Early identification of hearing loss and rapid rehabilitative intervention are the two key elements that will give an infant the best chance to develop normal speech and allow the family members to make appropriate adjustments that will enhance communication in the home environment. Hearing loss in an infant may be only one feature of a syndromic disorder, and the physician must aspire to diagnose and treat the entire dysfunction. While a limited laboratory evaluation and appropriate referrals to related specialties are helpful, a comprehensive history and a complete physical examination are the most effective means to identify syndromic hearing loss and to direct future evaluation and therapy.