There is significant variability among protocols for evaluation and management of pediatric sensorineural hearing loss. Factors such as ongoing developments in genetic testing capabilities, increased understanding of the role of CMV in hearing loss, and broad spectrum of hearing loss severity and laterality make it difficult to generalize testing and counseling to fit the needs of all patients. In this presentation, the focus will be on the clinician's approach to the family on the first visit after a child is diagnosed with hearing loss. Audience members will be asked to engage in a simulated discussion with family during that first visit. Panelists will engage with the audience and with one another regarding their approach, discussion strategies, and suggestions for next steps. Techniques to elicit parental concerns, understand parental values and opinions, and to engage in shared decision making will be reviewed. In addition, this complex topic will be distilled into distinct categories including congenital hearing loss, acquired hearing loss, and unilateral versus bilateral hearing loss. A discussion of how age at time of diagnosis affects testing and management strategies will be included. A systematic approach to evaluation and management towards these distinct categories will be discussed, with the understanding that an individualistic approach will still be necessary on a case-by-case basis. This panel is not intended to be a comprehensive literature review. Instead, the format will be a simulation of an encounter between a clinician and a parent with a child with hearing loss with presentation of simplified evidence that supports the discussion and answers.