Hearing Evaluation in Children

In the first few years of life, hearing is a critical part of kids' social, emotional, and cognitive development. Even a mild or partial hearing loss can affect a child's ability to speak and understand language.

The good news is, hearing problems can be treated if they're caught early — ideally by the time a baby is 3 months old. So it's important to get your child's hearing screened early and evaluated regularly.

Causes of Hearing Loss

Hearing loss is a common birth defect, affecting about 1 to 3 out of every 1,000 babies. A number of factors can lead to hearing loss, and about half the time, no cause is found.

Hearing loss can occur if a child:

• was born prematurely
• stayed in the neonatal intensive care unit
• had high bilirubin requiring a transfusion
• was given medications that can lead to hearing loss
• has a family history of childhood hearing loss
• had complications at birth
• had frequent ear infections; had infections such as meningitis or cytomegalovirus
• exposed to very loud sounds or noises even of brief duration

When Should Hearing Be Evaluated?

Most children who are born with a hearing loss can be diagnosed through a hearing screening. But in some cases, the hearing loss is caused by things like infections, trauma, and damaging noise levels, and the problem doesn't emerge until later in childhood. So it's important to have kids' hearing evaluated regularly as they grow.

Your newborn will likely have a hearing screening before being discharged from the hospital (most states require this). If your baby doesn't have this screening, or was born at home or a birthing center, it's important to have a hearing screening within the first 3 weeks of life.

If your baby does not pass the hearing screening, it doesn't necessarily mean there's a hearing loss. Because debris or fluid in the ear can interfere with the test, it's often redone to confirm a diagnosis.

If your newborn doesn't pass the initial hearing screening, it's important to get a retest within 3 months in order to start treatment right away. Treatment for hearing loss can be the most effective if it's started by the time a child is 6 months old.

Kids who seem to have normal hearing should continue to have their hearing evaluated at regular doctors' appointments. Hearing tests are usually done at ages 4, 5, 6, 8, 10, 12, 15, and 18, and any other time if there's a concern.

But if your child seems to have trouble hearing, if speech development seems abnormal, or if your child's speech is difficult to understand, talk with your doctor.

Symptoms of a Hearing Loss

Even if your newborn passes the hearing screening, continue to watch for signs that hearing is normal.

Some hearing milestones your child should reach in the first year of life:

• Most newborn infants startle or "jump" to sudden loud noises.
• By 3 months, a baby usually recognizes a parent's voice.
• By 6 months, an infant can usually turn his or her eyes or head toward a sound.
• By 12 months, a child can usually imitate some sounds and produce a few words, such as "Mama" or "bye-bye."

As your baby grows into a toddler, signs of a hearing loss may include: