Are ENT Evaluations Good for Speech-Delayed Toddlers?

By Sharon Perkins
An ENT doctor can help determine if your late talker has hearing problems.
An ENT doctor can help determine if your late talker has hearing problems.

When your toddler isn't talking as well as other kids his age, you might consider checking his hearing. Hearing loss can cause speech delays; even a child who appears to hear well may have issues affecting his speech development. A toddler who passed his newborn hearing test with flying colors can develop hearing loss in infancy or toddlerhood from frequent ear infections or other illnesses, such as meningitis, or from certain medications. An ENT -- ear, nose and throat specialist -- can diagnose or eliminate ear problems as a possible cause of speech delay.

When to See an ENT

Doctors who treat the ear, nose and throat are also known as otolaryngologists. Some ENTs specialize in pediatrics. Signs that your toddler might need an ENT evaluation include not babbling as much as other children, fluctuations in his ability to hear or not saying simple words such as "mama" or "dada" at 12 months. A toddler with mild hearing loss might not pronounce soft sounds such as "s," "f" and "th" because he has trouble hearing these sounds. He might also have a louder or a softer voice than other children; fluid in the ears can make his own voice sound louder than normal to him, otolaryngologist Dr. David Steward explains on, which provides health information from three major universities.

Problems That Cause Hearing Loss

An ENT examines your child's ears for any structural abnormalities of the inner ear that may be affecting your toddler's hearing. Structural abnormalities can include malformation of the bones in the middle or inner ear that transmit sound or a perforated eardrum. Fluid behind the eardrum or excessive wax in the ear can cause conductive hearing loss, meaning that sound doesn't travel through the ear properly. What your toddler hears might sound muffled, although fluid in the ear doesn't always cause hearing loss, Canadian pediatrician Dr. Alexander Leung notes in the June 1999 issue of "American Family Physician." Problems with the auditory nerve in the ear can also cause hearing loss.

Treating Hearing Loss

If your child has frequent ear infections that interfere with his hearing, an ENT doctor might recommend surgically implanting tubes in his ears so that the fluid can drain, which helps prevent infections and fluid buildup behind the eardrum. Around 75 percent of American children have at least one ear infection before their third birthday; of those, almost half have three or more infections in their first three years, according to the American Speech-Language-Hearing Association.


If the doctor finds an abnormality in your toddler's ear, or finds no correctable structural problem, you will need to see an audiologist, who can test your child's hearing to determine how much loss, if any, he has. If he has a hearing loss, working with a speech pathologist can help him overcome his limitations. If his hearing test comes back within the normal range, you can look for other reasons for delayed speech and work with a speech pathologist to improve his skills.

About the Author

A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.