Your child’s speech and language development

A normal child has the following Age-Speech-Hearing Developmental Milestones. These milestones are rough “rules of thumb”, for the majority of children. If your child is more than 2-3 months delayed compared to the above-mentioned age-groups, it might indicate a hearing loss or a delayed speech-language development.

9 months - Demonstrate an understanding of simple words “mommy” , “daddy” , “no”, “bye bye”

10 months - Babbling should sound “speech like,” with single syllables strung together (”da-da-da-da”). The first recognizable words emerge at about this time.

12 months - One or more real words spoken.

18 months - Understand simple phrases, retrieve familiar objects on command (without gestures) and point to body parts. Also should have spoken vocabulary between 20 and 50 words and use short phrases (”no more”, “go out”).

24 months - Spoken vocabulary should at least be 150 words, coupled with the emergence of simple two word sentences. Most speech should be understandable to adults who are not with the child daily. Toddlers also should be able to sit and listen to read aloud picture books.

3 to 5 years - Spoken language should be used constantly to express wants, reflect emotions, convey information and ask questions. A pre-schooler should understand nearly all what is said. Vocabulary grows from 1000 to 2000 words which are linked in complex and meaningful sentences. All speech sounds should be clear and understandable by the end of the pre-school peroid.

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Signs of hearing difficulties

You should always be aware when your child does not respond appropriately to sounds. Sometimes, a lack of response is attributed to inattention, but it is important to determine if inconsistent or no responses actually stem from an inability to hear.

Common Signs that children may not be hearing normally

• not aware someone who is out-of-view is talking, especially when distractions are minimal
• startled or surprised look when they realize their name has been called (at a normal or even loud level)
• sing “what?” of “huh?” frequently
• Intently watching the faces of speakers
• sitting close to the tv when the volume is sufficient for other family members
• increasing the volume of the tv or stereo to unreasonably loud levels
• not responding to voices over the telephone and/or switching ears continually
• not startling to intense sounds

The single most important sign of possible hearing loss, however, is a lack or delayed development of speech and language. Even if you do not suspect a hearing loss, if your child is not developing speech, especially compared to peers or olders siblings, then there is reason to be concerned about your child’s hearing.

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High risk hearing loss indicators

Outlined below are factors indicating that a child is at risk of a hearing loss.

Newborns - Birth to 28 Days

• family history of hereditary childhood sensorineural hearing loss
• in utero infection, such as cytomeglovirus, rubella, syphillis, herpes and toxoplasmosis
• Craniofacial deformities including those affecting the pinna and ear canal
• birth weight less than 1500 grams
• Hyperbilirubinemia at a serum level requiring transfusion
• Ototoxic medications, including aminglycosides used in multiple courses or in combination with diuretics
• Bacterial meningitis
• Apgar scores of 0-4 at 1 minute or 0-6 at 5 minutes after birth
• Mechanical ventilation lasting 5 days or longer
• Findings associated with syndromes known to include sensorineural hearing loss.

Infants -29 Days to 2 years

• concern regarding communication or developmental delay
• bacterial meningitis or other infections known to cause sensorineural hearing loss
• head trauma associated with loss of consciousness or skull fracture
• ototoxic medications, including chemotherapeutic agents or aminoglycosides used in combination with loop diuretics
• findings associated with a syndrome known to include sensorineural hearing loss
• otitis media with effusion for three month or longer

Noise Exposure

One of the most common, and yet completely preventable, causes permanent sensorineural hearing loss is noise exposure. High level of noise can cause temporary or permanent damage to the sensory hair cells within the cochlea. Vehicles, appliances and stereos, all produce noise which may be detrimental to hearing, depending on how close the noise source is and the length of exposure. In addition, some toys or computer games and certainly rock music concerts may damage hearing. Children should be taught the dangers of noise exposure and instructed to use ear protection when necessary.

Mixed Hearing Loss

Sometimes, a combination of factors occurs which affects both the middle ear and the inner ear (cochlea), resulting in a mixed hearing loss.

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When a child is diagnosed with hearing loss

The medical care of a child with hearing loss is provided by a physician (otolaryngologist of ENT specialist). The audiologist (hearing specialist) provides help in testing, monitoring and fitting hearing instruments and providing auditory therapy.

The physician may call for further testing to ascertain if other physical conditions are associated with the hearing impairment. Information from the tests are provided to the child’s pediatrician for inclusion in permanent health records.

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When permanent hearing loss exists

If your child has a hearing loss which cannot be treated medically or surgically, your audiologist can offer you various options to help your child hear better. There is now virtually no hearing loss that cannot be helped through the use of appropriate listening devices.

The goal for children with permanent hearing loss is to optimize auditory abilities to help them with language learning and academic development.

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Choosing a hearing instruments

Hearing instruments amplify sound and can be worn at any age. Behind-the-ear (BTE) style hearing instruments are most suitable for a child. These are placed behind the ear, attached to a custom-fit ear mold, which fit inside the ear canal. These hearing instruments come in a variety of colors and can help a wide range of hearing losses -- from mild to moderate to profound. Older children may be candidates for the in-the-ear (ITE) style hearing instruments which are custom-made to fit inside the ear canal and help with mild-to- severe hearing losses. the decision whether the child should be fit with one or two hearing instruments depends mainly on the configuration of the hearing loss.

New high-technology features today offer the use of remote controls, enabling the older child the ability to shift between several listening programs, suitable for the different acoustical situations a child encounters during a normal day. these programs are chosen in close cooperation between the child, the parents and the audiologist. Also, directional microphones give the child the chance to suppress background noises and “zoom in” on speech, even in a noisy classroom.

Talk to a Certified Audiologist about what might be suitable for your child.

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