The ability to communicate is a valued possession. The earlier the condition is professionally evaluated, the better the chances for successful treatment.

Hearing Loss in Children

Signs of a Hearing-Loss Problem
Signs of Hearing Loss in Older Children
Signs of Hearing Loss in Adults 
Signs Speech-Language/Hearing Problem
Speech, Language and Listening Milestones
 
Signs of a Hearing-Loss Problem

Hearing loss can occur at any age. It is often such a gradual process that the person with the impairment is the last one to realize there is a problem. If you think you or a family members has a hearing problem, consult a hearing health professional and arrange to be tested as soon as possible.

Many types of hearing loss are only temporary and can be treated by your hearing health professional. Other types of hearing loss are permanent but still can be improved with the proper hearing aid and training.

If you answer “no” to any of these questions, have your child’s hearing tested. Early detection of a hearing problem is important to your child’s proper development.

- Birth to 3 months: Is your baby startled by sudden loud sounds?

- 3 to 6 months: Does your baby respond to your voice? Does your baby enjoy rattles or other noise-making toys?

- 6 to 12 months: Does your baby respond to his or her name?

- 12 to 18 months: Does your baby understand “No” or “Bye-bye”? Can your baby imitate simple words or sounds?

- 2 years: Can your child point to familiar objects when you ask? Has your child started to talk?

Signs of Hearing Loss in Older Children


If you answer “yes” to any of the following questions, a hearing test is suggested.

- Does your child have problems paying attention in school?

- Does your child have a problem understanding if you speak from behind?

- Do you think you child can hear, but only when he or she wants to hear?

- Do you think your child speaks too loudly?

Signs of Hearing Loss in Adults

If you answer “yes” to any of these questions, you should have your hearing tested.

- Do you think other people mumble or speak too softly?

- Do you hear better with one ear than with the other?

- Do friends and family tell you that they have to repeat things for you?

- Do you have difficulty hearing when you are with a large group of people?

- Do people complain that you turn up the TV too loudly?

- Have you ever said, “I can hear you; I just didn’t understand what you said?”

- Do you avoid certain activities because it is too difficult to hear?

Signs of a Speech-Language or Hearing Problem

Speech problems in children may be evidenced by delayed development in comparison to other children of the same age. Lack of clear, concise communication may indicate a problem. Hearing disorders in children may be forewarned by an infant’s failure to react to noises and failure to follow simple commands by age two.

In adults, sound distortion and lack of clarity or a subdued quality in the sounds may indicate a hearing problem.

Voice problems in adults may be shown by persistent huskiness or coughing.

Speech, Language and Listening Milestones


Birth to 3 Months

  • Reacts to sudden noises by crying or jerking body
  • Reacts to familiar objects, such as a bottle, or familiar people such as parents
  • Differentiates the cry of pain from the cry of hunger
  • Coos, begins to form prolonged vowels with changes in intonation (“Ahhhhh-AH-ahhh!)
  • Watches objects intently


3 to 6 Months

  • Begins to babble, using syllables with a consonant and vowel (“baa-ba-BA-ba-ba!”) and uses intonation changes
  • Laughs and shows pleasure when happy
  • Turns the head to see where sound is coming from
  • Uses a louder voice for crying and babbling than before
  • Shows delight when bottle or breast is presented


6 to 9 Months

  • Begins to comprehend simple words such as no and looks at family members when they are named
  • Babbles with a singsong pattern at times
  • Controls babbling to two syllables, which sometimes sounds like words such as “Mama,” although meaning is, typically, not understood by the baby yet.
  • Understands facial expressions and reacts to them
  • Attempts gestures to correspond to a pat-a-cake and bye-bye
  • Shakes head to show no
  • Uses more and more sounds when babbling, such as syllables with da, ba, ka, pa, ma and wa


9 to 12 Months

  • Has fun imitating simple sounds and babbling
  • Begins to say “Mama” and “Dada” with meaning
  • Begins to understand that words represent objects
  • Jabbers loudly
  • Responds to music
  • Gives or seeks a toy or common object when requested
  • Imitates common animal sounds
  • Gestures and whines to request something
  • Looks directly at the source of sound immediately


