OTITIS MEDIA AND CHILD DEVELOPMENT Edited by J.F. Kavanagh York Press, Parkton, Maryland 1986. 232 pp.. S27.50
I am very disappointed with this book. The pediatrician needs a dispassionate and critical examination of data bearing on the effects of recurrent episodes of otitis media with effusion on cognitive development, a controversial subject. This volume fails to provide such an analysis.
The book consists primarily of papers (without discussion) delivered at a conference convened by the National Institutes of Child Health and Human Development presumably to assess "the state of the art." However, few of the authors address this task. Rather the tendency seems to be to admit or, in some cases, fail to mention that definitive observations are unavailable and then to cite uncritically those studies that support the view that hearing impairment during a "critical period" results in permanent and perhaps irreversible impairment of cognitive abilities. Hypotheses are treated as facts, and the statements of others often seem to be accepted at face value ("Smith has shown . . ."; "Jones states that . . ."). The reader is therefore left with the impression that despite the feet that some details might need to be fleshed out, the issue is actually already settled, which is far from the case. The most dissonant and perhaps important note is struck by Jerome Kagan who in a characteristically well reasoned and documented paper points out that available tests for "cognitive development" are imperfect and slanted and that the present lack of adequate measuring instruments renders research in the area flawed and even impossible. It is unfortunate that none of the investigators who in the past have published data that does not favor the "critical period" hypothesis were represented at the conference and, presumably, were not invited.
Jerome Klein's discussion of risk factors in otitis media is a good summary of that subject; on the other hand there are two surgical papers that present highly personalized and biased views. In fact, one of the authors lists only his own papers in the bibliography.
Except for Dr. Kagan's discordant voice, the general tone of harmony tends to mask the fact that most of the available data contain severe flaws and are uninterpretable.