Glue ear and hearing difficulties

Signs of glue ear

When my 18 month old son did not respond to our voices as we came into his bedroom in the morning,  and then startled when we came into view, I suspected that he was not hearing us. 

After passing his Health Visitor hearing screen and making several visits to the GP we finally reached Audiology  for a professional hearing test and he was diagnosed with glue ear. I also noticed as he got older that he frequently said “What?” or "Pardon" when he wasn’t hearing us!

Other signs that a child may have glue ear are a short attention span, speaking excessively loudly, wanting the TV turned up, becoming withdrawn and sometimes ear infections, although not every child will suffer from all of these symptoms.

One of the effects of glue ear that I come across frequently in my work as a speech and language therapist is delayed speech and/or language development. Children may be late acquiring words and phrases, or have difficulty with producing sounds for intelligible speech. 

What is glue ear?

Glue ear is the accumulation of sticky fluid (or glue) inside the ear. This prevents the tiny hair like cells in the inner ear from moving adequately and can reduce the hearing. See the Hearing Research UK website for more detailed information on glue ear.  Glue ear tends to cause a mild to moderate hearing loss. It may “muffle” sounds, a little bit like wearing cotton wool in your ears. However it can have a significant effect on the way a child is learning to speak because it occurs at such an important age for development. It may also impact on their ability to concentrate and learn in the classroom.

About three quarters of young children will suffer from a bout of glue ear at some point, but some children, who have a persistent problem may need treatment with grommets. The Great Ormond Hospital website has more information on treatment. The insertion of grommets is an effective, although short-term treatment, as eventually the grommets will fall out. My son had grommets inserted twice, each lasting about two years. Parents (with advice from the Ear Nose and Throat doctor) need to weigh up the benefits of significantly improved hearing against concerns about submitting their child for a minor operation.

Tips  for helping your child communicate

• Get face-to-face

Position yourself in front of your child so that they can watch your facial expressions and lips when you are talking.

• Use a loud voice

However avoid shouting.

• Turn off background noise

Be aware of the noises in the environment including washing  machines, dishwashers, radios, TV, which will make it hard for your child to distinguish speech.

• Keep your language simple so that your child can understand what you're saying

• Break down your sentences into shorter units e.g. Instead of saying

“Go upstairs, get your coat and hat and wait by the door”
 split this up into four phrases giving your child a chance to respond to each one before saying the next one.
“Go upstairs” ...Pause while your child goes upstairs... “Get your coat” ...Pause....“Find your hat” ...“Wait by the door”

• Use pictures and objects to help your child understand

E.g. hold up a cup when you ask “Do you want a drink?” Giving your child as many visual cues as possible will also help them learn to speak  through understanding.

• Use natural gesture or Makaton signs to illustrate your language

• Check that your child has understood what you have said
  

 

• Give you child extra time to listen and to process what you are saying.

• Pause and give your child lots of opportunities to tell you things in their own way.

At school or nursery

• Ensure that your child’s teacher knows he or she has a hearing difficulty

• Your child may need language made specific so that they can hear and understand it.

• Your child may need instructions for the whole class repeated for them individually.

• Make sure the child is sitting at the front of the class so that everything can be easily heard.

   The above recommendations need to be carried out sensitively so that the child doesn't feel singled out from the other children. The Hearing Research UK website has helpful information for teachers.

ICAN and the Hearing Research UK website also provide useful communication tips.