Sir.—In a recent Journal (132:1100-1104, 1978), Zinkus et al reported that children who have had a history of severe, chronic otitis media suffer later from developmental and learning problems. They conclude that hearing loss is the culprit.
Although they refer to an earlier article by Kaplan et al,1 the authors fail to note that those investigators found no relationship between the degree of otitis media—caused hearing loss and learning problems. Kaplan et al found only the same correspondence between chronic otitis media and learning disorders that Zinkus found.
There is no evidence that the mild hearing loss associated with otitis media causes poor learning, nor is it known what causes the relationship between otitis media and learning disorder. I have suggested elsewhere2 that a third factor, related to the predisposition to learning disability, may be responsible for the occurrence of chronic otitis media as well.