How do ear infections affect a baby's language development?

With the onset of winter, the incidence of ear infections increases in babies and kids. If your children get sick, here's what you should do.

 Pediatrician with baby at clinic (photo credit: INGIMAGE)
Pediatrician with baby at clinic
(photo credit: INGIMAGE)

You've filled up the closets with warm clothes, stocked everyone up with a coat and hat, and now you can say that you and the kids are ready for winter. Besides the rains and low temperatures, winter means lots of ear infections for babies and kids.

To talk about ear infections, you need to know the body's audio system. Meital Manshari, a pediatric speech therapist, explains that the audio system consists of three main parts: the outer ear, which includes the auricle and the ear canal; the middle ear, which is separated from the external ear by the eardrum and connected to the back of your nose and throat by a narrow passageway called the eustachian tube; and the inner ear with the cochlea and the vestibular system. 

The ability to hear depends on the integrity of these three parts. Shortly after birth, a baby's hearing is tested as part of a screening test at the hospital. This test allows for initial identification of a hearing problem, congenital or acquired.

What's an ear infection?

An ear infection is an accumulation of fluid in the middle ear cavity. In babies and toddlers, the process of draining fluids from the middle ear is less efficient than in adults, so ear infections are very common for them, especially during the winter.

An ear infection can manifest itself in the toddler's restlessness, fever or pulling the ear, which shows pain. Also, fluid can accumulate in the ears even without the appearance of inflammation.

 Baby with pacifier (credit: INGIMAGE)
Baby with pacifier (credit: INGIMAGE)

Infections affect language development

Beyond the medical issue that requires close treatment and follow-up by your doctor, ear infections affect hearing ability, which can make it difficult for kids to learn to speak

Imagine trying to hear yourself or someone else underwater. The sound is very faint. In fact, when fluid accumulates in the ears and isn't treated for a long time, a conductive hearing impairment appears, i.e. the conduction of the voice waves is disturbed by the fluids so you hear less well.

Usually, it's a "mild" hearing impairment but it may significantly affect language acquisition and speech development. Fluid can be found in one or both ears, but hearing loss in one ear also affects the acquisition of language and speech. 

Hearing is a necessary condition for typical language acquisition processes and the ability to speak clearly. When there's a disruption in one of the hearing mechanisms, language, sounds and the surrounding environment can't be heard.

What are the signs that hearing should be tested?

  • When kids don't turn their heads to a loud and sudden sound
  • When they often ask "what" and have trouble following the conversation
  • When it's hard for a kid to form words and difficult to understand speech

If you already know that your kids are prone to recurrent ear infections, it's very important to talk to them in a way that suits them and makes language and speech accessible. Reduce background noise as much as possible, use body movements, make sure kids see your face so they can process information by seeing facial expressions and mouth movements.

If you suspect that your child has a speech delay, seek an evaluation from a speech therapist and follow their recommendations.


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This article doesn't replace speaking with a pediatrician, ENT or speech therapist.

This article was written in cooperation with the JAMA parenting app.