When does secretory otitis media affect language development?

Secretory otitis media is a very common disorder in early childhood, but its effects on language development are still uncertain. We describe 10 children with secretory otitis media and illustrate the wide range of disability attributable to this. It is suggested that the impact of secretory otitis media on language development depends on at least five factors: age of onset, duration of the episode(s), severity of the hearing loss, intrinsic qualities in the child, and the linguistic environment. The implications of this hypothesis for clinical practice and research are discussed.