A prospective study examined 280 children aged between 2 and 11 years with mild or severe forms of otitis media with effusion (OME). There was a 2-year delay between the first suspicion of hearing loss and presentation to an otolaryngologist. In approximately 50% of these children hearing loss was first suspected by the mother and in 20-30% detection was by routine screening tests. In most cases actual hearing loss was the subjective presenting feature, but in others, speech, language or learning difficulties heralded the problem. It is suggested that such data might be incorporated into a questionnaire for parents which may then be used to assess parental ability to detect hearing loss due to otitis media with effusion in small children.