A child has the first 4 years of life in which to develop speech. The first 8-10 months see the ability to distinguish sounds; later comes further linguistic ability. A hearing impairment more than 25 dB in the better ear in the speech frequencies (500-4 000 Hz) for more than 3 months has clear consequences, especially in the first 4 years of life. Therefore early diagnosis and treatment with rehabilitation of hearing loss is important for proper speech development.