How Does Your Child Hear and Talk?

Hearing & Understanding Talking
Birth-3 Months
  • Startles to loud sounds
  • Quiets or smiles when spoken to
  • Seems to recognize your voice and quiets if crying
  • Increases or decreases sucking behavior in response to sound
Birth-3 Months
  • Makes pleasure sounds (cooing, gooing)
  • Cries differently for different needs
  • Smiles when sees you
4-6 Months
  • Moves eyes in direction of sounds
  • Responds to changes in tone of your voice
  • Notices toys that make sounds
  • Pays attention to music
4-6 Months
  • Babbling sounds more speech-like with many different sounds, including p, b and m
  • Vocalizes excitement and displeasure
  • Makes gurgling sounds when left alone and when playing with you
7 Months-1 Year
  • Enjoys games like peekaboo and pat-a-cake
  • Turns and looks in direction of sounds
  • Listens when spoken to
  • Recognizes words for common items like "cup", "shoe," or "juice"
  • Begins to respond to requests (e.g. "Come here" or "Want more?")
7 Months-1 Year
  • Babbling has both long and short groups of sounds such as "tata upup bibibibi"
  • Uses speech or noncrying sounds to get and keep attention
  • Imitates different speech sounds
  • Has one or two words (bye-bye, dada, mama). although they may not be clear
1-2 Years
  • Points to a few body parts when asked.
  • Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.
1-2 Years
  • Says more words every month.
  • Uses some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?").
  • Puts two words together ("more cookie," "no juice," "mommy book").
  • Uses many different consonant sounds at the beginning of words.
2-3 Years
  • Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down").
  • Follows two requests ("Get the book and put it on the table").
2-3 Years
  • Has a word for almost everything.
  • Uses two- or three- word "sentences" to talk about and ask for things.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or directs attention to objects by naming them.
3-4 Years
  • Hears you when you call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Understands simple "wh" (who, what, where, why) questions.
3-4 Years
  • Talks about activities at school or at friends' homes.
  • Speaks clearly enough that people outside of the family usually understand his or her speech.
  • Uses a lot of sentences that have four or more words.
  • Usually talks easily without repeating syllables or words.
4-5 Years
  • Pays attention to a short story and answers simple questions about it.
  • Hears and understands most of what is said at home and in school.
4-5 Years
  • Makes voice sounds clear like other children's.
  • Uses sentences that give lots of details (e.g., "I like to read my books").
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Says most sounds correctly (except perhaps certain ones such as l, s, r, v, z, ch, sh, th).
  • Uses the same grammar as the rest of the family.

Communication Tips

Talk naturally to your child. Talk about what your child is doing, and what your child sees.

Take time to listen to your child. Respond to what is said so your child knows you have been listening.

Read to your child frequently. This is the time children begin to develop early reading and writing skills.

Don’t push your child to learn to talk. Accept some speech mistakes as your child develops. Don’t ask your child to slow down or repeat.

Have you child’s hearing tested if you find you have to repeat a lot or have to talk loudly to get your child’s attention.

Seek professional help from an ASHA-certified speech-language pathologist if you’re unsure. Never wait to get help for your child if you suspect a problem. You and your family members know more about your child than anyone.

Early identification and treatment of hearing, speech, and language disorders can prevent problems with behavior, learning, reading, and social interactions.

What should I do if I think that my child may have a speech, language, or hearing problem?

If you think your child may have a speech, language, or hearing problem, you can contact an:

Audiologist—audiologists are hearing care professionals who specialize in prevention, identification, and assessment of hearing and related disorders and provide treatment, rehabilitative services, and assistive devices.

Speech-language pathologist—speech-language pathologists (SLPs) help people develop their communication abilities as well as treat speech, languages, swallowing, and voice disorders. Their services include prevention, identification, evaluation, treatment, and rehabilitation.

Newborn Hearing Screening

It is Important to Have Your Baby’s Hearing Checked!

