Background: Early detection of hearing loss is important to ensure optimal development, and may be influenced by the audiological assessment process.

Objective: To describe the actual practices and audiological findings with regard to the assessment of 0 - 35-month-old children referred for a hearing assessment at a public hospital.

Methods: A retrospective record review was conducted. The study sample comprised 100 participant files.

Results: The mean age of initial hearing screening was 13.1 months. Of the participants, 99% received an initial hearing screening and 44% received a second hearing screening. Only four of the eight participants who were referred underwent auditory brainstem response testing and were diagnosed with hearing loss. These four participants were diagnosed after the age of 2 years. The audiological protocol differed from that recommended by the Health Professions Council of South Africa, resulting in limited diagnostic assessment results.

Conclusion: The study highlighted gaps in the practice of recommended, age-appropriate audiological protocols as well as the ages at which the initial hearing screenings were conducted, which affects early diagnosis of hearing loss.