Three ways in which otitis media may affect development of hearing are explored. First, developmental effects may be due to illness in general; second, otitis media may cause fluctuating hearing loss which may lead to deficits in language in many areas; and, third, fluctuating hearing loss may have only a temporary effect on the acquisition of language and other processes, and recovery may be rapid when hearing returns to normal. Each of the 50 children in the sample was seen each week by a nurse who screened the children for signs of illness. Otitis media was diagnosed through a combination of pneumatic otoscopy and immittance audiometry. All children with signs of illness were then assessed by a physician. In an effort to examine the relationship between otitis media and attention, children were given a book-reading session when they were well, ill, and had otitis media. In addition, parents and day care teachers rated children's distractibility. The findings, which were based only on children between 12 and 18 months of age, revealed that even when well, children with high otitis media did not attend to language as much as children with lower levels of otitis media. These results suggest early effects of the disease. (RH)