There are pregnancy related and child related red flags that should be taken into account and imply a hearing evaluation.

Common child-related indicators of the need for a hearing evaluation are:

• baby does not react to sudden loud sounds, no blinking or startle reflex
• no babbling or babbling that is very monotone
• a speech delay or poor pronounciation
• asking for repeat
• not interacting well with other children
• frequent or recurrent middle ear infections
• hearing loss associated syndromes for example Down Syndrome, Alport Syndrome and Crouzon Syndrome.
• infections that may cause hearing loss for example Meningitis, Cytomegalovirus or measles.
• diagnosis of a learning disability

Circumstances surrounding pregnancy and birth that should increase a parents alertness for a possible hearing loss includes

• Prematurity and/or low birth weight
• low Apgar scores
• Jaundice after birth
• Hypoxia
• Maternal illnesses for example German measles, Rubella, during pregnancy