To determine the presence of balance disorders in young children who had otitis media with effusion (OME), 25 subjects, aged 13-57 months, diagnosed by pediatric otolaryngologists, were tested on the gross motor subtest of the Peabody Developmental Motor Scales, a standardized test of motor development with established norms. Parents also filled out questionnaires about their children's balance skills. Subjects with unilateral disease did not differ significantly from normals. Subjects with bilateral disease, however, were significantly impaired compared to normals on balance, locomotion and total score and they were significantly impaired compared to unilateral subjects on all scores. Parental perceptions of their children's balance correlated poorly with the test results. These data suggest that young children with bilateral otitis media with effusion are delayed in developing motor skills that require dynamic balance. Therefore, in spite of a negative history for balance problems physicians should consider balance performance when developing a treatment plan. Children with balance impairments might benefit from more aggressive intervention.