Glue Ear: Impacts on speech and language

Ear infections are very common in children and can cause serious and lasting problems for speech and language development. One of the main problems associated with ear problems for speech and language development is that it results in what we call fluctuating hearing loss. Fluctuating hearing loss means hearing is inconsistent and goes up and down.  As a result, kids get inconsistent hearing messages which makes it very difficult for their brain to make good strong connections about sounds and words.  This gets very confusing for your child’s developing brain and the result is difficulty with sounds (and therefore speech pronunciation) and words/sentences (and therefore expressive language or talking).  Many people aren’t aware how much ear infections and glue ear impacts on speech and language development.  Here are some helpful facts and answers to common questions about ear infections and glue ear.

A Few Glue Ear Quick Facts

  1. Glue ear is the common term for the medical condition otitis media with effusion.
  2. It is one of the most common childhood illnesses.
  3. Children under the age of five are most often affected.
  4. It is often linked with ear infections.
  5. Colds and flu, allergies and passive smoking can also contribute to glue ear.
  6. Glue ear will often clear up on its own after congestion has gone.
  7. But if it continues, it can cause temporary deafness, delayed speech development and affect behaviour.

Source:National Deaf Children’s Society   

Frequently asked questions about glue ear and ear infections   “How do I know if my child has glue ear?” An audiologist can test using impedance testing.  This is a simple test where they seal the ear canal with a machine and test how much air pressure can change in the ear canal which in turn shows how well the ear drum is moving.  If it’s not moving then it means the middle ear is most likely having some trouble.  Signs that your child might be having trouble with hearing (or at risk of glue ear) include: 

  1. repeated ear infections,
  2. wanting the TV up loud,
  3. lots of nasal/respiratory congestion
  4. seem to be off in own world,
  5. seem to miss spoken information or mishear words,
  6. pulling at ears. 

Many children don’t show a lot of pain with glue ear as it becomes normal for them so ear pain is not the best indicator a child is having difficulty.  “Won’t the grommet surgery fix his talking?”  Addressing your child’s hearing difficulties can have a positive impact on speech and language development but they have potentially missed essential learning and their brains have had confusing and changing messages due to the fluctuations (changes) in their hearing loss.  Most children with glue ear that has affected speech and language development will still require speech therapy and treatment by a qualified speech pathologist even after their hearing difficulties have resolved.  We know that this works best when it is provided as early as possible (early intervention).  “Should I wait until after grommet surgery to start speech therapy?”    If you have a child with glue ear then we recommend that you DON’T wait to start speech therapy.  Yes many children do improve after grommets are inserted but even with this improvement we also know that most of these children don’t develop “normal” speech and language skills without some assistance.  Therapy can help your child develop foundational skills that will help them to make best use of their better hearing once they have it.  

“What skills do children who have had glue ear often have trouble with?” Children with glue ear often have trouble with:

  • Speech sounds especially sounds that are quieter (harder to hear) such as /p/, /s/ and /f/.
  • Using small words in sentences such as “the” and “is”
  • Auditory processing and listening skills
  • Phonological awareness which is an essential foundational skills for reading and spelling

 “How can I help my child?” 

If your child is having trouble with their hearing right now see your GP/family doctor and get a referral for a hearing test and then if your child is showing signs of glue ear they will recommend a referral to an Otolaryngologist (aka ENT which stands for ear, nose and throat) who specialise in treating hearing difficulties like glue ear when medical treatments are required.  The ENT can then perform grommet surgery if it is needed.  If your child has had difficulties with their hearing our qualified Speech-Language Pathologists at Therapy Alliance Group (TAG) can help them learn the speech and language skills they need.  Speech therapy can help your child develop the listening and talking skills they need. 

                                          – by Rachel Tosh

About the Author

Rachel Tosh TAG clinic

Rachel Tosh
Speech Pathologist

Rachel is a Certified Practicing Speech Pathologist (CPSP) with a wide variety of clinical experience in inpatient and outpatient paediatric care in both Australia and the UK which enables her to translate theory into real life application across diverse clinical contexts. Her latest adventure, Speech Parent is changing the face of paediatric speech pathology internationally by empowering and educating parents of children with communication and feeding difficulties. She describes herself as a recovering work-a-holic (we all know she isn’t actually recovering – seriously who else sends emails at 4:30am!?). Rachel is passionate about: business leadership; literacy and feeding difficulties; educating and empowering others; and optimising therapy outcomes. Although these interests may seem diverse, the recurring theme through them all is a love for facilitating growth and development in others so they can achieve their own unique potential. Things I like: “Lamb roast, reading, helping others and creating systems that work…I may or may not enjoy these together!” Things I don’t like: “People not respecting each other and children missing out because of bad care or broken systems.” Favourite colour: “Can I have the whole rainbow?” How the TAG team describe Rachel: “Passionate”; “Hard working”; “Creative”.

“Be there for others but never leave yourself behind”    -Dodinski

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