Commentary: otitis media: consistency is the hobgoblin?

1994). Theoretically, early compromise of speech perception could, therefore, adversely affect phonologic awareness as well as oral and written language skills. As Johnson et al. (this issue) point out in their review of the literature, some have argued (Eimas & Clarkson, 1986) that persistent middle ear effusion, which can cause partial and intermittent impairment of hearing, can pose a threat to language development. Others have countered that any acute impairments will ultimately be compensated in the child’s development (Feldman & Gelman, 1986). Major longitudinal studies (Friel-Patti, Finitzo, Formby, & Brown, 1987; Peters, Grievink, Bon, & vanSchilder, 1994; Teele et al., 1990) have failed to resolve this question, suggesting overall that any effects are likely subtle and perhaps inconsistent across individuals. The current issue of Journal of Pediatric Psychology brings two more contributions to this literature. The first, by Johnson et al., uses an enviable longitudinal database wherein a very large sample of children was identified at birth and followed prospectively for 7 years. Occasions of MEE were carefully documented, and cognitive testing was performed at three time points: 3, 5, and 7 years. Using growth curve analysis, a developmental methodology in which the shape of the growth curve itself, over multiple time points, becomes the outcome variable, they demonstrated that there was no overall effect of duration of MEE. Children whose MEE had occurred between 6 and 12 months of age, however, showed a modest and temporary delay in cognitive Journal of Pediatric Psychology, Vol. 25, No. 1, 2000, pp. 19–21