When it's time to leave the playground for a nap or lunch, you might wonder if your child is ignoring your calls to head your way. But what if she's not trying to squeeze in more fun in the sandbox but instead can't hear what you're saying? 

Or maybe your toddler doesn't turn the first time you call her from across the room, or you notice she seems to ignore you when there's noise around.

While almost all children in the U.S. have a newborn hearing screening just after birth, some kids can develop hearing loss later on. Hearing loss can happen at any age for different reasons, though fortunately when identified early, there are ways to address it so that your child can continue to grow her language and learning.

If you suspect your child isn't hearing well, it's important to connect with a professional as soon as possible. Your pediatrician or an experienced audiologist can assess your child's hearing and recommend the right treatment for a particular hearing problem.

Here's more about hearing loss in children, including types of hearing loss, causes, and ways to manage it.

What is hearing loss in children?

Hearing loss can range from a mild impairment in a child's ability to hear to a significant or total loss of hearing. 

Hearing loss can be temporary and medically treatable, including a physical defect or problems with the middle ear. It can also be permanent and may be genetic in nature or of unknown origin.

Types of hearing loss in children

There are various types of hearing loss seen in children, including:[1]

  • Conductive hearing loss. This auditory issue is due to a structural abnormality in the outer ear canal or the middle ear. Wax build-up in the canal, fluid in the middle ear (either because of ear infections or something else), or problems with the tiny ear bones can also cause conductive hearing loss.
  • Sensorineural hearing loss. Caused by a malformation in the inner ear or the nerves that carry sound, sensorineural hearing loss is also called nerve deafness. This hearing loss in children may show up at birth or later and is very often genetic. It may also result from certain drugs or infections in pregnancy like toxoplasmosis or rubella.
  • Mixed loss. A combination of conductive and sensorineural hearing problems is called mixed loss.
  • Central loss. This type is due to a damaged section of the brain that controls hearing.
  • Auditory processing disorder (APD). When kids can’t understand what they hear, they may have APD, which affects 3 to 5 percent of children. APD kids can hear well, but their ears and brain don’t work in concert so they have trouble processing speech.

What causes hearing loss in children?

A variety of issues can impair hearing in children, and the cause is sometimes unknown. There are also certain conditions that may make hearing loss in toddlers and babies more likely, including the following:[2]

Continue Reading Below

Read This Next

Easing Ear Infections in Babies and Toddlers
How to Clean Toddler Ears
When Do Babies Understand Directions and Commands?
Easing Ear Infections in Babies and Toddlers
How to Clean Toddler Ears
When Do Babies Understand Directions and Commands?
  • Close relatives with hearing loss or congenital ear problems
  • Premature birth or a stay in the NICU
  • Severe jaundice as a newborn that required a blood transfusion
  • Exposure to extremely loud sounds or a head injury
  • A perforated eardrum
  • Chronic ear infections
  • Infections such as meningitis or cytomegalovirus (CMV)
  • Ototoxicity, which is hearing loss due to certain medications
  • Birth complications like a lack of oxygen, Rh factor in the blood or maternal diabetes
  • Illnesses like measles, mumps, chicken pox, encephalitis or influenza

Signs of hearing loss in children

Hearing loss is often a silent problem in that it may not be as obvious as other childhood conditions. If you’re wondering how to tell if a child has a hearing problem, it’s smart to brush up on the possible symptoms.

Here’s a breakdown of the signs of hearing loss in children by age:[3]

Signs of hearing loss in babies

A baby with hearing loss might not:

  • Startle or jump at loud noises by 1 month 
  • Turn to sounds by 3 or 4 months
  • Repeat babbled sounds like "ooh" and "aah" by 6 months
  • Recognize you by sound — only when she sees you in person
  • Vocalize or coo

Signs of hearing loss in toddlers

A toddler with hearing loss may: 

  • Have very limited, delayed or difficult-to-understand speech
  • Have no words at all by 12 to 15 months
  • Not speak five to 10 words by 18 months
  • Not seem to hear, follow directions or reply when spoken to
  • Not hear the TV at a normal volume
  • Hear some sounds but not others (not hearing whispers is a red flag)
  • Be easily frustrated when there's noise in the room
  • Turn her "good" ear toward you to hear better
  • Rarely sing or dance when music is played
  • Have balance issues and unsteadiness that may affect sitting and walking

When is hearing loss diagnosed in kids?

In most U.S. states and territories, newborn screenings at the hospital (in the first 24 to 48 hours after birth) include hearing tests among other important checks.

If this isn’t the case where you live or you gave birth at home, you should request a newborn hearing screen at your pediatrician's office in the early weeks. 

