Frustrated that your toddler doesn’t do as he’s told? He may have glue ear, says Dr Bernadette Borgstein.
Meet the expert: Dr Bernadette Borgstein is a paediatric consultant at The Portland Hospital for Women and Children. She specialises in treating children’s hearing problems.
When you next hear yourself saying though gritted teeth, ‘Will you please come and put your coat on!’, pause for a moment and consider if your toddler might have glue ear.
What is Glue Ear?
One in five two-year-olds have this condition of the middle ear, and it can cause hearing problems that appear a lot like your tot simply isn’t taking any notice of what you’re saying.
The middle ear is the part behind the eardrum which contains three small bones that are vital for normal hearing. It is normally filled with air, but when a child develops glue ear, it fills with liquid instead. This happens when a narrow tube linking the middle ear to the back of the throat – the Eustachian tube – becomes blocked. This leads to a build-up of thick, gluey fluid from cells in the ear lining. This fluid stops the eardrum moving normally and prevents vibrations being passed along those three bones. The result? Dulled hearing.
The Eustachian tube in babies and young children is narrow and easily blocked, especially when your little one has a cold or is suffering from an allergy. It can also be blocked by enlarged adenoids – these glands, similar to tonsils, are situated close to the exit of the Eustachian tube at the back of the throat. If large adenoids are to blame, then you may also notice your tot often snores, dribbles or suffers from colds that are difficult to shake off. If your child has Down’s Syndrome or a cleft palate, he’s also at a higher risk of developing glue ear. And exposure to smoking and a family history of glue ear also heighten risk.
Although it’s common in all under-sevens, including babies, youngsters often develop glue ear at the ages of two and five. It’s thought this is because children of this age catch more colds when they first mix with a large group of other children at nursery and school.
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Symptoms of Glue Ear
If you think your child could have a problem, look out for any hearing difficulties.
He may experience a popping sensation and find it hard to hear quieter sounds, especially when there is background noise.
He may find it tricky to understand what you’re saying in noisy environments or if you are far away. His hearing issues may vary from day to day, so on some days there may not seem to be a problem. He might also appear unusually tired or irritable, because he has to try harder to listen.
Children who find it hard to hear often become frustrated, which can lead to changes in their behaviour.
It might seem like he’s being naughty, when actually he is struggling to cope. You may also notice he is finding it difficult to sleep or that his speech is not as advanced as friends of a similar age.
The change in the middle ear can lead to your tot having balance problems, or being clumsy. It may also cause mild pain. Glue ear is particularly difficult to spot in babies and very young children, but he may play with his ears, flick them, or move his head in an unusual way, as these are all ways to try and clear the fuzzy feeling. An older child may complain that his ears feel like they are blocked. Your child may also experience earache and tinnitus, where he can hear sounds like buzzing, humming or whistling in his ears.
If you notice some of these signs, it’s a good idea to see your GP, who can refer your tot for an audiology assessment to rule out the condition and other hearing problems.
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How to treat Glue Ear
The good news is that the vast majority of children will grow out of glue ear by the age of seven, without any intervention. And nine out of 10 cases will resolve themselves within a year without any treatment, and often within three months. However, if your child has persistent glue ear, he may be offered a hearing aid to amplify sounds and allow him to hear while the condition gets better of its own accord.
In cases which aren’t showing any signs of improvement, a tiny tube called a grommet can be inserted into the eardrum. This tube temporarily takes over the function of the Eustachian tube. It’s inserted by an ear, nose and throat surgeon, under a light anaesthetic. No incision is made, as the surgeon accesses the eardrum down the ear canal. Once the grommet is in place, your child will be given a hearing test to ensure his hearing loss was due to glue ear, and not the result of another condition. The grommet usually works its own way out of the eardrum over the course of three months to a year. In most cases the glue ear does not recur.
If your GP diagnoses glue ear, and no treatment is necessary, your priority is to make it as easy as possible for your toddler to hear while the condition improves. You can do this by carrying out the following:
- Get your toddler’s attention before you speak to him – call his name and wait until he’s looking at you before you continue.
- Turn off any background noise, such as the washer or TV, when you speak to him.
- If your child is looked after by other family members or carers, ask them to follow the same advice.
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Can your tot hear?
Fill a box with a few pairs of toys with similar-sounding or rhyming names, for example, a train and a plane. Pick a pair of toys out of the box and ask your tot to take or point to one, by asking, ‘Which is the plane?’ and check that he knows the names of the objects. Now play the game again, but this time, put a hand in front of your mouth when you ask. Many toddlers will use the shape your mouth makes as a clue to help their hearing, and may struggle if they can’t see it.
If you have any concerns, see your GP.