My three year old daughter was diagnosed with developmental delay when she was 9 months old. When she was two and a half and she still wasn't walking I asked an ENT doctor to look into her ears. What he found was undiagnosed serous otitis media also called otitis media with effusion (OME). This means that there was fluid in her middle ear space. She had never had an ear infection, the fluid wasn't infected rather her adenoidswere enlarged and preventing her Eustachian tube from draining. This affected her hearing and balance. One week after the fluid was removed she started walking.
We noticed a lot of improvements right after her myringotomy and adenoidectomy but she still didn't come close to developing like a normal child her age. At this point (about 9 months after surgery), she attends a school for autistic children which specializes in ABA therapy. She has not been diagnosed with autism, but experts agree that she qualifies for a minimum diagnosis of PDD-NOS. While she does occasionally stim, her deficits are almost primarily communicative. While I know that she can hear at least some of the time she still has no startle reflex and I often have to call her multiple times before she will acknowledge me.
Just when I think I've come to terms with the idea that my daughter has autism I come across something like this study that makes me stop and think again. According to thearticle in Medical News Today scientists have discovered that a temporary hearing deficit, (such as is often caused by OME), at an early age can affect your child's hearing permanently, even after the problem should have resolved. According to researchers the auditory cortex must be stimulated at specific times (critical periods in a child's development) to develop properly and if it is not it can lead to long term problems. Impaired hearing makes it very difficult for children to learn how to talk, so the period of hearing loss leads to multiple communication deficits.
A quote from the article I'd like to share: ". . . children commonly experience a buildup of viscous fluid in the middle ear cavity, called otitis media with effusion, which can degrade the quality of acoustic signals reaching the brain and has been associated with long-lasting loss of auditory perceptual acuity," explains senior study author, Dr. Daniel Polley from the Massachusetts Eye and Ear Infirmary."
I don't know when or how I'll discover what really happened with my daughter but I encourage other parents to be aware of OME and to be extra vigilant if they have a child with development delays. I say, "extra vigilant," because I was aware of OME but it was ruled out by my regular pediatrician and two audiologists who had done tympanometrytesting on my daughter before it was finally discovered by our ear, nose and throat doctor. Fluid in the ear can be difficult to diagnose, it takes an experienced specialist to notice subtle changes in the ear drum. Also, remember, that the inner ear controls balance so gross motor delays are common among children with OME.