If your infant fails the hearing screening, she should get a follow-up screening as soon as possible. Urgent follow-up to a failed hearing screening is important for your child’s development. 

The American Academy of Pediatrics (AAP) recommends testing all infants by 1 month of age for hearing loss. The reason: The sooner a hearing loss is identified, the earlier your physician can begin medical treatment or, in the case of permanent hearing loss, the earlier your child can be fit with the appropriate hearing device.

When children are identified early (within three to six months) and receive the right treatment, the more successful they will be reaching their developmental milestones. 

Your child will also take hearing tests at well visits when she's 4, 5, 6, 8 and 10 years old, again at the preteen and teen years and any time you’re concerned about hearing problems.

How is hearing loss diagnosed in kids?

There are two types of hearing tests for babies that measure response to sound:

  • An auditory brainstem response (ABR) takes place when your baby is asleep and consists of clicks or tones played into her ears via little headphones.
  • An otoacoustic emissions test measures the ear’s sound waves with a tiny probe in the canal. Babies can be awake for this type of hearing test.

Toddlers and older children can participate in a test called behavioral audiometry, which checks hearing levels and how the eardrum is working. Your practitioner will give your child a set of soft earphones to wear and play a series of sounds and words for her to respond to.

Treatment options for hearing loss

Because hearing loss in kids affects speech and language development, it’s vital to treat the issue on multiple fronts as quickly as possible. 

Early educational intervention services can start from birth to 36 months, and they're available in each state through the Individuals with Disabilities Education Act. Older kids (3 and up) may also qualify for special education programs in school to address delayed learning.

Technological and medical treatments for hearing loss in kids depend on the severity, the potential causes, and the type of hearing difficulty your child has. These are the most common treatment options:[4]

Ear tubes

Mild hearing loss due to fluid in the middle ear may clear on its own or with the help of medications. But if fluid continues to pool and the loss doesn’t get better in three months, a doctor may recommend surgically inserting ear tubes through the eardrum under anesthesia.

Not only do the tubes reduce fluid and cut back on ear infections, but hearing will also improve if excess fluid was the cause.

Hearing aids 

A hearing aid amplifies the important sounds of speech that are important for your child’s development. Children today are initially fit with behind-the-ear style hearing aids. For kids who have conductive or mixed loss, bone-anchored devices may be appropriate.

Your audiologist may recommend a frequency modulation (FM) system, which improves the sound when there is a noisy environment. It works when the speaker wears a tiny microphone and transmitter that sends a signal to the child who has a wireless receiver on her hearing device.

Cochlear and auditory brainstem implants

Unlike hearing aids, these devices do not make sounds louder; cochlear implants send sound signals directly to the hearing nerve, while auditory brainstem implants stimulate hearing pathways in the base of the brain. They're often best for children with severe to profound hearing loss.

Both implants have two components: one in the inner ear or at the base of the brain and another partner piece worn on the outside of the ear. These are most helpful when placed by age 1, rather than later (after age 3). 

Corrective surgery 

If your child has conductive hearing loss caused by a malformed outer or middle ear, surgery can potentially improve or even correct this anatomical problem. You'll likely consult with an ear, nose and throat doctor (ENT) if that's the case.

Communication options

With advances in medical treatment and hearing technology available to infants and young children today, your baby can achieve the goals you have for her. Your pediatrician, pediatric audiologist or early interventionist can guide you in the steps to take to achieve these outcomes. 

You may hear the terms listening and spoken language (LSL) or auditory-verbal therapy (AVT) as an approach to listening and talking. Other communication methods could include lip reading or American Sign Language (ASL). Whatever your chosen goals, you’ll need to begin as soon as possible. Your practitioner can provide information to help you make the choice that is best for your family.

The key to getting your child the help she needs is early diagnosis, which makes a huge difference. Remember, call your doctor ASAP if you suspect a hearing problem and learn as much as you can about the outcomes possible today in the event your child has a long-term hearing problem.


Hearing Loss in Children FAQs

Conductive hearing loss is the most common type of hearing loss in children. It often develops after birth and is usually caused by a blockage to the outer or middle ear. That, in turn, stops sound waves from reaching the inner ear, which results in hearing loss in the child.

Your child's hearing develops during pregnancy, when your baby is a fetus in utero, and should be fully functioning at birth.

Yes, hearing loss can sometimes be reversed in children. If the hearing loss is very mild or temporary, the problem may go away by treating an ear infection or removing excess ear wax from a child's ear. More serious or permanent hearing loss can often be managed with hearing technology, usually in the form of hearing aids for children.

Some of the most common warning signs that your toddler may have hearing loss include not responding when spoken to, not reacting to loud noises, muffling sounds and speech, not saying some basic words, and having a hard time understanding words.