Universal hearing testing for newborns has helped to identify most children with hearing issues quickly and accurately. With a simple test, 80 to 90 percent of hearing loss can be detected, and children can begin early intervention with the best possible outcomes for language development.

“Even if your child passed the newborn screening at birth, however, keep in mind that hearing loss that is genetic or progressive in nature can manifest when your child is a toddler or older,” says Dr. Barbara Jenkins, an audiologist and writer of this article, with Hearing Health Magazine. “It’s important to identify signs that may suggest possible hearing loss in your child, so that testing can be done and treatment and management undertaken.”

The infant and young child

Delayed or absent speech development is the most important clue indicating a possible hearing loss in the very young child. Identifying hearing loss in the infant and young child requires watching for critical developmental milestones.

Use the following milestones from Hearing Health Foundation as a guideline, and always discuss any concerns with your pediatrician.

* By 3 months, your baby recognizes and quiets to your voice, makes cooing noises, and is startled by sudden, loud noises.

* By 6 months, your baby recognizes speech sounds and familiar voices, turns his head toward interesting sounds, plays with his own voice, and laughs. Your baby uses his voice to indicate pleasure and discomfort, and has speech-like conversations with caregivers.

* By 9 months, your baby can understand simple words like “mommy,” “daddy,” “no,” “bye-bye” and his own name.

* By 10 months, your baby’s babbling should sound speech-like with strings of single syllables (“da-da-da-da”).

* By 12 months, one or more real, recognizable spoken words emerge.

* By 18 months, your toddler should understand simple phrases, retrieve familiar objects on command (without gestures), and point to body parts when asked, “where’s your … ears, nose, mouth, eyes,” etc. Your toddler has a spoken vocabulary of between 20 to 50 words and short phrases (“all done,” “go out,” “mommy up”) and is learning new words each week.

* By 24 months, your toddler’s spoken vocabulary should be 200 to 300 words and simple sentences can be spoken. Adults not with your child on a daily basis can understand your child’s speech. A toddler at this age should be able to sit and listen while being read books.

The older child

Children who have developed speech skills are more difficult to identify. Use these guidelines from Hearing Health Foundation to discern a possible newly acquired hearing loss.

1. Your child seems to hear fine some of the time and then not respond at other times.

2. Your child wants the TV volume louder than other members of the family.

3. Your child says “what” more often than he used to.

4. Your child moves one ear forward when listening, or he complains that he can only hear out of his “good ear.”

5. Your child’s grades fall, or his teacher notes that he doesn’t seem to hear or respond in the classroom as well as other children.

6. Your child says that he didn’t hear you. This may seem obvious, but many parents assume that their children are not paying attention when in fact there may be an unidentified hearing loss.

7. It seems as though your child is just not paying attention.

8. Your child starts to speak more loudly than previously.

9. Your child looks at you intently when you speak to him. He may be depending more on visual cues for interpreting speech.

10. You just have a feeling. Sometimes you just can’t put your finger on what your concern is. Don’t let that stop you. Ask your child’s doctor for a referral to ease your mind.

There are many possible causes of acquired hearing loss that present themselves months or years after birth. Most hearing loss in children without obvious risk factors (such as premature birth) has a genetic cause. If you have any concerns, contact your pediatrician for a referral to a hearing health care provider for a complete hearing evaluation.

To learn more about genetic hearing loss, visit Hearing Health Foundation to read the Summer 2012 issue of Hearing Health magazine, available online at hearinghealthfoundation.org/hearing-health-magazine.  To learn more about the types of newborn hearing screenings and the importance of early detection and early intervention, visit hearinghealthfoundation.org/newborn-screening-information.