Glue Ear: Guide

Speech and Language

Spoken language is acquired by hearing speech.  It is heard, copied, practised and then perfected.  Children with Glue Ear may not overhear conversations which provide the necessary repetition to learn speech.

Glue Ear can impact on speech intelligibility.  Some speech sounds will be clearer than others, resulting in speech that is muffled and difficult to understand.  For this reason Glue Ear can cause delays in speech and language.

A child needs to receive good auditory feedback of their own voice to monitor the production of their speech and change it accordingly.

In spoken English, morphemes are used at the ends of words to make grammatical changes, altering the meaning of words.  Plurals, possession and the third person (he eats) involve adding an ‘s’ to the end of the word.  This high frequency sound will be very quiet (around 20dB) and may not be heard when a child has Glue Ear.  Similarly past tense markers (cries/cried) will be produced at a quiet level at the end of the word. A child with a conductive hearing loss may that not access these quiet differences in speech and may be at risk of being held back in the development of their receptive and expressive language.

The Consonantal Speech Banana (Keen 2014) shows how the loudness of a sound changes depending on its position within a word.

When speech is presented at a distance and in noise, clarity will be further compromised.  If a child is unable to hear the sounds of speech clearly this will have an impact on the development of both their receptive and expressive language.

Each sound of speech can be described in terms of pitch (frequency) and loudness (intensity). An understanding of the acoustic properties of speech is important to understand the impact of hearing loss on speech access. Speech sounds vary in frequency. Accessing the consonants of speech is important and 70% of word recognition comes from sounds in the frequency range of 500 to 2000Hz (Northern & Downs 2002). 

Spoken language is acquired by hearing speech.  It is heard, copied, practised and then perfected. A child needs to be able to hear the sounds of speech, which are in the frequency range of 250 Hz to 8000Hz (Cole & Felxer, 2011) to be able to produce them.

A child needs to receive good auditory feedback of their own voice to monitor the production of their speech and change it accordingly.

The sounds of speech can be plotted on an audiogram, a graph which shows loudness and pitch. This audiogram shows what is often referred to as the ‘speech banana’: a banana shaped area on the audiogram containing the frequencies and decibel levels needed to hear the sounds of speech.

References

Butler, C., MacMillan, H., (2001) Does early detection of otitis media with effusion prevent delayed language development, Archives of Disease in Childhood 85 pp96–103

Cole, E. & Flexer, C. (2011) Children with hearing loss: Developing listening and talking. (Second edition). San Diego, CA: Plural Publishing Inc. 

Keen, P. (2014) ‘New Consonantal Speech Banana’. [Online]. [Accessed: 09 Sept. 2023]

Northern, J.& Downs, M. (2002) Hearing in Children (5th Edition). Baltimore, MD:Williams and Wilkins Co.