentences may be choppy; grammar in particular may be impacted.
They may not respond appropriately to questions or instructions

Without intervention, such as through speech and language therapy, these delays will continue to impact your child’s overall communication skills and their learning once they start school.

What causes glue ear?

Glue ear can be caused by a variety of thing; in particular, by anything that blocks the Eustachian Tube. For example:

Allergies and sinus infections
Cold and flu
Passive smoking

Glue ear tends to often occur in children with disorders like cleft palate, or genetic conditions like Down’s syndrome, who tend to have smaller Eustachian Tubes.

What are the symptoms of glue ear?

Symptoms can be subtle, and varies from child to child depending on the degree of glue ear and impact on hearing. Some symptoms include:

Changes in behaviour – such as more temperamental or irritable behaviour
Mishearing instructions
Not responding to instructions or their name
Lack of attention or concentration span
Getting tired more quickly
Delays in speech and language development

For further information about glue ear, see:

https://www.kidshealth.org.nz/glue-ear

https://www.healthline.com/health/glue-ear

If you have concerns about your child’s hearing, talk to your GP. They can refer your child to an ENT (Ear Nose and Throat specialist), or to an Audiologist to get their hearing checked.

If you have concerns about your child’s speech and language development, contact Cornerstone Therapy or a Speech and Language Therapist in your area.