An Audiologist's Viewpoint of Middle Ear Issues

We're continuing our conversation about middle ear fluid with an audiologist’s point of view! Read on to learn about the ins and outs of middle ear fluid and how your child's audiologist can help you tackle middle ear issues.

Meet Lynn A. Wood, M.A. CCC-A, LSLS Cert. AVT. Lynn is a Rehabilitative Audiologist with a private practice at the Auditory Verbal Center of Wheaton in Illinois. Auditory Verbal Therapy is the heart of her practice but she also specializes in post cochlear implant rehabilitation for teens and adults and therapy for individuals with auditory processing needs. Lynn began her LSL experience in college and then in 1994 was certified in the inaugural group of AVTs by Auditory Verbal International, Inc.

If your child with hearing loss has middle ear fluid, this is a call to action for prompt and aggressive management. The presence of fluid or infection in the middle ear space behind the eardrum may prevent your child’s access to sound.

Of course, hearing loss of any type and degree blocks the doorway to get auditory information the child’s brain, but even fluid alone can fluctuate and cause 5dB to as much as 40dB decrease in hearing (Estabrooks, et. al., 2016). Couple this to a pre-existing loss and a moderate hearing loss can become severe or profound. Persistent middle ear fluid has negative consequences on auditory, spoken language and cognitive development.

Understanding Middle Ear Fluid
Last week, Marge Edwards shared her story about her son’s experience with middle ear fluid. The big takeaway is that middle ear fluid is common with estimates that 75% of children experience at least one episode by their third birthday. And, almost half of these children will have three or more ear infections during their first three years. In fact, children who are not breastfed, those attending large child care centers and living in homes with smoke present (cigarettes, wood stoves) are more likely to experience repeated ear fluid or infections.

Many children with Otitis Media with Effusion (OME) also known as middle ear fluid, experience chronic recurrence and with accompanying colds or allergies, can have middle ear fluid  for many months of the year. Any decrease in hearing caused by fluid means poorer auditory access and has detrimental effects on a child’s spoken language development. This can significantly affect listening and spoken language outcomes for children with hearing loss!

How can you and your LSL professional team work together? You will need to work closely to monitor your child’s hearing status. A positive LSL outcome requires that you stay the course in monitoring your child’s hearing status through daily listening checks and performing the Ling Six-Sound Test. Share any change in your child’s responses with the members of your LSL professional team. 

The journey to listen and talk requires a team committed to monitoring, treating and addressing the causes and symptoms of middle ear fluid. Don’t wait!

OME and the Role of the Pediatric Audiologist

Your pediatric audiologist tests and monitors your child’s hearing, the status of the middle ear fluid and manages hearing technologies. They can examine your child’s ears and perform tympanometry to measure middle ear function. For tympanometry, a soft probe is placed in the child’s ear which causes changes in the air pressure and measures eardrum movement. The results of this test can determine the need for a medical referral.  

Many audiologists regularly test the hearing of a child with chronic fluid to determine their access to sound. This is integral to understanding what speech information is being heard and what is being missed. Repeated audiograms over time are used to monitor the effects of OME on hearing. Based on the results, the audiologist may increase the volume and adjust the hearing technology to compensate for the loss of hearing resulting from OME.

Whatever It Takes

The goal for a child with a mixed hearing loss is to do whatever it takes to ensure optimal auditory access in order to power language, literacy and lifetime success. The child cannot afford to miss out on acoustic access to speech and sounds. You’ll want your LSL team to be vigilant and committed to aggressively monitor, treat and address the causes and symptoms of OME following evidence-based practices.

Wondering what you should be on the lookout for with middle ear fluid? Our Middle Ear checklist can help you and your LSL team make decisions for monitoring hearing status, auditory access and referral for treatment so your child can get the most out of learning through listening.

Stay tuned for part three of the middle ear series where we’ll hear from an otologist and learn more about the physician’s role in treating middle ear fluid.

Download the middle ear handout.