Signs a Child May Not Be Hearing Well, by Age

AudiologyOctober 6, 20266 min read

A child who is not hearing well may not react to sounds, may be slow to babble or talk, may not respond when called, or may often ask for things to be repeated. The signs look different at each stage of childhood, and they can be subtle, especially when only one ear is affected or the problem comes and goes.

If you notice any of the signs below, trust your instincts and arrange a pediatric hearing test. Children of any age can have their hearing tested, and a test gives a clear answer rather than guesswork.

Why can hearing problems be hard to spot?

Children are good at adapting. They may watch faces, follow routines and copy other children, which can hide a hearing difficulty. A child may hear some sounds but not others, for example hearing loud voices but missing quieter speech sounds. Temporary problems such as fluid behind the eardrum can make hearing vary from week to week. This is why patterns over time matter more than a single moment.

Signs to watch for, by stage

These are general warning signs, not a checklist for diagnosis. Every child develops at their own pace, but any of the following is a good reason to have hearing checked.

Newborns and young babies

Does not startle or blink at sudden loud sounds.
Is not soothed by a familiar voice.
Did not pass the newborn hearing screening, or the follow-up was not completed.

Older babies

Does not turn towards sounds or voices.
Does not respond to their name.
Babbling is limited, or stops after starting.
Seems more responsive to things they can see than to things they hear.

Toddlers

Uses few words or is not adding new words.
Does not follow simple spoken requests without gestures.
Does not point to familiar objects or people when they are named.
Prefers the television or tablet very loud, or sits very close to it.

Preschool children

Speech is hard for others to understand.
Often says "what?" or "huh?", or answers questions inappropriately.
Has difficulty following conversations in groups or noisy places.
Seems to ignore people, or only responds when looking at the speaker.

School-age children

Often asks for repetition or misunderstands instructions.
Seems inattentive or daydreams in class, or tires easily at school.
Struggles more in noisy classrooms or playgrounds.
Turns up the volume on devices, or complains of ringing in the ears.
A teacher mentions concerns about listening, attention or progress.

Signs that may point to an ear problem

Some signs suggest a middle ear issue such as an infection or glue ear, which is common in young children:

pulling or rubbing at the ears, or complaining of earache;
hearing seeming to change after a cold;
balance problems;
fluid or discharge from the ear.

Ear infections can cause temporary hearing difficulty. Ear pain with fever or discharge should be seen by a doctor.

Is it hearing, attention or something else?

Hearing difficulty, attention difficulties and language difficulties can look similar, and they can occur together. A child who "only hears what they want to" may simply be busy, or may be missing quiet speech. A hearing test is often one of the first steps, because it rules hearing in or out and helps the next professional, such as a speech-language pathologist or doctor, know where to focus. If speech or language is a concern, see when to consider a speech and language assessment and signs of speech delay in children.

What happens at a child's hearing test?

The test is chosen to suit the child's age. Babies can be tested with methods that measure the ear's responses while they rest. Toddlers may turn towards sounds and be rewarded with a lighted toy. Preschool children often do a listening game. A gentle check of the middle ear may also be done. Results are explained to parents, along with any next steps. Our pillar guide to children's hearing explains each stage in more detail.

You can book an appointment when you are ready.

When to see a specialist

Arrange a pediatric hearing test if you notice any of the signs above, if your child did not pass or missed the newborn screening, or if speech and language seem behind. It is also sensible to check hearing after repeated ear infections or if a teacher raises concerns.

See a doctor promptly if your child has ear pain with fever, discharge from the ear, or a sudden change in hearing. You can book an appointment online or contact us if you are unsure where to start.

Frequently asked questions

My child passed the newborn screening. Can hearing still change?

Yes. A pass at birth is reassuring, but some hearing loss develops or becomes noticeable later, and temporary problems such as fluid behind the eardrum are common in young children. If you notice signs of hearing difficulty at any age, arrange a hearing test.

Could it be attention rather than hearing?

It could be either, or both, because the signs can look similar. A hearing test helps separate the two by showing whether your child is hearing sounds clearly. If hearing is normal, other professionals can then look at attention, language or other factors.

Who should I see first?

If your main concern is how your child hears or responds to sound, a pediatric hearing test is a practical first step, and no referral is needed. If there is ear pain, fever or discharge, see your child's doctor first. Speech or language concerns may also involve a speech-language pathologist.

Sources

This article is general information and does not replace advice from a qualified professional.

Children's Hearing Tests & Assessment Ashfeera Ashraf