The contribution of parental suspicion in the original identification of a 16 year cohort of 171 children with varying degrees of hearing impairment who were screened and identified in childhood was studied. Only a quarter of the children with permanent hearing loss were identified as a result of parental concern. The presence of parental suspicion preceding the audiological diagnosis was also measured. Of the children with severe or profound deafness, the parents only suspected the presence of hearing loss in 44%. Parental suspicion was even lower for those with a mild or moderate permanent hearing loss, and for those with an otherwise symptomless conductive hearing loss caused by otitis media with effusion. Some parents did identify hearing impairment in their children, and parental suspicion should never be professionally disregarded. Most parents, however, experienced initial difficulty in recognising their children's hearing loss, even when the children were comparatively old. The study confirms the need to continue to identify deafness early by both parental vigilance and sensitive hearing screening programmes.