Otitis media (middle ear infection) is one of the most common childhood diseases all over the world and is very prevalent in many indigenous populations including Australian Aborigines. When children have otitis media they often have a hearing loss that can range from slight to moderately severe. This hearing loss is often hard to identify and can come and go. The problem often starts in infancy and can continue for years; hearing returns to normal in some children but some have permanent hearing loss. Even a mild hearing loss in early childhood can seriously affect communication development and learning. This can make it very difficult for children to succeed in the classroom — even when they no longer have active otitis media or hearing loss.