Infants and children can have temporary or permanent hearing loss that may vary from slight to profound in its severity.

The most common reason for hearing loss in children is middle ear inflammation (otitis media), or blocked ear canals. This may or may not be due to infection but, infectious or not, it interferes with the conduction of sound to the inner ear. This problem is called "glue ear" if there is a long term build up of thick or sticky fluid behind the ear drum; there may even be visible secretions leaking from the ear.

However, a smaller number - up to 170 babies every year in New Zealand - are born with permanent congenital hearing loss.

It is important to detect all hearing loss as early as possible, ideally in the first few months, as an infant's inability to hear can affect learning, concentration and communication. Currently, many of these children with hearing problems are not picked up until about three years of age. (See panel on Newborn Hearing Screening at the end of this topic.)

Research from the New Zealand Ministry of Health shows that if hearing loss is diagnosed early, by recognising this and making use of the options to restore a child's hearing, the child is likely to have improved language, learning and social development.

Test your child's hearing

As a parent, you are the person most likely to notice if your child has a hearing problem. The sooner you discover this, the sooner your child can be tested further and treated if necessary.

The checklist below - which is only a guide - can alert you to potential problems with your child's hearing. If you are worried, print out the checklist, take it to your doctor or nurse and ask about getting your child's hearing tested.

Six weeks: When there is a sudden loud noise, does your baby…

• jump or blink
• stir in their sleep
• stop sucking for a moment
• look up from sucking
• cry?

Three months: Does your baby…

• blink or cry when there is a sudden noise
• stop crying or sucking when you talk
• wake or stir to loud sounds
• coo or smile when you talk
• turn his or her eyes toward voices
• seem to like a musical toy
• stop moving when there is a new sound
• seem to know your voice?

Six months: Does your baby...

• turn toward a sound or someone speaking
• smile when you talk
• cry when there is a sudden noise
• stop moving when there is a new sound
• like music
• make lots of different babbling sounds?

Nine months: Does your baby...

• respond to his or her own name
• look around to find new sounds, even quiet sounds
• understand 'no' and 'ta-ta'
• listen when people talk
• like copying sounds
• use babbling that sounds like real speech
• try to talk back when you talk?

Twelve months: Does your child…

• point to things and people he or she knows when asked to
• copy and repeat simple words or sounds
• try to talk
• understand phrases such as 'come here'
• say two or three words
• listen when people talk
• do what he or she is told
• say sentences with two words, like 'me drink'
• know a few parts of the body
• do one thing when asked, such as 'get your shoes'
• ask for things by pointing, trying to say the word
• understand things like 'give me that', or 'don't touch'?

Two years: Does your child…

• do two things when asked, like 'get the ball and bring it here'
• repeat what you say
• know lots of words
• like being read to
• point to a picture when asked, like 'show me the baby'
• use the names of people and things she or he knows
• have a name for himself or herself
• like the radio or stereo
• say simple sentences, like 'milk all gone'?

Three years: Does your child…

• know a few nursery rhymes or songs
• understand most words
• find you when you call from another room
• sometimes use whole sentences
• use words like go, me, in, and big
• tell a story
• say how she or he feels
• remember and tell about things that have happened
• count to three
• speak clearly so that everyone can understand him or her
• ask lots of 'why' and 'what' questions
• like naming things she or he sees and knows?

At five years, does your child…?

• tell a long, clear story about things they have done?
• speak well, with only a few sounds mispronounced, like 'r' or 's'?
• know what things are for (such as a hat, apple or plate)?
• like books and being read to?
• understand most of what you say?

Talk to your nurse or doctor if you think your child is not hearing well.

(Checklist from The WellChild/Tamariki Ora Health Book)

Original material provided by WellChild/Tamariki Ora, The National Screening Unit and the National Foundation for the Deaf Inc. Reviewed and edited by everybody, June 2008