12 to 18 Months

  • Understands 50 to 75 words
  • Uses 3 to 20 “real” words, even if not produced completely clearly
  • Points to known objects when named
  • Points to a few simple body parts, such as eyes and nose
  • Babbles and uses nonsense words while pointing
  • Follows simple one-step commands
  • Uses words like more, all-gone, mine and down
  • Imitates words
  • Pronounces some understandable words
  • Typical utterances at this age:


“Mama”
“No!”
“Daddy, doppit” (stop it)
“Appuh” (apple)
“Gimme da!” (give me that)
“Baw” (ball)
“Too-duh” (toothbrush)
 

18 Months to 2 Years

  • Comprehends about 300 words
  • Uses about 50 recognizable words, mostly nouns
  • Speaks with mostly “real” words now
  • Wants to hear the same stories over and over
  • Uses rising intonation pattern to show a question
  • Shakes head to answer yes/no questions (“Do you want more milk?”)
  • Follows two related commands (“Go upstairs and get your bottle.”)
  • Begins to use some verbs (go) and adjectives (big)
  • Joins two related words to make one word (geddown for get down or stoppit for stop it)
  • Starts to ask, “What’s ’at?” (what’s that)
  • Talks about what is happening now
  • Tells you his or her name when asked
  • Joins in nursery rhymes and songs
  • Speaks with many pauses between words
  • Typical utterances at this age:


“Dawddie bad!” (Doggie bad!)
“Go ‘way!” (Go away)
“No, Mommy.”
“See...horsey,... Daddy!”
“Danwit... goo’... Mommy.” (Sandwich good, Mommy.)
“Nigh’nigh’ now?” (Night-night now?)
“Go dore?” (Go store?)


2 to 3 Years

  • Understands about 900 words
  • Uses about 500 words
  • Pronounces words more clearly
  • Engages in eye contact during conversations with occasional prompting
  • Makes frustrations known more with words and less with temper tantrums and crying
  • Sits and listens to stories for 10 to 20 minutes
  • Identifies a boy and girl
  • Answers simple questions beginning with who, where, and what (“Who drives a firetruck”)
  • Understands prepositions such as in, on and so forth
  • Begins to ask yes/no questions (“It raining?)
  • Talks to self while playing
  • Begins to use function words such as is (“Ball is red”)
  • Begins to use past tense verbs (walked, kicked)
  • “Stutters” when excited sometimes
  • Pronounces these sounds consistently in words: m, n, p, f, b, d, h, y, m
  • Typical utterances at this age:


“Daddy’s tar...so big!” (daddy’s car so big)
“Mommy put dat downstairs?” (Mommy put that downstairs?)
“On no! My-my-my jeth iddirty!” (Oh no! My dress is dirty.)
“You wanna ‘nana, An Pat?” (You want a banana, Aunt Pat?)
“I doe wannit!” (I don’t want it)
“Mattchew’s yeg is beedin’!” ( Matthew’s leg bleeding)
“Duh wabbit eated duh cawit!” (The rabbit eated the carrot)


3 to 4 Years

  • Begins to use is at beginning of questions
  • Understands about 1,200 words
  • Uses about 800 words
  • Uses eye contact more consistently during conversations
  • Asks many questions, usually what or who questions
  • Understands time concepts such as morning, lunch time, tonight
  • Understands positional words such as in front, behind, up and down
  • Starts to use s on verbs to show present tense (he runs)
  • Uses contractions won’t and can’t
  • Uses and
  • Uses plurals consistently (books, toys)
  • Use are, or contracted form, with plural nouns (“Kids’re playing outside”)
  • Initiates conversations, making comments or observations
  • Asks many questions, sometimes the same one several times in a few minutes
  • Follows a simple plot in children’s storybook
  • Sits down and does one activity for 10 to 15 minutes
  • “Stutters” less frequently
  • Pronounces the beginning, middle and ending sounds in words, except for consonant blends (e.g., bl, fr cr)
  • Uses k and g sounds correctly, but s may still be somewhat “lispy” sounding; r and l may be distorted: v, sh ch, j and th still may not be used consistently
  • Typical utterances at this age:


