Missing: The Sign Post

“Joe has ADD,” his father informed me. “Can you test him to make sure?”

“How do you know Joe has ADD,” was my natural question.

“His teacher told me, he can’t pay attention he keeps daydreaming,” responded Dad.

Well Joe did pay attention while we tested his hearing, listening, and vision. He did have a history of middle ear fluid (otitis media). This was present today and gave him a little bit of a hearing loss as well as great difficulty listening with noise in the background.

“Not possible”, said Dad, “he isn’t complaining of pain.

Unfortunately, obvious pain is the only sign parents know of for what is a very common childhood condition. What is problematic is that otitis media can have a very serious effect on development. Your pediatrician and ENT are rightly concerned with the medical ramifications of otitis media, given the ear’s proximity to the brain. The developmental audiologist is here to address the developmental havoc otitis media can cause. The fluid acts as an obstacle preventing proper stimulation. This related auditory deprivation effects speech, language and vestibular function. With 90% of early childhood learning occurring through incidental learning i.e overhearing, you can see how important healthy ears and good hearing really is. The American Academy of Pediatrics recommends that a child with 1 or more risk factors on the hearing risk assessment have at least 1 diagnostic audiology assessment. You will note communication concerns is listed first. In a position statement The American Academy of Audiology
recommends that when there are concerns of developmental deficits in communication, attention and behavior and a history of otitis media the auditory system should be assessed (not screened) to ensure optimal function.

https://www.audiology.org/publications-resources/document-library/audiologic-guidelines-diagnosis-treatment-otitis-media

https://pediatrics.aappublications.org/content/124/4/1252/tab-figures-data