Roberts J E, Burchinal M R, Zeisel S A, Neebe E C, Hooper S R, Roush J, Bryant D, Mundy M, Henderson F W
Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-8180, USA.
Pediatrics. 1998 Aug;102(2 Pt 1):346-54. doi: 10.1542/peds.102.2.346.
To examine the relationship between otitis media with effusion (OME) and associated hearing loss between 6 and 24 months of age and children's language and cognitive development at 2 years of age.
A prospective cohort design in which 86 African-American infants who attended group child-care centers were recruited between 6 and 12 months of age. Between 6 and 24 months, assessments included serial ear examinations using otoscopy and tympanometry, serial hearing tests, two ratings of the childrearing environment at home and in child care, and language and cognitive outcomes at 2 years.
Children experienced either unilateral or bilateral OME an average of 63% and reduced hearing sensitivity an average of 44% of the time between 6 and 24 months of age. Although proportion of time with OME or with hearing loss was modestly correlated with measures of language and cognitive skills, these relationships were no longer significant when the ratings of the home and child-care environments were also considered. Children with more OME or hearing loss tended to live in less responsive caregiving environments, and these environments were linked to lower performance in expressive language and vocabulary acquisition at 2 years.
Both OME and hearing loss were more strongly related to the quality of home and child-care environments than to children's language and cognitive development. Study results might be explained either by suggesting that children in less responsive caregiving environments experience conditions that make them more likely to experience OME and/or by suggesting that it may be more difficult for caregivers to be responsive and stimulating with children with more OME.
研究6至24个月大的儿童中耳积液（OME）及相关听力损失与2岁时儿童语言和认知发展之间的关系。
一项前瞻性队列研究，招募了86名在6至12个月大时参加集体儿童保育中心的非裔美国婴儿。在6至24个月期间，评估包括使用耳镜检查和鼓室图进行的系列耳部检查、系列听力测试、对家庭和儿童保育环境的两次评分，以及2岁时的语言和认知结果。
在6至24个月大期间，儿童单侧或双侧OME的平均发生率为63%，听力敏感度下降的平均发生率为44%。虽然OME或听力损失的时间比例与语言和认知技能的测量指标存在适度相关性，但在同时考虑家庭和儿童保育环境评分后，这些关系不再显著。患有更多OME或听力损失的儿童往往生活在反应性较低的照料环境中，而这些环境与2岁时表达性语言和词汇习得表现较低有关。
OME和听力损失与家庭和儿童保育环境质量的关系比与儿童语言和认知发展的关系更为密切。研究结果的解释可能是，反应性较低的照料环境中的儿童更易出现OME，或者是照料者对患有更多OME的儿童做出反应和给予激励可能更困难。
