Abstract
Considerable controversy surrounds whether a history of otitis media with effusion (OME) in early childhood causes later speech and language problems. We conducted a meta-analysis of prospective studies to determine: 1) whether a history of OME in early childhood is related to receptive language, expressive language, vocabulary, syntax, or speech development in children 1 to 5 years old and 2) whether hearing loss caused by otitis media in early childhood is related to children`s receptive language or expressive language through 2 years of age. We searched on line da ta bases and bib li og ra phies of OME studies and reviews for prospective or randomized clinical trials published between January 2000 and October 2002 that examined there lation ship of OME or OME-associated hearing loss in early childhood to children`s later speech and language development. We performed 11 meta-analyses. There were no significant findings for the analyses of OME during early childhood versus receptive or expressive language during the preschool years in the correlation studies. The magnitude of relationship suggests a small effect, but the 95% CI cannot exclude a trivial (-0.07) or almost good (-0.41) effect. There was a smaller d in the 2 randomized studies (-0.23) than in the observational studies (-0.25), but sensitivity analysis showed no impact of randomization on outcomes (ANOVA: P = .908). Our results indicate no to very small negative associations of OME and associated hearing loss to children`s later speech and language development. These findings may over estimate the impact of OME on outcomes, because most studies did not adjust for known confounding variables.
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