Could my child have hearing loss?
Signs to Watch For
If there are situations where your child is not responding to sound appropriately, this may be a sign of hearing loss. The single most important sign of hearing loss in children is the failure to develop or the delayed development of spoken language.
If children have severe or profound hearing loss, it is usually obvious that they do not respond to sound, but sometimes it is difficult to detect mild forms of hearing loss, including hearing loss in only one ear. Even a mild hearing loss can significantly impact a child’s ability to learn, impacting language and speech development. Children with mild hearing loss may struggle in school and have attention, behavioral or social problems in the classroom.
Common Warning Signs for Hearing Loss
Family member or teacher concern regarding:
- Hearing ability
- Delays or differences in speech and language development
- Lack of attention or behavioral difficulties
- Poorer-than-expected academic performance
- Not responding to someone talking out of view, particularly with minimal distractions
- Displaying a surprised look when the child’s name has been called at a normal or even fairly loud level
- Using “what?” or “huh?” frequently
- Intently watching the faces of speakers
- Difficulty understanding speech in background noise
- Sitting close to the TV set when the volume is adequate for others
- Increasing the TV or stereo/CD player volume to unreasonably loud levels
- Not responding to voices over the telephone or switching ears repeatedly when the phone is used
- Not being startled by intense sounds
- Not being able to locate the source of a sound accurately
If your child displays one of the common warning signs, contact us at 469-803-5552 to schedule an appointment to test your child’s hearing.
Communication Milestones
There are critical milestones that are rough “rules of thumb” for the majority of children with normal hearing. If your child is more than 2 to 3 months delayed compared to the age groups mentioned below, it may indicate hearing loss or delayed speech-language development.
Newborn
The sensory organ of hearing called the cochlea is full adult size and enables a fetus to hear by the twentieth week of pregnancy. This means that voices of parents and other sounds can be heard even before birth. However, their ability to use hearing comes with experience. Most babies are born with normal hearing. If your newborn is awake, alert and quiet, you may observe eye movement or a slow head turn in the direction of a sound.
5 Months
At five months, babies begin to seek the sound source. At about this age, the head turn changes from a reflexive activity (in the newborn) to a purposeful response. Try making soft sounds from behind and to one side as your baby looks straight ahead. Shaking a soft rattle at ear-level or whispering the baby’s name should elicit a head turn towards the source. Infants should startle when they hear very loud sounds, but should also respond to soft sounds. During the first year, a baby’s ability to accurately locate sounds is refined. Your baby should look for the sources of common sounds.
6 Months
By 6 months, babies recognize speech sounds of their own language more than those of a foreign language. They recognize familiar voices, play with their own voices, engage in vocal play with parents, and experiment with multiple speech and non-speech sounds.
9 Months
By 9 months, a baby should demonstrate an understanding of simple words like “mommy,” “daddy,” “no,” and “bye-bye.”
10 Months
By 10 months, a baby’s babbling should sound “speech-like,” with single syllables strung together (“da-da-da-da”). The first recognizable words emerge at about this time.
1 Year
By 12 months, one or more real, recognizable spoken words emerge.
18 Months
By 18 months, babies should understand simple phrases, point to body parts, and retrieve familiar objects on command (without gestures). They should have a spoken vocabulary of between 20 and 50 words and short phrases like “no more,” “go out,” and “mommy up”.
2 Years
By 24 months, a toddler’s spoken vocabulary should be 200 to 300 words coupled with the emergence of simple two-word sentences. Most speech should be understandable to adults who are not with the toddler on a daily basis. Toddlers should be able to sit and listen to read-aloud storybooks.
3 to 5 Years
Between 3 and 5 years, spoken language should be used constantly to express wants, reflect emotions, convey information, and ask questions. A preschooler should understand nearly all that is said. Vocabulary grows rapidly from 1000 to 2000 words, which are linked together in complex and meaningful sentences. All speech sounds should be clear and understandable by the end of the preschool period.
If you feel your child is delayed compared to the age groups mentioned above, it might indicate hearing loss. Contact us at 469-803-5552 to schedule an appointment to test your child’s hearing.
High-Risk Indicators
There are certain indicators that put children at risk for hearing loss that is present at birth, can develop later, or be acquired (Joint Committee on Infant Hearing, 2019). However, 50% of children with permanent hearing loss have no apparent risk indicators, which is why newborn hearing screening is important.
When children with hearing loss have no obvious risk indicators, the hearing loss is typically genetic in origin. If your child has a permanent hearing loss, your child’s otologist will guide you through the medical and genetic evaluations that determine the cause or causes of hearing loss.
The following are risk indicators for hearing loss in infants and children:
- NICU stay longer than 5 days
- Family history of permanent childhood hearing loss
- Infections during pregnancy that can affect hearing
- Certain infections after birth, including meningitis
- Significant jaundice requiring exchange transfusion
- Certain medications that can affect hearing
- Head trauma
- Chemotherapy
- Craniofacial differences involving the ear or temporal bone
- Certain genetic conditions or syndromes associated with hearing loss
- Congenital CMV (cCMV)
- Caregiver concern regarding hearing, speech, language, or development
IMPORTANT NOTE: Some risk factors require hearing monitoring even when a baby passed their newborn hearing screening.
Hearing and Communication Development
Every child develops at their own pace, but hearing plays an important role in speech, language, learning, and communication.
Talk with your child’s doctor or audiologist if you notice:
- Limited or inconsistent responses to sound
- Not turning toward voices or sounds as expected
- Not responding consistently to their name
- Delayed babbling or speech development
- Speech that is difficult to understand for their age
- Difficulty following spoken directions
- Difficulty hearing from another room or at a distance
- Trouble understanding speech in noise
- Changes in previously established speech, listening, or communication skills
Can hearing loss develop later?
Yes. Some children are born with typical hearing and develop hearing loss later, while others have hearing loss that changes over time. Hearing should be reevaluated whenever there is a new concern, even if your child passed their newborn hearing screening.
What happens if I’m concerned?
Dallas Ear Institute provides comprehensive pediatric hearing evaluations for infants, toddlers, children, and adolescents. Testing is tailored to your child’s age and developmental abilities.