Impact of Hearing Loss

• Speech Delay
• Language Development
• Reading

 

Your child needs to develop language skills in order to adjust socially. However, conditions like pediatric conductive or sensorineural hearing loss may cause speech problems early in development. The conditions might interfere with a child’s ability to learn and hinder language development or cause problems like speech delay.

Pediatric hearing loss may be present at birth or can develop at any point throughout your child’s life. A “passed” newborn hearing screen insures you that your child’s hearing was normal at birth, at the point of the hearing screen. A “passed” newborn hearing screen does not insure normal hearing throughout your child’s life. The type of hearing loss your child has (conductive or sensorineural) will determine the types of intervention you child’s physician at ENT for Children will recommend.

Speech Delay

Speech delay, as the name implies, is when your child takes longer than normal to begin talking. Parents, caregivers and doctors alike will track your child’s speech milestones as they grow. As a child misses those speech milestones, you will need to be aware of the signs or symptoms of hearing related speech delay. The symptoms vary by age as follows:

By 12 Months of Age

Babbling and cooing indicate the earliest stages of speech development. During this stage, children begin using their voice to react to their environment. Babies should be able to recognize names of common objects like “ball.” Children who have hearing loss at this age may exhibit the following symptoms:

• Doesn’t use gestures like shaking the head, pointing or waving
• Doesn’t babble to talk
• Doesn’t attempt to pronounce consonants like “b” or “p”
• Doesn’t respond to words such as “no.”

Babies who do not react to sound but seem to be observing may be showing signs of hearing loss.

15-19 Months of Age

As children grow, they should have a wider range of speech in their vocabulary. Your child should be able to imitate sounds and words. Symptoms that indicate hearing loss at this age include:

• Doesn’t point to what he/she wants
• Doesn’t point to at least one part of the body when asked
• Doesn’t have a rapidly growing vocabulary. Children this age should be able to learn at least one word per week.

18 to 24 Months of Age

Most toddlers should be able to say 50 or more words by the time they turn two. Although the number may vary in some cases, children at this age should still be able to combine two words together like “baby crying.” A two year old should also be capable of identifying common objects. Children who suffer from hearing loss at this age may exhibit the following signs:

• Doesn’t imitate words modeled by you or family members
• Doesn’t respond to simple directions
• Doesn’t imitate actions
• Can’t join two words together
• Cannot point and identify images in picture books
• Doesn’t know how simple household items like a toothbrush or spoon work.

3 to 4 Years of Age

Your child should be able to combine two to three words into sentences frequently at this age. Parents often experience an explosion in their child’s vocabulary at this age. A three year old should also be able to comprehend certain commands. For example, he/she should know what commands like “Put this on the table” or “lie on the bed” mean. Symptoms that are indicative of hearing loss at this age are as follows:

• Cannot understand short instruction
• Cannot speak short phrases
• Unclear speech
• Does not want to interact with other children
• Does not want to detach from the parent
• Stutters frequently

At 4 Years of Age

• Does not understand the concept of “different” and “same”
• Cannot use pronouns like “you” and “me” properly
• Hasn’t mastered most single consonants.

Language Development

Speech involves the verbal expression of language or articulation (the way words are formed), while language refers to a broader range of communication. Children who suffer from hearing loss may have problems practicing one or both. For example, a child with hearing loss may be able to articulate single words but might be unable to put two or more words together to make a sentence.

On the other hand, some children with hearing loss may be able to use words to express ideas but their speech may be slurred or difficult to understand. Similarly, a child who suffers from hearing loss may be able to speak well but may also be unable to follow directions.

Hearing loss is most commonly related to speech and language delay in children. ENT for Children may recommend screening tests for a child who exhibits symptoms of speech delay due to a possible hearing impairment.
The following are a list of helpful speech and language developmental milestones that your physician at ENT for Children will expect to see your child reach:

At age 18 months, your child…

• uses 10 to 20 different words
• starts to combine 2 words, such a “all gone,” “Daddy bye-bye”
• uses words to make wants known, such as “more,” “up”
• points to own toes, eyes, and nose
• brings familiar object from another room when asked
• knows and says the names of 5 things
• mixes real words with jargon, on occasion

At age 2 years, your child…

• has around 200 words in speaking vocabulary
• understands simple questions and commands
• identifies body parts
• uses mainly the names of thins, actins, persons, and situations in their language
• sentence length is compsed of 2 to 3 words
• asks “what’s this?” “what’s that?” and “where’s my …?”
• refers to self by name
• listens to stories and points to pictures when asked
• asks for drink, toilet, food

At age 2½ years, your child…

• uses about 450 words
• gives first name
• uses past tense and plurals and combines nouns and verbs
• refers to self as “me” rather than by name
• uses “no” or “not” in speech and may say “no” when he or she means “yes”
• answers “where” questions
• uses short sentences to announce what he or she has done or will like (for example, “Me do it,” or “Me want to jump”)

Reading

Many parents ask how they can best help their child’s speech and language development. The best answer to this question may be “READING”. Reading for a child’s enjoyment should include 2-3 books every night. One of the books ideally is the same exact book every night. The repetition of reading the same book to a child every night (for several years) leads to the child knowing the book by memory at approximately 3-3½ years of age. This creates the appearance that your child knows how to read, when in fact they are actually reciting by memory the words at their appropriate page in the book.

This repetition is a valuable learning tool for your child’s speech and language development. Some examples of common books used for this repetitive task, include: “The Little Engine That Could”, “Green Eggs and Ham”, “Ten Apples Up On Top”, “The Little Gorilla”, etc…