A rather robust literature exists that views children's language development in the context of interactions with adults. This literature generally focuses on typically developing children and suggests that joint attention facilitates communication development whereas directives do not. In order to understand the crucial features of input supporting language acquisition, research must examine children in less than optimal conditions, including children with chronic otitis media (OM). Controversy exists regarding the outcomes of children with OM, and we argue that parental input is an important factor often neglected in research that may mediate language outcomes. The current study investigates whether parents interact differently with their 12-month-old children based upon children's OM status. The results indicate that parents of chronically affected children direct attention more often and engage in fewer joint attentional episodes than parents of nonchronically affected children. Findings suggest that chronic OM has a localized affect on attentional interactions, the forms of input consistently implicated in language acquisition. Thus, children with OM may receive less than optimal input than peers.