The earlier you identify and address a child's hearing loss, the less serious its impact will be.

By Jennifer Wilson
March 03, 2014

Hearing loss can happen when any part of the ear is not working correctly. The Centers for Disease Control and Prevention (CDC) estimates that 1 to 3 children per 1,000 have hearing loss. Additionally, 5 per 1,000 children between ages 3 and 17 have mild to severe hearing loss. If you suspect your kid has a problem hearing, see your health-care provider right away. Kids can be tested for hearing loss at any age. If they do have a problem and it's caught early enough, they can develop communication and social skills on par with those of hearing kids.

Close up of baby's ear
Credit: JGI/Jamie Grill/ Getty Images

How Children Respond to Sound

It helps to know how kids respond to sound at different ages so you can recognize a hearing problem.

The American Speech-Language-Hearing Association (ASHA) outlines these hearing milestones:

Birth to 3 Months

- Startles to loud sounds

- Quiets or smiles when spoken to

- Seems to recognize your voice and quiets if crying

- Increases or decreases sucking behavior in response to sound

4 to 6 Months

- Moves eyes in direction of sounds

- Responds to changes in your voice's tone

- Notices toys that make sounds

- Pays attention to music

7 to 12 Months

- Likes games such as peekaboo and pat-a-cake

- Turns toward direction of sounds

- Listens when spoken to

- Recognizes common words (cup, shoe, book, milk)

- Begins to respond to requests ("Come here," "Want more?")

1 to 2 Years

- Points to a few body parts when asked

- Follows simple commands ("Bring the ball," "Kiss the baby")

- Understands simple questions ("Where's mama?")

- Listens to simple stories, songs, and rhymes

- Points to pictures in a book when named

If you have concerns after reviewing these milestones, talk with your doctor about a hearing evaluation. The earlier that hearing loss occurs in a child's life, the more seriously it can affect development, according to ASHA. In the same way, the earlier you identify and address a child's hearing loss, the less serious its impact will probably be.

When to Test Hearing

Most hospitals screen hearing shortly after a baby is born, says Anne Oyler, Au.D., associate director for audiology professional practices for ASHA. The screening is easy and painless and lasts only a few minutes. "If your baby fails the hospital hearing screening, you'll be referred to a pediatric audiologist, or hearing doctor, for a more thorough test," she says.

Babies younger than 6 months of age can be evaluated with auditory brainstem response (ABR) testing, usually done when your baby is asleep in the examination room. Sensors are taped to the baby's head. Soft sounds play through earphones, and the response of the auditory (hearing) nerve is recorded.

This test can take up to two hours to complete. It may require a few visits, but the test should be completed before your child is 3 months old, after which children often require sedation so they will stay still during testing.

For children older than 6 months, audiologists can also use behavioral tests, carefully observing responses to different pitches in sound in a special sound-treated room.

"Kids who are old enough to cooperate for testing should be well-rested, relaxed, and ready to play," says Dr. Oyler.

Even if your baby passes that first hospital hearing screening, hearing loss can develop later in his life. Your child should be routinely screened for hearing loss during well visits.

Talk to your pediatrician if your instincts suggest that you should be concerned about your child's hearing. ASHA notes these indicators of hearing loss in kids:

- Inconsistently responding to sound

- Delayed language and speech development

- Unclear speech

- Turns volume high on electronic equipment

- Does not follow directions

- Often says "Huh?"

- Does not respond when called


According to the CDC, services for children with hearing loss are available through local early-intervention agencies or your public school. To find your state's contact information, call the National Dissemination Center for Children with Disabilities (NICHCY) at 1-800-695-0285.

Ear Infections and Hearing Loss

Most children will have their one and only ear infection during the first year of life, says Dr. Oyler, though some kids continue to have ongoing infections later in childhood.

If kids have recurrent ear infections or ones that are resistant to antibiotics, they may need surgery to insert pressure-equalization tubes into the eardrums.

"Most hearing loss from ear infection is temporary and resolves when the infection clears up," says Dr. Oyler. "But chronic untreated ear infections can lead to permanent hearing loss, so it's really important to take your child's ear infections seriously."

Dr. Oyler says signs of hearing loss due to ear infections include tugging or pulling at the ear, trouble sleeping, ear drainage, crying more than usual, fever, or not responding to sounds.

If your child's ear infection doesn't seem to be clearing up, and you're seeing these signs, call your health-care provider.

Protecting Those Ears

Start protecting and preserving your family's hearing early, says Dr. Oyler. "Parents should practice and model safe listening behaviors for their kids." Wear ear protection during noisy activities such as concerts and lawn-mowing. Get kids used to wearing earmuffs when they're in a noisy place.

Each year, right before the holidays, the Sight and Hearing Association publishes a list of the noisiest toys. Take note, and also listen to any toy before you purchase it. "Kids tend to hold toys very closely to their heads, which makes those sounds even louder," says Dr. Oyler.

As your kids get older, talk to them about protecting their hearing. Starting at age 5 or 6, kids love learning how their ears work and why we must protect them. Check out these sites that teach kids about noise:

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