Everyday signs a child may benefit from a hearing evaluation

World Hearing Day (WHD) is observed every year on March 3 to raise awareness about hearing health across the lifespan. For children, hearing is closely tied to speech and language development, academic participation, and social engagement.

In many parts of the world, newborn hearing screening has significantly improved early detection. When implemented effectively, it can support earlier identification and access to timely intervention. However, screening does not reach every child. Some are born in regions without universal programs. Some families move between healthcare systems. And some hearing losses develop later, or progress gradually, after the newborn period.

That is why early identification is not only about screening programs. It also depends on recognizing patterns in everyday life and supporting families in seeking referral for comprehensive assessment when concerns arise.

Why early identification matters

The first years of life are an important period for auditory and language development. Consistent access to sound supports the building blocks for communication, including speech perception, expressive and receptive language, literacy, and social interaction.

Evidence from pediatric research suggests that earlier access to appropriate intervention is associated with stronger language outcomes compared to delayed identification.¹ While each child’s developmental path is unique, reducing delays between identification and intervention may support stronger communication outcomes.

When hearing loss is identified early, families can access support sooner. Depending on the child’s needs, this may include appropriately fitted amplification such as hearing aids or cochlear implants when indicated, family-centered counseling, and structured support across listening environments.

Pediatric expertise to support every step
Phonak supports pediatric hearing care through child-specific solutions and resources developed in collaboration with audiologists who work with children and families every day. This perspective helps translate early concerns into clear next steps, from referral and assessment to family counseling and ongoing support.

Why screening alone is not always enough

Even in countries with strong newborn screening programs, some children may still be missed. Hearing loss may be mild, progressive, late-onset, or acquired after infancy due to illness or other factors.

As children grow, listening demands increase. Background noise becomes more prominent. Instructions become more complex. Classroom conversations move quickly. For some children, hearing challenges may become more apparent during these increasingly demanding listening situations. Ongoing vigilance beyond infancy remains essential.

Practical signs to watch for

These signs do not confirm a diagnosis. However, when reported consistently by caregivers or educators, they should prompt further questioning and consideration of comprehensive audiological assessment.

Infants (0–12 months)

Many infants with hearing loss begin babbling. One possible early sign is when babbling starts but does not progress as expected, or seems to diminish over time.

Other observations may include:

• Does not consistently startle to loud, sudden sounds
• Does not reliably turn toward voices or sound sources, particularly by around 6 to 9 months
• Babbling is limited, changes noticeably, or does not continue to develop
• Appears to rely heavily on visual cues

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Toddlers and preschool-aged children

At this stage, caregivers may report that communication seems different from peers or that the child misses spoken information unless face-to-face.

Signs can include:

• Speech and language developing more slowly than expected
• Difficulty following verbal instructions
• Inconsistent response when called from another room
• Frequently watching faces closely to understand speech
• Responds inconsistently to speech or their name, especially without visual cues

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School-aged children

In school settings, hearing difficulties may be mistaken for behavior, attention, or motivation concerns, particularly in noisy or fast-paced environments.

Signs can include:

• Appears disengaged during group activities or in noisy environments
• Struggles when the speaker is at a distance, such as across the room
• Does not respond unless looking directly at the speaker
• Frequently asks for repetition or misses parts of instructions
• Prefers higher volume levels for media (e.g., music, audiobooks)
• Comes home fatigued after school, which may reflect increased listening effort

Sometimes what looks like “not paying attention” may reflect a child working extra hard to follow speech, especially in a busy classroom.

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Closing

As a pediatric audiologist in Germany, I see how early identification depends not only on screening programs, but also on everyday observations from families and educators.

For hearing care professionals, the key is helping caregivers translate “something seems off” into the right next step. Asking for concrete examples, reviewing relevant history, and recommending a comprehensive assessment when appropriate can help avoid delays.

With this year’s World Hearing Day theme, “From communities to classrooms: hearing care for all children,” we are reminded that early support is a shared responsibility. Clear counseling and early referral can make a meaningful difference in how a child communicates, participates, and learns.

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To support clinical practice

Explore Phonak pediatric resources:

Pediatric tools hub: https://www.phonak.com/en-int/professionals/audiology-hub/pediatric-tools

Phonak’s pediatric hearing solutions, designed to support listening, learning, and everyday participation across home and school settings:  Pediatric hearing solutions and Phonak Roger™ for Education.

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References:

1. Tomblin, J. B., Oleson, J., Ambrose, S. E., Walker, E. A., & Moeller, M. P. (2015). Language outcomes in young children with mild to severe hearing loss. Ear and Hearing, 36(Suppl. 1), 76S–91S. https://doi.org/10.1097/AUD.0000000000000219