Middle Ear Effusion, Attention, and the Development of Child Behavior Problems

Objective: Much interest centers on whether middle ear effusion (MEE) early in life has lasting developmental consequences. It was hypothesized that episodic loss of hearing acuity associated with MEE results in a deficit in attention, a core factor in the development of child behavior problems, and that impaired attention is related to behavior problems during the early years of childhood. Method: This was a prospective study of a large sample of children (n = 698) that was representative of the local population in terms of socioeconomic and ethnic characteristics. The children were recruited at birth and were monitored with regular home visits for 3 years to check for the presence of MEE. Assessment of attention occurred at 2, 3, 5, and 7 years. Behavior problems were assessed at 3, 5, and 7 years. Results: The results did not support the hypothesis that children with greater duration of MEE experience greater attention deficits and more behavior problems than children with a shorter duration of MEE. Structural Equation Modeling parameter estimates resulted in no support for the primary hypothesis. Correlational analyses also did not support the hypothesis. Attention and behavior problems were related significantly. Conclusions: Our negative findings call into question the results of previous studies relating MEE to behavior and attention problems, studies that may have been biased by small, non-representative samples and retrospective designs that lacked careful documentation of MEE.