As a mom of three children under four, I spend a lot of time with fellow parents and caregivers. I am currently a stay-at-home mom but I have a background in audiology, so I’m often asked by mom friends about how they might know if their toddler has a hearing loss.
“She doesn’t listen to anything!,”
“He asks me to repeat myself,”
“My daughter has one volume, and it’s loud.”
These parents aren’t wrong to wonder, as any of these symptoms could indicate difficulty hearing. But the key thing to examine is the circumstances in which these behaviors are occurring.
Imagine you were in the middle of crafting an email and your partner came in and said “Hey, I’m in the mood for a sandwich. Let’s go to the deli and grab lunch!” You might be really focused on your word choice for said email and take a beat to even notice that he’s talking to you.
“Sorry, what?,” you say, after a moment of recognition that he’s standing there.
“I’m dying for an Italian sub. Let’s go to that new place up the street.”
You think to yourself, lunch sounds good, and I’ve been wanting to try that new spot. But I’m in the middle of something that I want to finish. “Okay,” you tell him. “Can we go in like fifteen minutes?”
“No,” he says emphatically. “I want to go now.”
Whoa, you think. What is with the urgency here? You ignore him for a moment, thinking maybe you can just give this email a quick read through and send it off.
“Hey! Are you listening? Let’s go get lunch!”
Now you’re getting annoyed. Can’t he see you’re in the middle of something?
“Are you ignoring me? I really want to get there before the lunch rush.”
You hold up a finger to indicate you need one more minute, and he stands there impatiently letting out loud sighs until you finally conclude your email and wait for the whooshing sound that indicates it has been sent off before clicking your laptop shut and agreeing to walk to the deli.
Now imagine this scenario again, except your toddler building a house out of magnatiles is you, and you are your partner.
It’s a silly example, and certainly the stakes seem higher for your email composition, but your child doesn’t see it that way. When they are focused on a task (or a screen, or a snack) and you come in and want them to switch gears to something else, their “not listening” behavior can present itself as an actual inability to hear you, in part because of the frustration of these situations.
Here are some simple ways you can think about your child’s hearing and listening behavior at home.
1. When they “don’t hear you,” are they in the middle of a task?
Are you asking them to do something desirable (eat ice cream) or undesirable (go to bed)? If there is a difference in their responsiveness, it isn’t a hearing problem.
2. How is their speech and language development?
This is probably the biggest indicator. We learn to speak based on our ability to hear, so if your child has normal speech and language it is highly unlikely that they have any hearing difficulties. (I say “highly likely” because recurrent ear infections or large amounts of earwax can cause temporary hearing loss.)
I find this chart to be quite useful when considering whether a sound is expected at a certain age. I like it because it represents that there is a wide range of “normal” and that some sounds are physiologically more complex for children to learn.
3. How is the volume of your child’s voice?
Are they modulating it to be (somewhat) appropriate with the environment/number of people around them/urgency of their request?
My middle daughter is two and I often feel that she is loud all of the time. But when I stop to think about it, she is often loud because she is seeking attention. When she is feeling calm and/or in a one-on-one she is able to speak at a normal conversational level.
4. Do other caregivers or important adults in your child’s life have concerns about their hearing?
If your child attends a daycare or nursery, or spends a lot of time with a grandparent or other caregiver, they will be quite attuned to hearing ability.
I have generally found that my children are on their worst behavior for me and are much better at nursery school, thus their teachers are not experiencing the absence of listening ability on the same scale that I am.
Getting Expert Help for Your Child's Hearing
If you are able to work through these items and feel that there is legitimate cause for concern, you should consult your child’s pediatrician. They can make a referral to a pediatric audiologist for a diagnostic hearing evaluation. Often these are quite fun for toddlers, as we make the hearing test into a game and there are lots of lights and sounds and stickers.
When I was a graduate clinician in audiology, I remember feeling that hearing loss was such a solvable problem. It wasn’t that I didn’t understand why parents would be devastated by a diagnosis, but just that it was an easy fix. Hearing aids or cochlear implants in cute bright colors, wear them all waking hours, magic!
I cringe about this now because I know the hopes and dreams we all place on our kids. We want them to be well, we want to eliminate as many obstacles for them as we can, and we want them to feel loved and accepted in the world. And I know that I can barely keep socks on my children, let alone hearing aids.
My loud two-year-old recently woke up one weekend morning and we noticed one of her front teeth was a bit gray. It became more pronounced over the next couple of days and a dentist ultimately confirmed that it was dead.
“Has she hit her head recently?”
I wanted to respond, “Yes, daily. She’s a toddler,” but I just shrugged noncommittally.
The anguish I have felt over one of my daughter’s baby teeth going gray is disproportionate to the reality that it does not cause her any pain or distress or really change her life in any way except that her cute smile is slightly less cute or, as the dentist described it, “unsightly.”
So while I have developed a great deal of empathy for parents of children with hearing loss, I feel that same confidence that I had as a graduate student about the ability of hearing aid and cochlear implant technology to work wonders for these children. Over 90% of children born with hearing loss are born to hearing parents, so it often comes as a shock. Pediatric audiologists are incredibly well-versed at the tips and tricks for navigating amplification and how it will grow with your child.
But before you panic and go down that road, you might want to whisper from the other side of the room, “Do you want to watch Bluey and eat ice cream?” and just see what happens.
Conclusion About Toddler Hearing Loss
In the end, if you find legitimate cause for concern, consulting your child’s pediatrician is the next step. A referral to a pediatric audiologist for a diagnostic hearing evaluation could provide added clarity.
It’s essential to remember that solutions for hearing loss have advanced significantly, and pediatric audiologists are well-equipped to guide you through any necessary interventions.
However, before leaping to conclusions, it might be worth testing the waters with a simple invitation to see if your child's attention shifts.
Also check out: Games To Play With Your Toddler When You're Tired AF
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