Recently published guidelines for otitis media with effusion (OME) apply to children aged 2 months through 12 years with or without developmental disabilities. The information updates 1994 clinical practice guidelines, which formerly were limited to children 1 to 3 years old with no craniofacial or neurologic abnormalities or sensory deficits.
Experts in primary care, otolaryngology, infectious diseases, epidemiology, hearing, speech and language, audiology, and advanced-practice nursing revised the OME guidelines. The committee was selected by the American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery.
ASHA was represented by Joanne E. Roberts, a scientist and professor at the FPG Child Development Institute, University of North Carolina, Chapel Hill. Roberts, dually certified as an SLP and audiologist, is an ASHA Fellow.
Expanding the age range for which the guidelines applied was important because children with developmental disabilities are often at great risk of OME, she said. "I feel that the committee considered very carefully the importance of hearing to children's language development and the need to assess and monitor language development in children. I think this is an important document for both SLPs and audiologists," Roberts said.
The guidelines include evidence-based recommendations on diagnosing and managing OME in children. Following are excerpts from the report.
"The subcommittee strongly recommended that clinicians use pneumatic otoscopy as the primary diagnostic method and distinguish OME from acute otitis media. Other recommendations included that clinicians should: 1) document the laterality, duration of effusion, and presence and severity of associated symptoms at each assessment of the child with OME, 2) distinguish the child with OME who is at risk for speech, language, or learning problems from other children with OME and more promptly evaluate hearing, speech, language, and need for intervention in children at risk, and, 3) manage the child with OME who is not at risk with watchful waiting for 3 months from the date of effusion onset (if known) or diagnosis (if onset is unknown)."
The recommendations were published in the May 2004 issues of Pediatrics and Otolaryngology-Head and Neck Surgery.