Objective To identify and evaluate the routes through which children with hearing loss are identified post the newborn hearing screening programme, in a chosen healthcare trust.

Method Establish a database of a sample of 62 children born between 2004 and 2012 identified through a route other than direct assessment following a failed newborn hearing screen and in the care of the chosen Paediatric Audiology department for a permanent hearing loss. Use this data to evaluate their routes of identification.

Results 30.6% of children were identified by the targeted behavioural test, having met the criteria and been eligible for this. 27.4% of children were identified by parental concern. Interestingly, 24.2% were identified by school-entry screening, despite recent efficacy concerns. Other significant pathways included school concern, professional concern, oncology referral and post-meningitic referral.

Conclusions Despite the success of the newborn hearing screening programme, a significant population of children rely on alternative and reactive pathways of identification. In this area, these pathways provide an invaluable back-up to the newborn hearing screening programme.