Only half of babies born have their hearing tested in the United States, yet 3 out of every 1000 have serious problems. An equal number struggle with moderate hearing loss.

“I knew there was something wrong with Jason when he was a baby,” says Raylette Pickett whose son’s hearing loss went undetected for 10 years. “Doctors thought he might be autistic or have attention deficit disorder. He fell behind in school and needed special education.”

Very young infants typically make cooing and gurgling sounds and turn toward a new noise. They tend to calm down when spoken to in a gentle voice. By 6 months, they make noise to get attention, and they watch the face that’s talking to them.

By 12 months babies understand their own name and simple words like “bye-bye” and “up.” They reach for things and look at others in an effort to communicate and show what’s on their mind.

A hearing loss may not be suspected, however, until around 18 months or 2 years when other children the same age start speaking clearly. “Then you’ve passed a critical window of opportunity,” says Nina Shapiro, M.D., a pediatric hearing specialist at UCLA. “The child develops language skills much more successfully if they are fitted for a hearing aid by 6 months. “There seems to be something magic about that period, probably to do with brain development.”

Babies as young as four weeks can be fitted with hearing aids. “With appropriate early detection and intervention, these infants have the opportunity to develop on a par with their hearing peers by the time they reach school age or sooner,” says the president of the American Speech-Language-Hearing Association Jeri Logemann Ph.D.

Research indicates that 80 percent of the children with hearing loss develop normal speech and language if they get hearing aids early. Unfortunately, Jason Pickett didn’t get one until age 10. He was already receiving intensive speech therapy and special education at school.

“Other kids would sort of act like ‘You can’t play with me,” says Jason’s mom. “’You talk funny, you look funny. We can’t understand you.’ So Jason got a lot of teasing.

“His speech would have been much clearer from the beginning if his hearing loss had been corrected from infancy. He wouldn’t have been in special education classes or fallen behind his grade in reading and math.”

Doctors test an infant’s hearing a few days after birth by measuring the faint sounds that the inner ear actually makes in response to noise. A tiny flexible plug projects sound into the baby’s ear and a microphone inside the plug records the sounds that the normal ear produces in response to the incoming sound. The emitted sounds are not measurable in an infant who cannot hear.

“We’re testing the baby’s response to sound,” says Dr. Shapiro. “We put a clicking sound in the child’s ear, and electrodes and a computer pick up how it’s being processed by the baby. It measures the signal as it travels along the acoustic nerve up to the brain stem, and it measures whether the signal is getting through, and whether it’s normal in terms of the time it takes to get to the brain stem.”

Dr. Shapiro further explains that doctors get a highly accurate responses from newborns. “They check for the key frequencies, the key sounds for speech, and they can pick up even a mild hearing loss.”

Dr. Shapiro advises parents to watch for startle reactions in their baby in response to loud sounds like a dog barking near the crib or a door slamming. The American Academy of Pediatrics recommends universal screening of newborns for hearing loss and offers the following quiz about warning signs. Parents should consult their doctor if questions arise over any of these signs.

  1. Does the baby turn her head when she’s called? Does she respond to clapping noise, even when she’s not looking at the person making the noise?
  2. Does the baby of 6 or 7 months babble and imitate the tone of other voices? Does he respond to the sounds around him?
  3. Has the child been less responsive since having an ear infection? Fluid buildup following middle ear infections may cause this.
  4. Has the child gradually become hard of hearing? This may be caused by a blockage of the ear by foreign body or wax buildup.
  5. Has the child had an injury to the ear? If so, he or she may have a perforated ear drum.
  6. Has the child been hard of hearing since taking a recent plane journey or a roller-coaster ride? Change in air pressure may cause this.
  7. Does the child get severely dizzy and lose his balance? Does he have attacks of nausea and vomiting? Does he complain of ringing in the ears (tinnitus)? This may indicate a neurological disorder.

“The best feeling I had as a parent was when Jason first got his hearing aids,” says Pickett. “The smile on his face told it all. We put them in and he said ‘Mom I can hear’. We could have avoided all the frustration and special ed if we’d known earlier.”