Fluid in ear and speech development

kcisthebombdotcom · June 2012

At my youngest child's checkup today, we found out she has an excess of fluid in her right ear. Pedi said it was quite severe and she likely could not hear out of the ear at all. She's definitely had a regression in the amount of words/speaking she was doing, but I chalked it up to her being a late walker and being more focused on those skills recently. Naturally, I feel terrible and can't believe I didn't know there was a problem.

I am concerned for her language development now we know there is a problem with hearing currently. As my pedi suggested I did make a call to early intervention and we are going to get her hearing evaluated in another month if the fluid has naturally drained itself.

I guess I just need to hear some happy stories how she's going to be fine and they're going to get her ear drained combined with some speech therapy and her language is going to explode. I'm really feeling down especially with all we've been going through with my older child.

MaxandRuby · June 2012

DS2 (2.5yr old) has a history of fluid in his ears but no history of ear infections. We have been doing periodic hearing tests for 2yr to keep on eye on things since they typically show normal or on the edge of normal/mild hearing loss. This last round of tests showed a possible high frequency hearing loss and we are going back at the end of this month to do a recheck and try and get better testing results.

As for his speech, he has had speech therapy for at least 18mos (off and on with frequency) and 2x/week for 30min each since October. His speech has improved a lot these last 8mos or so.

Assembly_Reqd · June 2012

I think if you ask about getting ear tubes on the 12-24 or 24+ month board you will get a lot of great success stories.

Nate got ear tubes, but his speech is delayed for other reasons. We did get a 10 decibel gain on each ear from the tubes and the fluid was starting to destroy his mastoid bone because it had been there so long.

kcisthebombdotcom · June 2012

MaxandRuby:

DS2 (2.5yr old) has a history of fluid in his ears but no history of ear infections. We have been doing periodic hearing tests for 2yr to keep on eye on things since they typically show normal or on the edge of normal/mild hearing loss. This last round of tests showed a possible high frequency hearing loss and we are going back at the end of this month to do a recheck and try and get better testing results.

As for his speech, he has had speech therapy for at least 18mos (off and on with frequency) and 2x/week for 30min each since October. His speech has improved a lot these last 8mos or so.

This has been similar. My DD has never had an ear infection in her life. I am totally blindsided by this.

I noticed she doesn't always respond to her name/commands, but I assumed that was more because she is 17 months old and wants to do what she wants to when she wants to do it.

Assembly_Reqd · June 2012

Nate never had an ear infection either. You can have fluid w/o symptoms. I think it is called OME (otitis media with effusion)

ETA: Besides always having a flat tympanogram, no one really ever told us about it either. We just happened to get and MRI/CT scan for other reasons and it was found then as well as the damage it was doing to Nate's mastoid. I called the ENT right quick and insisted on ear tubes.

kcisthebombdotcom · June 2012

Assembly_Reqd:
Nate never had an ear infection either. You can have fluid w/o symptoms. I think it is called OME (otitis media with effusion)

Thank you for the information. I'll have to do a little research on that. I just hope dr. google doesn't scare me too much!

LydiaE2 · June 2012

Fluid in the ears can cause a bunch of problems, speech delay, sensory issues and behavioral issues. If it were me, I would request a hearing test now, and based on the results of that an appointment with an ENT. I found that my child's pediatrician was hesitant to refer my son to an ENT even though he had an ear infection that just wouldn't clear up and a large speech delay. My son's Developmental Pediatrician actually went over my son's regular pediatrician's head and ordered the necessary tests and based on the results made an ENT referral. For us tubes have been extremely helpful, my son's language delay has improved significantly and many of his sensory issues have gone away (we are getting therapies for these, but the progress was much slower before the tubes than after). In terms of speech delay, my son no longer has a receptive language delay (it was a 40% delay) or an expressive language delay (20% delay), just a pragmatic speech delay (not sure how they measure that one). The tubes also have stopped each cold from such a big deal, he now gets better in the normal one to two weeks rather than the two to four weeks it used to take and hasn't had to miss any school do to not feeling well during a cold (he had missed a lot of school this fall due to fevers and fatigue with colds).

Oh and if you get a hearing test done, try to get it done at a children's facility. A children's facility can test hearing accurately for newborns and other non-verbal/pre-verbal children. My son actually never talks during his hearing tests, they just watch for reactions to sounds in the room and through headphones.

Tubes are a really minor surgery. My son only received gas as anesthesia and was out of surgery and into recovery in less than 10 minutes (I didn't even have time to order a coffee and go to the bathroom). We did relaxing things the rest of the day, the next day he went to his therapies as scheduled and the day after that went on vacation with my parents to a water park.

The Housewife · June 2012

DS started speech therapy for an expressive language delay (12-15 month level at 26 months old). His receptive language was right on target though, so we never had concerns about his hearing. After a few months of ST we went ahead with the ENT and had his hearing tested because he just wasn't making progress. The ENT saw fluid (he has never had an ear infection). We did 2 in office tests which he didn't do well at (either because of hearing loss, being 2, or a combo). So we opted for a sedated test to be sure. The results of that were moderate low frequency hearing loss and was corrected with tubes.

It was explained to us that DS had heard everything like he was under water. So his receptive language was on par because that was the language he had always heard and was used to it. When he "talked", which just sounded like a strange babble with "o", "r" and "w" sounds, he was talking in the language that he understood. Anyways, about 6 months post tubes we noticed a huge boom in language. He is still very behind his peers, but leaps above where he was. We are about 1 1/2 years into ST now.

HTH a little, and good luck with everything!

Andrewsgal · June 2012

I would call an ENT ASAP. I am not a fan of the wait and see approach when a child is in the important stages of speech development. DS had fluid and I fought for tubes with our ENT for 4 months, it was the best thing I have ever done for him. He was never really behind in speech, but he had a huge language explosion right after the tubes. My only regret is I did not do it sooner.

robynlesley · June 2012

Get thee to an ENT... (my 2 cents).

Without going into a lot of details, my son has been receiving speech therapy (and other services) from EI since he was 24 months old. Initial hearing tests were inconclusive. But his OT suggested a visit to an ENT at his 6 month review due to some vestibular issues (balance, etc.) and he had fluid in his ears and mild hearing loss stemming from it. He got tubes on March 1st.

While he had shown good improvement with his speech prior to the procedure, he has had a language explosion after it. His ST feels he is at age level now for expressive language, though he does have end consonant deletion and some other articulation issues and we will continue with speech until he ages out of EI in August.

I wish I had taken him to an ENT sooner as I feel his remaining speech issues may have resolved by now had I done so.

kcisthebombdotcom · June 2012

Thanks for the feedback ladies.

I can't go to a ENT on my own because I have a HMO and need a referral from my pedi. We're getting a hearing test done early next week so based on the results of that, I may push to be seen sooner if it seems like her hearing has been very affected.

LydiaE2 · June 2012

If the hearing test results come back showing even a minor hearing loss, push for an ENT referral from your pediatrician. You may have to be insistent. My son's former pediatrician wanted us to wait a few months and get a retest on the hearing when my son had a 40% delay in receptive language, which is completely ridiculous. My son's ENT considers any hearing loss to be a big deal in a child with a language delay. My son's hearing test only showed that his hearing was on the low normal end, but that combined with a positive on the fluid in the ears test, and a documented speech delay justified tubes. My son's pediatrician focussed on the minor hear loss and felt that did not justify tubes and tried to talk us out of getting tubes at my son's pre surgical appointment. Needless to say we don't see that pediatrician anymore, but yeah, he is not alone in his feelings and you may need to fight to see an ENT.

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