Hearing Loss in Children

Early identification is important because if hearing is impaired spoken language may not develop properly. The first three years of a child’s life are critical for language development—whether spoken or signed—making early detection and intervention absolutely critical. Identification of hearing loss in infants and children requires careful observation, thorough medical examination with an extensive case history, and audiological testing.

When and How to Evaluate

If speech and language development begins normally and then stops, refer immediately for a hearing evaluation. A child of any age can have an audiology evaluation. The evaluation technique used depends on the developmental age of the infant or child. Our pediatric audiology team can help decide which method is best for your child. In order to obtain complete and accurate test results, children may need to be seen for multiple appointments. Early identification and assessment are the first steps in the successful management of the hearing impaired child.

High Risk Factors:
  • Birth – 28 days
    • Malformations of the ear, nose, or throat
    • Rubella during pregnancy
    • Rh incompatibility
    • Family history of hearing loss
    • Severe neonatal infections
    • Meningitis
    • Low birth weight (under 3.3 lbs)
    • Hyperbilirubinemia
    • Ototoxic medications
    • Severe respiratory distress and/or prolonged mechanical ventilation (10 days or more)
  • 29 days – 2 years
    • Meningitis
    • Presence of neonatal risk factors
    • Head trauma
    • Stigmata (physical or mental characteristic left by disease)
    • Ototoxic medications
    • Exposure to loud sounds
    • Neurological disorder
    • Childhood infectious diseases associated with hearing loss (e.g. mumps, measles)
Possible Signs of Hearing Loss:
    • People have to raise their voice to get the child’s attention
    • Inconsistent response to sound, sometimes hearing it and other times not
    • History of ear infections, often getting earaches or ear drainage
    • The child watches the speaker’s face carefully (at any age)
    • The child turns his head so that one ear is facing the direction of the sound source
    • Complaints of ears hurting
    • Preference for low pitch or high pitch sounds
    • Talking in a soft or loud voice
    • Turning the radio or TV up
    • Child does not use verbal language
    • Frequently asking for things to be repeated
    • Answering questions with unrelated answers
    • Inattentive at home or school
    • Easily distracted or bothered by background noise
    • Problems with spelling and phonics
    • Difficulty telling one sound from another
    • Problems following auditory directions
    • Language problems, including sentence structure, vocabulary, and word formation
    • Child has trouble with articulation (pronunciation)
    • Confusing words that sound alike
    • Overactive, aimless behavior
    • Aggressive or destructive behavior
    • The child is withdrawn or out of touch with their environment
    • Excessive fears or anxieties
    • The child’s speech is below his or her age-level peers
Milestones of Typical Development:
  • 0 – 4 months: Stops movement or quiets in response to speech or unfamiliar noises. Startles to loud sounds. Moves eyes toward sound sources. Rouses from light sleep to sudden loud noises. Imitates gurgling or cooing sounds and shows responses to noise-making toys. At 3 months, the child should be soothed by or respond to their mother’s voice.
  • 4 – 7 months: Begins to turn head towards sounds and voices out of sight (4 months), and turns head directly toward the sound source (7 months). Smiles in response to speech. Looks in response to own name. Begins babbling.
  • 7 – 9 months: Turns to find a sound source out of sight. Gurgles or coos to sounds out of sight. Intonation patterns heard in speech. Comprehends “no.” Babbles in multiple syllables. Makes some kind of response to his or her own name. Responds to household sounds such as a spoon rattling in a cup, running water, the noise of a washing machine, or footsteps from behind. At 9 months, the child should engage in loud shrieking and sustained production of vowels.
  • 9 – 12 months: Acquires first true word. Imitates sounds. Looks at a common object when named. Responds to music. Understands simple commands. Uses his or her own voice to get attention. At 12 months, the child should imitate sounds and simple words.
  • 13 – 18 months: Uses sentence-like intonation. Perceives emotions of others. Uses 3–20 words. Uses all vowels and consonants in jargon.
  • 19 – 24 months: Uses more words than jargon. Asks questions by rising intonation at end of phrases. Comprehends about 300 words. Uses about 50 words. Produces animal sounds. Combines 2 words into phrases. Listens to simple stories. At 21–24 months, the child should localize directly to sounds, at all angles.

Early intervention is important to maximizing your child’s communication potential. Contact us today if you suspect your child may have a hearing loss.