Diagnosis of hearing impairment: factors of delay.

In a retrospective study based on parents' personal interviews, the diagnosis circumstances were analysed in a group of 88 deaf children (moderate to profound deafness). We reported first the age when the parents emitted doubts, and second the age of diagnosis. It appeared that the age of first suspicions, and of diagnosis, was correlated to the degree of deafness. The population of children was divided in two groups depending on the presence of a delay or not in the diagnosis. The first group (24 children) was diagnosed early because of neonatal screening, or of early suspicions by parents or pediatrician. In the second group (64 children) were a delay was observed, seven causes were identified with variable frequency according to the level of deafness. The first four main causes for delayed diagnosis were: 1) parents, 2) medical refutation, 3) otitis media with effusion (OME), 4) progressive hearing loss. In conclusion, the age of diagnosis and the age of first suspicions were too late. Universal neonatal screening is recommended but do not appear to be the exclusive procedure to reduce the diagnostic's delay. This analysis of the factors of delay, prompted us to recommend: 1) information to parents on deafness, 2) careful attention to parents suspicions, 3) an objective evaluation of auditory function,especially after OME cure and 4) a follow-up of children to identify progressive hearing loss.