Throughout the last two decades, we have witnessed a gradual change in the audiological profile of the hearing-impaired child. The number of children with severe to profound hearing losses seems to be declining, while those with minimal losses seems to be increasing. Such losses include unilateral sensorineural, mild bilateral sensorineural, and bilateral conductive hearing loss. Historically, children with minimal hearing loss have received limited attention from physicians, audiologists, or educators. It has been assumed that minimally hearing-impaired children will exhibit few, if any, handicaps and require no special assistance in the academic setting. Recent evidence challenges that assumption, however, and suggests that, in fact, children with minimal hearing loss can demonstrate significant academic and communicative difficulties. It is recommended that children with minimal hearing impairment be considered at high risk for communication and educational difficulties and that assessments be made early in order to identify problems and implement management programs.