On this page:
\n- \n
- Talk to your doctor \n
- Your baby\u2019s hearing and communicative development checklist \n
- Where can I find additional information about hearing development?
\n
Some babies are born with hearing problems. Other children are born with normal hearing and begin to have hearing problems as they grow older.
\nIt\u2019s important to know what to expect as your baby grows, because hearing problems can delay the development of voice, speech, and language skills. The checklist below presents the average age by which most babies accomplish a variety of early speech and language skills. Typically, a child may not accomplish all the items in an age category until he or she reaches the upper age in the age range.
\nFind your child\u2019s age range in the checklist. Check \u201cyes\u201d or \u201cno\u201d for each item. After you complete the checklist, if any of the items are checked \u201cno,\u201d show it to your child\u2019s doctor. Tell the doctor if you think your child has trouble hearing.
\n![\"Infant\"](\"https://www.nidcd.nih.gov/sites/default/files/Content%20Images/FS-BabyChecklist-baby.jpg\")
\n A 4- to 6-month-old baby with normal \n
hearing development will follow sounds \n
with his or her eyes. \n
Talk to your doctor
\nIf you think your child may have a hearing problem, here are some things that your doctor might ask you about:
\n- \n
- Do others in the family, including brothers or sisters, have a hearing problem? \n
- Did the child\u2019s mother have medical problems in pregnancy or delivery (experienced a serious illness or injury or needed drugs or medications)? \n
- Was the child born early? \n
- How much did the child weigh at birth? \n
- Did the child have physical problems at birth? \n
- Does the child rub or pull on his or her ear(s) often? \n
- Has the child ever had scarlet fever? \n
- Has the child ever had meningitis? \n
- How many ear infections has the child had in the past year? \n
- How often does the child have colds, allergic symptoms, or ear infections? \n
Some words the doctor may use are:
\n- \n
- Audiogram: a chart that shows how well you can hear. \n
- Audiologist: a person who tests and measures hearing. \n
- Earache: pain deep inside the ear. \n
- Otitis media: middle ear infection. \n
- Otolaryngologist: a doctor who treats diseases and problems of the ear, nose, and throat. \n
- Otologist: a doctor who treats diseases of the ear. \n
- Pediatrician: a doctor who takes care of infants and children and who treats their diseases. \n
- Speech-language pathologist: a health professional trained to evaluate and treat people with speech or language disorders. \n
What are voice, speech, and language?
\nVoice, speech, and language are the tools we use to communicate with each other.
\nVoice is the sound we make as air from our lungs is pushed between vocal folds in our larynx, causing them to vibrate.
\nSpeech is talking, which is one way to express language. It involves the precisely coordinated muscle actions of the tongue, lips, jaw, and vocal tract to produce the recognizable sounds that make up language.
\nLanguage is a set of shared rules that allow people to express their ideas in a meaningful way. Language may be expressed verbally or by writing, signing, or making other gestures, such as eye blinking or mouth movements.
\nYour baby\u2019s hearing and communicative development checklist
\nBirth to 3 Months
\nReacts to loud sounds
\nCalms down or smiles when spoken to
\nRecognizes your voice and calms down if crying
\nWhen feeding, starts or stops sucking in response to sound
\nCoos and makes pleasure sounds
\nHas a special way of crying for different needs
\nSmiles when he or she sees you
\n4 to 6 Months
\nFollows sounds with his or her eyes
\nResponds to changes in the tone of your voice
\nNotices toys that make sounds
\nPays attention to music
\nBabbles in a speech-like way and uses many different sounds, including sounds that begin with p, b, and m
\nLaughs
\nBabbles when excited or unhappy
\nMakes gurgling sounds when alone or playing
with you
7 Months to 1 Year
\nEnjoys playing peek-a-boo and pat-a-cake
\nTurns and looks in the direction of sounds
\nListens when spoken to
\nUnderstands words for common items such as \u201ccup,\u201d \u201cshoe,\u201d or \u201cjuice\u201d
\nResponds to requests (\u201cCome here\u201d)
\nBabbles using long and short groups of sounds (\u201ctata, upup, bibibi\u201d)
\nBabbles to get and keep attention
\nCommunicates using gestures such as waving or holding up arms
\nImitates different speech sounds
\nHas one or two words (\u201cHi,\u201d \u201cdog,\u201d \u201cDada,\u201d or \u201cMama\u201d) by first birthday
\n1 to 2 Years
\nKnows a few parts of the body and can point to them when asked
\nFollows simple commands (\u201cRoll the ball\u201d) and understands simple questions (\u201cWhere\u2019s your shoe?\u201d)
\nEnjoys simple stories, songs, and rhymes
\nPoints to pictures, when named, in books
\nAcquires new words on a regular basis
\nUses some one- or two-word questions (\u201cWhere kitty?\u201d or \u201cGo bye-bye?\u201d)
\nPuts two words together (\u201cMore cookie\u201d)
\nUses many different consonant sounds at the beginning of words
\n2 to 3 Years
\nHas a word for almost everything
\nUses two- or three-word phrases to talk about and ask for things
\nUses k, g, f, t, d, and n sounds
\nSpeaks in a way that is understood by family members and friends
\nNames objects to ask for them or to direct attention to them
\n3 to 4 Years
\nHears you when you call from another room
\nHears the television or radio at the same sound level as other
family members
Answers simple \u201cWho?\u201d \u201cWhat?\u201d \u201cWhere?\u201d and \u201cWhy?\u201d questions
\nTalks about activities at daycare, preschool, or friends\u2019 homes
\nUses sentences with four or more words
\nSpeaks easily without having to repeat syllables or words
\n4 to 5 Years
\nPays attention to a short story and answers simple questions about it
\nHears and understands most of what is said at home and in school
\nUses sentences that give many details
\nTells stories that stay on topic
\nCommunicates easily with other children and adults
\nSays most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th)
\nUses rhyming words
\nNames some letters and numbers
\nUses adult grammar
\nThis checklist is based upon How Does Your Child Hear and Talk?, courtesy of the American Speech\u2013Language\u2013Hearing Association.
\nWhere can I find additional information about hearing development?
\nThe NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.
\nUse the following keywords to help you search for organizations that can answer questions and provide information on speech and language development:
\n \nFor more information, contact us at:
\nNIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: nidcdinfo@nidcd.nih.gov
NIH Publication No. 10\u20134040
Updated September 2010
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