The records were studied of all children identified in the last 16 years as having severe sensorineural hearing loss (bilateral 60 dB or more, across all frequencies) in west Essex (a typical health district with a child population, 0-16 years, of 54,000). The person to first suspect the child's hearing loss and the results of their 8-month distraction test are discussed. The reasons for delay in diagnosis and acquisition of aids are examined.