The association between otitis media in early childhood with later behaviour and attention problems: A longitudinal pregnancy cohort

Ali A H Altamimi; Monique Robinson; Elizabeth J McKinnon; Eman M A Alenezi; Tamara Veselinović; Robyn S M Choi; Christopher G Brennan-Jones

doi:10.1016/j.ijporl.2023.111545

The association between otitis media in early childhood with later behaviour and attention problems: A longitudinal pregnancy cohort

Int J Pediatr Otorhinolaryngol. 2023 May:168:111545. doi: 10.1016/j.ijporl.2023.111545. Epub 2023 Apr 3.

Authors

Ali A H Altamimi¹, Monique Robinson², Elizabeth J McKinnon², Eman M A Alenezi³, Tamara Veselinović⁴, Robyn S M Choi⁴, Christopher G Brennan-Jones⁵

Affiliations

¹ Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia; Faculty of Life Sciences, Kuwait University, Kuwait. Electronic address: ali.altamimi@telethonkids.org.au.
² Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
³ Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia; Faculty of Allied Health Sciences, Kuwait University, Kuwait.
⁴ Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia.
⁵ Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; The University of Western Australia, Perth, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.

PMID: 37043962
DOI: 10.1016/j.ijporl.2023.111545

Abstract

Objectives: The present study aims to investigate the association between an early history of recurrent otitis media (OM) with or without ventilation tube insertion (VTI) and later behavioural problems in childhood and adolescence.

Methods: Parental reports in a longitudinal pregnancy cohort were used to classify children into three groups; recurrent OM without VTI (rOM group; n = 276), recurrent OM with VTI (VTI group; n = 62), and no history of early-life recurrent OM as a reference group (n = 1485). The Child Behaviour Checklist (CBCL) was administered at ages 5, 8, 10, and 13 years and data were analysed for psychological wellbeing. Mixed-effects regression modelling was used to investigate the associations between a history of rOM and CBCL T-scores across all ages for rOM and VTI groups compared to the reference group. All analyses were controlled for a wide range of confounding variables.

Results: The analyses revealed a significant association between recurrent OM and behavioural problems. While there was a general decline in scores (i.e. improvement) observed over the duration of the follow-up period, children in the rOM group displayed significantly higher scores for internalising and externalising behaviours at ages five, eight and 10 years. Attention scores were significantly higher across all ages in the rOM group. A transient increase in internalising behaviour was observed in the VTI group at ages eight and 10 years. Logistic regression models showed an increased overall likelihood for the rOM group only to fall within the abnormal clinical range for internalising and externalising behaviours.

Conclusion: Early-life recurrent OM with and without VTI was associated with increased behavioural and attention problems in early and late childhood. This suggests that recurrent OM can have a significant impact on children's behaviour and attention that can persist into early adolescence.

Keywords: Attention; Behavioural development; Otitis media; Ventilation tube insertion.

MeSH terms

Adolescent
Child
Child Behavior / psychology
Child Behavior Disorders* / complications
Child Behavior Disorders* / etiology
Child Development
Child, Preschool
Female
Humans
Longitudinal Studies
Otitis Media* / complications
Otitis Media* / epidemiology
Otitis Media* / psychology
Pregnancy
Problem Behavior*