The prerequisite for normal speech development is the ability to hear normally. Our objective here is the detection of a hearing deficit with a relevant impact on the acquisition of speech before the child is three months old. Such a hearing impairment due to sensorineural deafness requires the provision of a hearing aid, which needs to be done before the child is six months old. If the provision of a hearing aid fails to provide the desired results, or if they may no longer be expected, a cochlear implant is indicated. In the event of tympanic effusion persistence, an adenotomy with paracentesis, and possibly the insertion of an ear tube, is indicated. This intervention can be done before the child is one year old. Permanent sound-conduction deafness may be due to auditory canal atresia or middle ear anomalies. In such cases, it is important to establish whether surgical reconstruction, for example of the sound conduction system, can restore good hearing over the long term. Prior to surgery at the age of about five, the child must be provided with a hearing aid.