On the basis of certain fundamental data for pathological hearing in children and its effects on speech development an attempt is made to summarise the most important considerations regarding the primary choice of a device and the subsequent procedures of fitting to optimise the benefits over a range of ages, from the small infant to school age children. Selection criteria and adjustment parameters are discussed, showing that the hearing aid fitting procedure must be embeded in a complex matrix of requirements related to the development of speech as well as to the cognitive, emotional and social development of the children. As a rule, finding and preparing the "optimal" hearing aid for a child is a prolonged and often difficult process, which cannot be schemantically performed. The limitations of the available devices and the different procedures and philosophies of hearing aid selection and fitting strategies represented by various groups active in the field of pedaudiology in Germany and in other institutions are discussed, underlining the magnitude of task still to be fulfilled in the Federal Republic of Germany.