The impact of otitis media on speech production in children: A systematic review.

Introduction: Otitis Media (OM) is one of the most common infections in young children and can create fluctuating hearing loss. Despite the commonality of this condition, there is a lack of conclusive evidence on its impact on speech production outcomes. Therefore, the aim of this systematic review was to identify the impact of otitis media on speech production in children.

Method: A systematic review of peer-reviewed publications since 2000 was conducted using five data bases (PsycINFO, Medline, CINAHL, Pubmed and SpeechBITE). Studies were included if they reported a previous or current experience of otitis media (OM), assessed and reported on the speech production of children before the age of 12 years and the child's speech productions were assessed in the English language. Titles and abstracts of 332 articles were reviewed, followed by full-text review of 58 studies. Due to variability in study procedures and outcomes, a narrative synthesis was completed.

Results: 12 studies met inclusion criteria for this review investigating 1,265 children aged between 12 months and 7 years of age. Eight studies used a prospective design, three studies used a retrospective design, and one study used a case study design. Six studies found no relationship between OM and speech production although five of these studies formed part of a larger study of 639 children. Comparatively five studies identified a link between OM history, chronicity of OM and/or elevated hearing levels and speech production. Specifically, OM was linked to the presence of backing in obstruents.

Conclusions: Overall findings were mixed likely due to the presence of multiple influencing variables such as duration, severity, medical intervention, age, hearing status and socio-economic status. Results of this review are limited as prospective studies only considered cases of OM which are treated and therefore do not represent children who have unidentified and/or untreated OM. Furthermore, many studies did not consistently report on the hearing levels of children and only two studies included cohorts of children from an Indigenous background.