Assessing the feasibility of quantifying the presence of middle ear effusion during the first three months of life in a typical outpatient practice

The literature offers no consensus on the relationship between Middle Ear Effusion (MEE) and language development. This dissertation was motivated by the theory that quantified experience with hearing loss secondary to MEE, during a biologically defined period of development, alters the course of language acquisition.;Although the first twelve months are biologically crucial in language development, no reliable/valid quantitative tympanometric standards are available for measuring MEE hearing loss in the newborn population. This investigation tested the feasibility of gathering large numbers of quantified and qualified samples of newborn middle ear conditions in a typical audiologic/otologic practice using measurement tools employed by a majority of clinicians.;Twelve weekly exams were attempted on 39 newborns, with 576 ears evaluated on 288 infant visits. Twenty-eight infants were evaluated on seven or more consecutive weeks. All 576 ear samples were used in statistical inference and descriptive data analysis to measure the relationship among variables in the audiologic/otologic evaluation and examine the level of agreement between different disciplines' measurement outcomes.;Significant correlation (p < .01) was found on data between two audiologist's blind rankings as well as on digitally metered tympanograms. However, the data further suggests agreement on otologic and audiologic measures is not likely to be found in the target population in a typical out-patient setting.;The data suggests an amplitude of <.30 ml generated by a rapid positive to negative automated pump pressure and 226 Hz probe tone could be used as a candidate threshold for surgical confirmation of MEE in children under three months of age.;Study data imply a large number of quantified samples can be effectively and inexpensively accumulated in a typical audiologic practice using existing protocol and commercially available equipment.;The existence of large numbers of surgically confirmed MEE cases would allow researchers to accurately develop control and study groups for evaluation of language development outcomes in children with and without early MEE history.;This study identifies an appropriate starting point to examine the elusive relationship between middle ear effusion, hearing loss, and language development.