Behaviour and cognitive outcomes from middle ear disease

OBJECTIVES: To resolve controversies over associations between a history of middle ear disease and psychosocial or cognitive/educational outcomes. DESIGN: Multipurpose longitudinal birth cohort study. Original cohort comprised all UK births between 5 and 11 April 1970; data were available for approximately 12,000 children at 5 years old and 9000 children at 10 years old. METHODS: For 5 year old children, parent reported data were available on health, social, and behavioural factors, including data on two validated markers of middle ear disease. Cognitive tests were administered at 5 and 10 years of age, and behavioural problems rated at 10 years by the child's teacher. RESULTS: After adjustment for social background and maternal malaise, the developmental sequelae of middle ear disease remained significant even at 10 years. The largest effects were observed in behaviour problems and language test data at age 5, but effect sizes were modest overall. IMPLICATIONS: These results provide an epidemiological basis for policies that aim to minimise the sequelae of middle ear disease by awareness in parents and preschool teachers, early referral, and intervention for more serious or persistent cases.