#### What you need to know A 3 year old child attends with his mother, who is worried about his hearing. Staff at the child’s nursery say he doesn’t always respond immediately, and his mother is concerned that he is not talking as much as other children. Paediatric hearing loss is a common problem; diagnosis and appropriate intervention are central to the child’s development. It is estimated that one in five children of around 2 years will have been affected by glue ear and eight in 10 will have been affected once or more by the age of 10.1 ### History The observations of parents or professionals are key; explore inattentiveness at home, nursery, or school, and increased television volume, delayed language skills, and speech impediment. Symptoms will vary with severity and the age of the child. Ask about #### Box 1: Neonatal hearing screening programme A well baby (where there is no need for special care, or <48 hours special care) undergoes an automated otoacoustic emissions test. If this is not “passed” after two attempts, then the baby has an automated auditory brainstem response test. Babies in neonatal intensive care or at risk have …