As many as 3 of every 1,000 babies are born in the United States each year with hearing loss. Your baby can’t tell you if he or she can’t hear. Babies who do not hear you voice, a lullaby or nursery rhyme may have problems learning to talk.

It is vitally important to have your babies hearing tested before you leave the hospital. Hearing problems need to be identified as early as possible so that you may take actions that give your baby the best chance to develop speech and language.

Why Should My Babies Hearing Be Screened?

Hearing loss is a hidden disability; that is why it is so important to have your babies hearing evaluated. Each year, more than 4,000 babies are born with hearing loss. Most babies born with hearing problems are otherwise healthy and have no family history of hearing loss. It is important for you to be sure that your baby has normal hearing. It is unlikely that your baby will have a hearing loss; however, the only way to know is to have your baby’s hearing tested as early as possible. The first year of life is critical to the development of normal speech and language.

How Will My Baby’s Screening Test Be Done?

There are two types of hearing screening test that may be used with your baby. Both tests are very safe and take only minutes to evaluate each ear. Most babies sleep through their hearing screening test.

Auditory Brainstem Response (ABR) tests the infant’s ability to hear soft sounds through miniature earphones. Sensors measure your baby’s brainwaves to determine if soft sounds can be heard.

Otoacoustic Emissions (OAE) are measured directly with a miniature microphone and sent to a special computer to determine your baby’s hearing status.

What if My Baby Does Not Pass the Test?

There are many reasons your baby may not “pass” the first hearing test and require a second evaluation. Perhaps your baby was too active, too wide-awake, or you were discharged from the hospital before the hearing test was completed.

It is important that you follow through with any recommendations made by your audiologist, hospital staff member and/or physician.

If My Baby Passes the Screening, Do I Need to Have the Hearing Checked Again?

Hearing screening test usually confirm that your baby has normal hearing. However, hearing problems in your baby can develop after you leave the hospital. If anyone in your family has hearing loss, your baby should be tested every year.

If you ever have concerns about your child’s hearing, speech or language, be sure to discuss them with your audiologist and/or physician.

Types of hearing tests for children

If you think a hearing loss may be present the first step is to ask your medical practitioner to refer your child for an audiological assessment. This assessment will determine whether a hearing impairment exists and to what degree. No child is too young to receive a thorough hearing evaluation and today’s technology allows testing of newborns.

Hearing screening

This is testing which can be carried out at any age. Hearing screening usually shows simply that a child’s hearing is not at a normal level. If a child fails a screening test, he / she will be referred for a more detailed assessment. In recent years the importance of hearing screening for infants has been recognized. There is now legislation in many countries recommending that all newborns are screened for hearing loss. When hearing loss is identified early appropriate support measures also can begin sooner.

Behavioral hearing tests These tests usually require the child to respond to soft sounds in some way (verbally, by picture pointing, raising the hand or through a “game”). These tests can be fun and for infants and toddlers, a head-turn response to a test signal is usually the best and most reliable testing method.

Auditory Brainstem Response (ABR)

For newborns or infants and children who cannot reliably perform the behavioral test procedures, other more objective tests, such as ABR, can help determine hearing abilities. Clicks or tonal “pips” are sounded in an infant’s ears through earphones. The ABR provides information about the function of the auditory pathway to the level of the brainstem. The response to the clicks or tones are recorded, providing an estimate of hearing sensitivity.

OtoAcoustic Emissions (OAEs)

These tests provide a unique way to examine the function of the cochlea. Sounds are sent to the child’s ear with a small loudspeaker. A microphone records the response to the sound from the cochlea (known as an emission). This offers valuable information about the sensory hair cells in the cochlea.

Tympanometry (acoustic immittance testing)

This test helps determine how well the eardrum and middle ear are working. A gentle puff of air is delivered into the child’s ear and the amount the eardrum moves in response to change in air pressure is recorded. If the eardrum does not move, for example, it could mean there is fluid behind the eardrum and otitis media with effusion may be present.

The Hearing Doctor, your Tulsa Audiologist, can answer your questions about pediatric hearing.