Otitis media and respiratory sinus arrhythmia across infancy and early childhood: Polyvagal processes?

Otitis media (OM)-or middle-ear inflammation-is the most widely diagnosed childhood illness, with evidence implicating OM in a range of distal problems (e.g., language delays, attention problems). Polyvagal theory (Porges, 1995, 2007) posits that there also are likely important connections between middle-ear functioning and children's developing parasympathetic nervous systems (PNS). Using prospective longitudinal data from the Family Life Project (n = 748), we tested within- and between-person relations between indicators of OM (middle-ear spectral gradient angle; SGA) and children's trajectories of respiratory sinus arrhythmia (RSA)-a marker of parasympathetic control of the heart-between the ages of 7 and 35 months. The results suggested that, irrespective of age, children with indications of chronic OM (low cumulative SGA) tended to show atypical RSA reactivity to moderate cognitive challenge, compared with the reactivity patterns of their low-OM-risk peers (mid-to-high cumulative SGA). Specifically, on average, low-OM-risk children showed RSA decreases in the context of challenge in infancy, with the magnitude of the decline weakening and eventually changing direction (i.e., RSA increase) by 35 months. In contrast, those with indicators of chronic OM evinced blunted RSA responses to challenge, irrespective of age. Within-person, temporal bouts of OM-risk were not predictive of within-person changes in RSA reactivity across early childhood.