Otitis Media with Effusion (OME)

A 5-year-old boy presents to the ENT clinic with his mother reporting decreased school performance, frequent "What?" responses, and turning the TV volume up loud. He has had 4 episodes of acute otitis media in the past year. Otoscopy shows bilateral retracted, dull tympanic membranes with an air-fluid level behind the right tympanum and yellowish fluid suggestive of middle-ear effusion. Pure-tone audiometry reveals the audiometric pattern marked **A** in the diagram: mild bilateral conductive hearing loss of 30 dB with an air-bone gap of 25 dB and a flat Type B tympanogram. According to AAO-HNS guidelines, what is the most appropriate initial management for this child?