Growing evidence indicates that a significant relationship exists between the conductive hearing loss resulting from recurrent otitis media (OM) during the first 3-5 years of life and subsequent problems in acquisition of language and academic skills. To assess current knowledge of OM and its consequences for cognitive and linguistic development, to exchange viewpoints, and, if possible, to determine directions for future research, a conference was sponsored by the National Institute of Child Health and Human Development (NICHD). Among the epidemiologic studies cited, some found a very high incidence of OM in North American Indians and Eskimos, caused, according to one hypothesis, by a genetically different eustachian tube. Another researcher advised that basic language development should be carefully assessed in all cases of OM in young children. Conferees agreed that intervention programs must be developed and implemented until preventive measures are available. One model program emphasizes prevention of developmental difficulties based on the known and suspected sequelae of OM and on the known principles of language development. Conference participants recommended that all infants and young children, particularly those at risk, be examined for OM during regular medical checkups. In addition to treating the disorder, measures should be taken to deal with any significant hearing loss. If drug therapy is inadequate to clear effusion from the middle ear, surgery should be considered. Speech and language intervention should be undertaken when required.