It’s a familiar scene: a bright, engaged toddler goes off to pre-K and shortly thereafter becomes sullen and withdrawn, even at home. His teacher calls his parents to suggest that he may have developmental problems. He is socially awkward and often seems distracted and confused. His language skills are not on par with other children his age.

Symptoms of Hearing Loss

In situations like this, the first thing a parent should do is have the child’s hearing tested. All of the symptoms mentioned above can indicate a hearing problem. Behavioral and communicative skills are greatly influenced by a child’s ability to hear. Hearing impairment can also cause difficulties in reading, spelling, math, and problem solving.

Socially, children with hearing loss may experience feelings of isolation, embarrassment, and helplessness. They are sometimes bullied and called “slow” or “stupid.” Over time, this leads to feelings of inferiority, avoidance of group activities, and, in some cases, hostility or antisocial behavior.

These symptoms usually don’t appear until the child enters school, as his hearing may be adequate for one-on-one communication at home, but not good enough to decipher directions given in a noisy classroom. Or, the hearing problem may be a recent development, perhaps following an ear infection. The important thing to do at this stage is to test the child’s hearing and, if a hearing loss is detected, take prompt action to treat it.


There are four categories of hearing loss in children — mild, moderate, severe, and profound. Treatments vary according to the type. Overall, there are two factors that contribute the most to helping children make maximum use of their residual hearing:

  1. Provide hearing assistance through the use of technology, such as hearing aids, cochlear implants, or FM systems.
  2. Enhance the child’s acoustic environment to make it more favorable to hearing, usually by eliminating or reducing background noise.

Mild Hearing Loss

When children with mild hearing loss receive hearing aids, their school performance usually improves, along with their social abilities. Most attend regular schools and, depending on their age when the hearing impairment was discovered, are able to progress along with their peer group. It can also be helpful to provide these children with a supportive, appropriately trained coach, meant to help them learn to interpret social signals, focus their attention, and employ other compensatory behaviors that supplement their hearing.

Moderate Hearing Loss

Children with moderate hearing loss can hear speech clearly only when the sound source is very close to them (about two feet away at most). These children require hearing aids for the development of understandable speech. Those who receive hearing aids before they are four years old are the most likely to show rapid progress in learning speech. Reducing noise in the learning environment is also helpful to this group. Children with moderate hearing loss can usually attend regular schools, but many will need special help to keep pace with their classmates.

Severe Hearing Loss

Children with a severe hearing loss do not perceive speech, no matter how close they are to the speaker, and will not learn to speak intelligently without hearing aids and special help.

The earlier a severely impaired child receives hearing aids, the better chance they will have of developing useful speech. A child who does not receive hearing aids until age six or older may never develop clear speech, and may also never develop the ability to understand the speech of others.

All children with severe hearing loss require special help, because even with hearing aids, they receive only a portion of the clues necessary to easily understand another’s speech. Sometimes these children can learn to use their eyes to supply the details that they miss. For instance, by using lip reading and listening together, those with severely impaired hearing may receive about half of the clues that fully hearing people use to understand speech.

Profound Hearing Loss

Children with profound hearing loss receive almost no auditory information. As with all levels of hearing impairment, the younger a child is when he receives hearing aids, the greater his chances of developing speech. Some of the children in this group may also be helped by a cochlear implants, which is a surgically inserted, electronic device that generates sound signals to the auditory nerve, similar to the way that a healthy inner ear functions. Children with a profound loss often depend greatly on their vision to perceive speech.

How to Get Help

If you suspect that your child is hearing impaired, ask your pediatrician to refer you to an audiologist for a hearing test. If your child does not have a pediatrician, call the local office of your state or city health department. Many clinics and hospitals offer hearing screenings, so don’t delay in getting this very important test for your child.