The validity of hearing screening programmes undertaken within the Community Child Health Services is currently being critically reviewed. The study of 198 children with permanent hearing loss born between 1973 and 1988 confirms the prevalence of different degrees of deafness in an East London district of urban deprivation. Within this district the expansion of community audiology services has resulted in a significant reduction in the age of identification of those children with a moderate, severe or profound bilateral deafness, measured over a 15 year period. However, despite these improvements, the modal age of identification of those children with a unilateral deafness or with a bilateral deafness of mild degree remains at the age of primary school entry. The implications of this for planning future screening programmes is discussed.