Common Signs Your Child May Need Hearing Support

Do you know that, by the week 18 of pregnancy, your baby’s ear is well enough developed to start detecting noises? Around weeks 27 to 30, babies can respond to sounds they can hear outside the womb. In the early phase of fetal development, hearing develops and is fully functioning at birth. A fully functioned hearing plays a vital role in their speech and language acquisition and for their social skills too. However, some children can have a hearing impairment since birth, congenital hearing loss or it can be acquired at a later stage during the child's development.  

The impact of hearing loss on a new-born or developing child is vast. Undetected hearing loss in infants and young children could affect their language development and personal achievement. Without appropriate intervention or management, children could not learn language since they learn how to talk by imitating the sounds, they could hear around them, and this leads them to fall behind their normal hearing peers in language, cognition, social-emotional development, and academic achievement. However, based on many research, its states that when a hearing loss is identified early (prior to 6 months of age) and followed immediately, within 2-3 months with appropriate management, outcomes in language development, communication competency, and social emotional development will be significantly better when compared with children with later identified congenital hearing loss. 

Causes of hearing concern in children 

Hearing loss in children could be divided into 2 categories, which is congenital and acquired hearing loss. 

Congenital hearing loss can be caused by genetic, infection/virus such as toxoplasmosis, rubella or cytomegalovirus (CMV), head trauma, ototoxic medications which was used during the antenatal period and several perinatal risk factors such as prematurity, low birth weight, hyperbilirubinemia and craniofacial abnormalities. 

Acquired hearing loss can be caused by middle ear infection (otitis media with effusion), ototoxic drugs, meningitis, noise exposure and many more.

Symptoms of hearing concern in children 

Signs and symptoms of hearing loss in infants and toddlers vary and may include the following:

  • lack of startle to loud noises
  • absence of reaction to voices
  • Poor in sound localization (lack of attempts to locate the source of a sound)
  • Poor and inconsistent attentions to sounds 
  • interruption in babbling and making new sounds
  • delay in reaching communication milestones


 Signs and symptoms of hearing loss in children may include the following:

  • delayed speech and/or language development
  • speech sound disorder
  • difficulty in following or understanding instructions
  • frequent need for repetitions
  • use of increased volume on the TV or other listening devices
  • difficulty effectively expressing themselves 
  • frustration with communication breakdowns
  • feeling of exhaustion at the end of a school day
  • academic, behavioral, or social difficulties at school 
Types of Assessment for Children that we offer in 20dB Digisound
1. Otoscopic examination

Otoscopic examination is to examine the external auditory canal with an otoscope. It is used to ensure that there are no contraindications to placing an earphone or probe into the ear canal. It is essential for the audiologist to verify that the external auditory canal is free of obstructions (e.g., foreign objects, impacted cerumen, vernix) and that there is no drainage from the middle ear. To the extent possible, the audiologist examines the tympanic membrane about color and abnormalities. A visual inspection for obvious structural abnormalities (e.g., ear pits, ear tags, atresia, low-set ears) of the pinna and/or ear canal is typically included in this assessment.

2. Tympanometry 

Tympanometry test, which is also known as test of middle ear, tests how well your eardrum moves. The audiologist will put a small probe, into each ear. A small device attached to the probe will push air into your ear. All your child must do is sit still. The person testing you will see a graph on the device, called a tympanogram. 

The shape of the graph tells the audiologist about how the eardrum moves. It will show if the eardrum moves the correct way, is too stiff, moves too much, or has a hole in it. This can help the audiologist know if you have middle ear fluid, a hole in the eardrum, or wax in your ear canal. The test can help find out if a child has an ear infection.

3. Otoacoustic Emissions (OAE)

Our ear is made up of three parts and which are the outer, the middle, and the inner ear. This OAE test is used to specifically test on how your inner ear, which is the cochlea, organ of hearing works. This test measures the otoacoustic emissions, or OAEs which are the sounds given off by the inner ear when responding to a sound. The tiny hair cells in the cochlea will respond to sound by vibrating and which produces a very quiet sound that echoes back into the middle ear. This sound is the OAE that is measured during the test. A small earphone, or probe, is placed in your child’s ear to measure this sound and it is done while the baby sleeps or when the child is seated quietly.

4. Conditioned Play Audiometry (CPA)

Conditioned Play Audiometry (CPA) is a test to measure a child’s hearing threshold level. The child must respond to various sound levels using headphones or insert phones by putting a block into the box or put a ring on a cone everything they can hear a sound. This test designed for children between the ages of 2 and 5.


If your child is showing any of the above-mentioned symptoms or suffering from hearing-related issues, we strongly advise for an audiological test as soon as possible to help with the identification and management for hearing loss.

We provide all the above-mentioned tests with the highest quality care for infants and children by our audiologist. With the availability of all the tests and equipment, we believe that we can make a difference in the lives of the young ones by creating an awareness for the importance early detection and intervention of hearing loss. 

“As we also strongly believe that your little ones need to hear the words of love from their loved ones!” 

Book an appointment for 1:1 audiologist consultation and hearing test today!


Written by: Mohana, Audiologist at 20dB Digisound