Children's Hospital Colorado

Babies, Toddlers and Hearing Loss

Surprisingly, one of the most common birth defects in the U.S. is hearing impairment, affecting 1 to 6 children per 1,000. Luckily, if detected early and treated, it can be managed with minimal consequences.

Types of hearing loss

There are several categories of hearing loss. Most hearing loss present at birth (congenital) is called “sensorineural.” This means there is an abnormality of the inner ear or in the nerve that carries sensory information to the brain. Sensorineural hearing loss can be inherited or acquired.

What can cause hearing loss later in life?

The other broad type of hearing loss is conductive hearing loss. This means there is a disruption to the transfer of sound to the sensory system. This can occur from a blockage in the ear canal, fluid in the middle ear, or an abnormality of the small bones in the middle ear known as ossicles. In children, the most common cause of conductive hearing loss is middle ear effusion (fluid) due to an ear infection.

How does hearing affect my child's speech?

Hearing and speech go hand in hand. Without adequate hearing, speech is delayed and a child may never achieve normal speech and language development. Studies have shown that if not detected and rehabilitated early, hearing loss can lead to learning and social difficulties. Since 1993, 43 of 50 states have implemented mandatory hearing screening of newborns. This has allowed early detection of hearing loss with intervention via hearing aids or cochlear implants prior to the development of speech.

Since hearing loss is so common in children, recognizing the symptoms in your child is very important.

Age:  Your child should be:
Birth to 3 months old Startled by loud sounds; calmed by familiar voices; crying differently for different needs; making pleasure sounds
4 to 6 months old Localizing to sound; paying attention to music; chuckling and laughing; vocalizing excitement and displeasure
7 months to 1 year old Responding to name; recognizing words for common items; mimicking sounds; speaking one or two meaningful words around child's 1st birthday
1 to 2 years old Following simple commands; listening to simple stories; saying more words every month; putting two words together
2 to 3 years old Following two requests; using a word for almost everything; understood by familiar listeners most of the time
3 to 4 years old Hearing when called from a different room; hearing television or radio at same loudness level as you do; using four sentences at the same time that have four or more words

Hearing milestones for your child

Age  Your child should be
Birth to 3 months old Startled by loud sounds; calmed by familiar voices; crying differently for different needs; making pleasure sounds
4 to 6 months old Localizing to sound; paying attention to music; chuckling and laughing; vocalizing excitement and displeasure
7 months to 1 year old Responding to name; recognizing words for common items; mimicking sounds; speaking one or two meaningful words around child's 1st birthday
1 to 2 years old Following simple commands; listening to simple stories; saying more words every month; putting two words together
2 to 3 years old Following two requests; using a word for almost everything; understood by familiar listeners most of the time
3 to 4 years old Hearing when called from a different room; hearing television or radio at same loudness level as you do; using four sentences at the same time that have four or more words

Hearing loss can also occur later in childhood. If your child is not meeting these milestones, has any risk factors, or you have concerns, see your pediatrician or family physician for a hearing screening and possible referral for a full hearing test.

Read more about the Bill Daniels Center for Children’s Hearing at Children’s Hospital Colorado.


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