“The bider its cwawlin’ up duh twee!” (The spider is crawling up the tree)
“Dad, the tiddy-tat breaked the diss.” (Dad, the kitty-cat breaked the dish.)
“Is Mom-Mom comin’ today?”
“Where’s the hop-sital?” (Where’s the hospital?)
“Yesterday my dog Wainbow ate six bixkits.” (Yesterday, my dog Rainbow ate six biscuits)

 

4 to 5 Years

  • Comprehends 2,500 to 2,800 words
  • Uses 1,500 to 2,000 words
  • Speaks clearly most of the time
  • Describes pictures with complete sentences
  • Makes up stories
  • Uses all pronouns correctly: he, she I, you, them
  • Describes what you do with common objects
  • Speaks in complex sentences that often run together
  • Uses past, present and future tenses of verbs (sit, sitting, sat, will sit)
  • Uses irregular verbs (drank, ate) and irregular nouns (men, children) somewhat consistently
  • Follows three-step commands
  • Explains events that took place in the past with accurate detail
  • Knows common opposites such as big/little, heavy/light
  • Plays dramatically and chats a lot
  • Repeats a sentence with 10 to 12 syllables
  • Listens and attends to stories, conversations, and movies
  • Mispronounces s, r, th, l, v, sh ch j and blends
  • Typical Utterances at this age:


“Daddy, I wanna go to Joey’s house after lunch ‘cause he’s got this great new truck I wanna play wif (with).”
“Is this your pocketbook? Could I thee (see) what you have inside it?”
“Do you have any gum in there?”
“I found all these wed (red) marbles on Jose’s floor, Mommy. Can I have them? I want to play with them for a little while.”
“Look at all those gwirrels (squirrels) runnin’ across the road!”
“Johnnie cutted the paper all up.”

 

5 to 7 Years: The Refinement Years

  • Refines pronunciation, sentence structure, word use, attention span for listening, and memory for directions
  • Increases vocabulary; incorporates new words into spontaneous speech
  • Retells stories: explains experiences more, in a cohesive, sequential manner and with greater elaboration
  • Participates in group discussions and takes turns in conversation; comments are more relative to topic being discussed
  • Begins to learn language relationships: opposites (big/little, sad/happy), synonyms (big/large, sad/unhappy), associations (bread/butter, pencil/eraser), and classification (shirt/pants/socks belong in the category of clothing)
  • Typical utterances at this age:


“Last week Daddy took me and Levonne to the Bronx Zoo.”
“You shoulda seen the monkeys and elephants!”
“She has ‘amonia and she’s really sick, so she has to stay in the hopsital for another week.”
When children begin school, language is translated into written symbols through spelling and comprehended through reading. Written words are developed into sentences and stories. Children whose oral language is deficient (beyond the typical errors a child of this age displays) are at risk for reading, writing and spelling problems. However, teachers are trained to teach children in a way that best suits their individual needs. So, although communication problems may present a challenge, they certainly can be managed with a little bit of teamwork, creativity, and patience!


7 Years to Adolescence

  • Possesses a functional and abstract language system
  • Shows age-appropriate skills in reading, writing, speaking and listening
  • Joins sentences to form coherent, descriptive thoughts and stories; listeners are not left confused
  • Masters word relationships (synonyms, antonyms, association, classification, etc.)
  • Pronounces multisyllable words correctly once practiced a few times
  • Comprehends information heard and read when adequately taught and explained
  • Understands and uses more idoms (pain in the neck, out of your mind)
  • Understands plots with increasing depth and complexity when read or watched in a movie or television show
  • Typical utterances at this age:


“Essentially, a child’s language at this age mirrors an adult’s, but with more simplicity.

These then are the milestones, the points of progress children should reach in their own style, at their own pace.