Otitis media and learning disabilities: the case for a causal relationship.

Despite an extensive literature suggesting a relationship between otitis media in early childhood and later learning disabilities, controversy still exists as to whether this link is causal. The hallmarks of otitis media, including decreased hearing and delayed language acquisition, and the characteristics of learning disabilities are reviewed. Further analysis of the studies that support a relationship between otitis media and learning disabilities strongly suggests that the relationship is causal in spite of methodologic limitations of some individual studies. If a causal relationship is accepted, then otitis media in early childhood is a disease with significant long-term morbidity that deserves careful follow-up and, when indicated, preventive interventions.