Speech and Language Development

Otitis Media with Effusion (OME)

Also called ear fluid, OME can affect your child’s ability to hear normally. This hearing loss could affect speech and language development in some children, especially when the fluid is in both ears and lasts a long time. This information will help you better understand how ear fluid might affect your child.

Your Child’s Speech

Speech (sometimes called articulation) is the physical production of sounds in sequence to form words. Children with delayed speech may omit sounds or substitute easy sounds for harder sounds (i.e., t/s as in “I tee the tun in the ty.”). These errors can affect the clarity of your child’s speech.

Findings that Suggest Delayed Speech Development

  • Your child doesn’t babble using consonants (particularly b, m, d, and n) by 9 months.
  • Your child uses mostly vowel sounds and gestures after 18 months.
  • Your child’s speech is hard to understand at the age of 3 years.
  • Your child frequently leaves out or adds consonants in words at the age of 3 years.
  • Your child is not able to produce most sounds by the age of 5 or 6.

Your Child’s Language

Language is the meaning or message conveyed back and forth through speech, writing, or even gestures. Receptive language is the ability to understand what others say. Children with delayed receptive language may have difficulty, compared to other children, following directions or understanding the words or sentence structures used by others. Expressive language is the ability to choose the right words when communicating, and then put the words together appropriately for sentences and meaning. Children with delayed expressive language may have short utterances or sentences.

Findings that Suggest Delayed Language Development

  • Your child does not use any single words by 16 to 18 months.
  • Your child cannot follow simple instructions, such as “Give me your shoe,” or cannot point to body parts or common objects following a verbal request by 18 months.
  • Your child does not use 3-4 word utterances by the age of 2 years.
  • Your child does not communicate with complete sentences by the age of 3 years.
  • Your child’s sentences are still short or noticeably incorrect at the age of 4 years.

Your Child’s Language

Wear hearing protectors, especially if you must work in an excessively noisy environment. You should also wear them when using power tools, noisy yard equipment, or firearms, or riding a motorcycle or snowmobile. Hearing protectors come in two forms: earplugs and earmuffs.

What You Can Do?

If there are delays in your child’s speech or language development because of fluid, these delays usually disappear once the ear fluid goes away on its own or ear tubes are inserted. If a delay persists, your child should be referred to a speech-language pathologist for evaluation and treatment, as necessary. Reading to or with your child is also important because reading and spelling are strongly linked to speech and language development.


Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline (update): otitis media with effusion. Otolaryngol Head Neck Surg. 2016;154(1 Suppl):215-225.

Related Conditions

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.