Perform a general examination
A general examination should be performed to look for any
features suggestive of syndromes that include hearing loss or
developmental delay. Look for any changes in hair colour
such as a white forelock that occurs in Waardenburg
syndrome. Examine the face for features suggestive of Down
syndrome, Treacher Collins syndrome and Goldenhar
syndrome. Eye features such as coloboma may resemble
CHARGE syndrome. Be aware of the abnormal facial
characteristics of DiGeorge syndrome (22q11 deletion) as
these children often have speech and language problems and
are easily missed. A neurological examination should be
performed to identify central nervous system pathology