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Persistent middle ear effusion in the first 3 years of life is not associated with behavior problems or parental stress

Several previous studies have attributed both heightened parental stress and various disturbances in children's behavior to persistent or recurrent middle ear inflammation early in the children's lives. However, these results are questionable because all of the studies have had methodologic problems such as selection bias or inadequate sample size. Now, a recent controlled study has found that chronic middle ear inflammation during the first 3 years of a child's life has little to do with parent-child stress or the child's behavior problems during that time. The study was part of a long-term study of the possible effects on development of otitis media (middle ear inflammation) in early life, which was supported by the Agency for Healthcare Research and Quality (HS07786).

Jack L. Paradise, M.D., of the Children's Hospital of Pittsburgh, and his colleagues tested relationships between parents' ratings of parent-child stress at ages 1, 2, and 3 years, their children's behavior problems at ages 2 and 3 years, and the children's cumulative duration of middle-ear effusion (MEE) in the first 3 years of life. The researchers obtained standardized baseline measures of parental stress, intensively monitored the children's middle-ear status by pneumatic otoscopy and tympanometry during their first 3 years of life, and treated children for otitis media according to specified guidelines.

In 2,278 children, they found no substantial relationships between parents' ratings of parent-child stress or children's behavior problems and the cumulative duration of the children's MEE. On the other hand, ratings of both parent-child stress and behavior problems were consistently highest among the most socioeconomically disadvantaged children and lowest among the most socioeconomically advantaged children. Ratings also tended to be highest among children whose parents' baseline stress scores were highest.

See "Parental stress and parent-rated child behavior in relation to otitis media in the first three years of life," by Dr. Paradise, Heidi M. Feldman, Ph.D., M.D., D. Kathleen Colborn, B.S., and others, in the December 1999 Pediatrics 104(6), p. 1264-1273.

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