Hearing screening by community physicians in under-2 year-olds.

The efficacy of neonatal screening in lowering age at diagnosis and treatment in congenital hearing loss should not mask the limitations due to the fact that hearing loss often appears or is detected after birth. Early diagnosis of secondary or progressive postnatal hearing loss is nevertheless necessary and justifies systematic screening of hearing disorder in all children seen in consultation, for whatever reason. Screening bilateral hearing loss in under-2 year-olds in a community context is feasible, using simple means: parent interview, clinical observation, and acoumetry using the voice and sound-emitting toys. In case of abnormality detected or suspected on screening, children of whatever age should be referred to an ENT specialist for complete audiometric assessment. Behavioural audiometry is feasible in very young children, and indispensable to diagnosis. The parents will only be reassured after specialized hearing examinations have been performed.