Otitis media with effusion (OME) is one of the most common illnesses of early childhood. Children with many developmental disabilities (eg, Down syndrome, Williams syndrome, Apert syndrome, fragile X syndrome, Turner's syndrome, and cleft palate) are at increased risk for OME. Because OME is typically accompanied by a mild to moderate fluctuating hearing loss, children with disabilities who are already at risk for delays in language learning may be at an even greater risk for language learning difficulties because of OME. The prevalence of OME was studied in 14 children between 8 and 66 months with developmental disabilities attending center-based childcare. The children were examined every other week using tympanometry for 7 months. Consistent with studies of typically developing children, younger children demonstrated more OME than did older children. Children with Down syndrome had the highest incidence of OME regardless of age. Early interventionists can be an important resource to families by sharing information about OME, and strategies for promoting healthy settings, encouraging children's listening, language learning, and early literacy skills in both home and classroom settings.