fluid may or may not be infected. As a result, normal hearing can be affected.

Even a mild, temporary hearing loss can delay the development of speech and language skills. Early recognition and treatment of Otitis Media cannot be over emphasised.

Why is Otitis Media so common in children? Children are more susceptible to middle ear infections because a child's eustachian tube (a passage between the middle ear and the back of the throat) is smaller and more nearly horizontal than in adults, providing easier access for infection causing bacteria.

How can I tell if my child might have Otitis Media? Some of the common symptoms of Otitis Media are: Earaches or draining of the ears.

Fever.

Irritability.

Rubbing or pulling at the ear.

Changes in sleeping or eating habits.

Talking less than usual.

Turning the television or radio up louder than usual.

Frequent need to have directions and information repeated.

Unclear speech.

Delayed speech and language development.

Partial loss of hearing.

Some of these symptoms can appear during or after a cold or respiratory infection. Since fluid can collect in the middle ear without causing pain, children with Otitis Media may not complain about it. Parents may even notice symptoms before their child does.

What is recurrent Otitis Media? Recurrent Otitis Media is when a child gets Otitis Media several times during a year. A preschool child with this condition frequently experiences a temporary loss of hearing. The loss may continue for up to six weeks after the ear infection has healed. Such a hearing loss is described as "mild and fluctuating''. But this may be a major cause of speech and language delay during the preschool years.

Communication development is at its peak from 12 months through five years of age. Fluctuating hearing loss during that time interferes with learning speech and language skills. Many children with Otitis Media cannot hear clearly. They may "tune out'' everyday sounds -- even your voice! If your child has Otitis Media, similar words may sound the same. If you are talking in a noisy room, or have the water running or have your back to your child, hearing becomes even more difficult.

To learn what speech actually sounds like to a child with Otitis Media, plug your ears with your fingers or with ear plugs. Listen to another adult read aloud to you. What happens when the speaker is not facing you? What happens when background noise, or other distractions are present? Did you get tired or bored with listening. You probably had some difficulty hearing exactly what was said. Final consonants can be especially difficult to hear in words that sound the same like in bead/beat back/bat. What about word endings like play/played, cat/cats? Final consonants, past tense, and plural word endings are often left out by children with recurrent Otitis Media. Since they don't hear these sounds properly when others talk, they don't learn how to say them properly.

What can develop with children who have recurrent Otitis Media over several months or year age: Permanent hearing loss if left untreated.

Speech and language delays.

Problems focusing attention.

Academic problems.

Low self-esteem/confidence.

Social interaction problems.

How can parents help if they think Otitis Media is causing a hearing, speech or language problem? If you notice one or more of the symptoms, parents should seek prompt medical attention from their family physician or paediatrician. If further testing is required than referrals can be made to an Otolryngologist (an ear nose and throat specialist) or an Audiologist (specialist in testing hearing).

There are many types of treatment for Otitis Media. Medical professionals are still debating which treatments are most effective. The two most common methods are the use of antibiotics to control the infection and the placement of grommets (tubes) in the ear to drain the fluid. Usually antibiotics are tried for a period. Then, if necessary the placement of grommets is considered.

In addition to medical treatment young children with recurrent Otitis Media often need help from a Speech and Language Pathologist. Working together, the parents can do a tremendous amount at home to improve their child's speech and language skills.

How can parents improve their child's communication skills during everyday activities.

Be a good speech and language model.

Speak clearly.

Develop good eye contact when speaking and listening.

Talk about what your child is doing.

Comment/expand on your child's responses not by correcting him/her but by modelling the correct words of sentences, i.e., child says; "I like ticken thoup. Mom says: yes, chicken soup is your favourite soup.

Structure the environment to help your child listen and learn.

Get your child's attention before beginning to talk. Call your child's name, tap the shoulder or say "look at me''.

Use gestures and facial expression to help convey the message.

Get down to their eye level.

Emphasise word endings that may be difficult for your child to hear.

Reduce background noise. Turn off the radio or television when talking with other people in the room.

Reduce physical activities in the room during the communication process.

Play listening games to help learn the meaning of sounds and words.

Parents should not be afraid to let their instincts guide them in seeking professional help whenever they are concerned about their children's health or development.

For more information on any of the issues discussed today please do not hesitate to contact the Department of Health at 236-0224 ext. 325.