Improving learner outcomes

Glue Ear

internal ear image

Author Carmel Capewell

Date 23rd Mar 2018


What is glue ear?

Otitis media, or glue ear, has been known about for thousands of years.

It’s a worldwide condition, affecting about 80% of children under the age of 7 years, and there is no agreement about causation. Before the advent of antibiotics, it could lead to death, and still does in countries where these are not widely available.

A build-up of fluid (the glue) in the middle ear results in a temporary hearing loss, similar to the sound of someone’s voice when you’re underwater.

It’s the most common reason for surgery in children in economically developed countries. Grommet surgery, in which small plastic ventilation tubes are inserted into the ear drum under general anaesthetic, provides temporary respite from hearing loss and infections, but the grommets tend to fall out after one to nine months.

Because glue ear is common it’s often perceived as trivial, particularly as the hearing loss is only temporary and often intermittent. However, the hearing loss can persist for anything between 4 and 12 weeks, and is more common in winter months.

There are peaks in occurrence at 2 and 5 years of age – the periods when children are learning to speak, developing social interactions and laying the foundations for academic skills.

What are the implications of glue ear for child development?

As young children develop social skills, they need functioning ears and eyes.

Research suggests that while listening to a child with whom they’re interacting, young children tend to scan the room at the same time, observing how other children behave. Children with glue ear spontaneously learn to lip read, and so they’re focusing on the mouth of the child in front of them, rather than watching others. If that child moves so that their mouth cannot be seen, the child with glue ear may not always follow the conversation, leading to misunderstandings.

Children with early onset glue ear are often described as ‘day dreamy’, as the level of concentration required to focus on what’s being said is thought to cause them to switch off. Just like children whose first language is not English, they may need additional time to process the meaning of each word, and to decipher the structure of sentences.

Children with glue ear often play with younger children, whose language structure may be simpler, or they may prefer to play alone.

Some children can become frustrated or aggressive, and their behaviour can be misinterpreted.

How does noise impact children with glue ear?

We don’t fully develop the ability to identify the direction of a sound until we’re about 15 years old.

A child who has repeated episodes of glue ear is less likely to gain the experience needed to acquire this skill, and they can be confused about where noise is coming from. This can lead to them feeling overwhelmed and distressed in a noisy environment, from which they may try to hide or escape.

This blog was originally posted on

About the author

Carmel Capewell is a chartered psychologist with 20 years’ experience teaching in secondary schools in the UK. Her PhD thesis, The lived experience of glue ear: listening to the voices of mothers and young people, focuses on how young people are impacted by glue ear and what can be done to minimise this.


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  • OLT
    OLT said on: 5th Jul 2017 at 15:41

    Do you have a child with intermittent hearing loss in your class? Might the environment be causing difficulties, rather than a problem in the child?

  • Jo West said on: 27th Mar 2018 at 22:58

    I am a Peripatetic Teacher of the Deaf and find myself called back to a follow up visit to a Key Stage 1 pupil today who has persistent glue ear. Pupils with persistent glue ear may be offered hearing aids as a non-evasive option. Parents often choose hearing aids for their child, rather than repeated grommets which can cause scar tissue on the ear drum and potentially lead to more permanent deafness. Students with glue ear may adapt well to their hearing aids in quiet conditions, however competing sounds are inevitable in the school environment, and can prove very challenging. Amplification for glue ear involves sound boost matched to the loss at the time of the hearing test. However, hearing fluctuates with glue ear which makes it difficult to give a lasting accurately prescribed hearing aid. Hearing aids also amplify all sounds. Acoustic conditions are not always favourable: Some school buildings may have classrooms with high ceilings and are not always carpeted. This, together with hard tables and other surfaces, equipment and chairs can all contribute to a highly reverberant environment. Poor acoustics, combined with the challenges of open plan, shared or parallel learning environments, all need consideration for the hearing aid wearer. My students report talk partner work to be one of the most difficult scenarios to hear in. Digital Hearing aid technology has enabled much finer tuning of hearing aids, to maximise access to speech sound in noise. However, hearing aids do not replace natural hearing and cannot fully choose desired speech over noise. There is additional equipment and other strategies can be offered to help minimise the negative affects of poor acoustics and ambient noise. This is for another post.

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