The American Academy of Pediatrics recommends that babies be screened soon after birth for hearing loss, but even with a passing test then and regular pediatric checkups, some hearing loss might not develop or be noticed until the toddler years. Hearing loss in toddlers usually stems from either a physical deformity inside the ears, a buildup of fluid in the middle ear, or even nerve damage inside the ear. Some cases are congenital, while others can be a result of the mother carrying certain viruses while pregnant.
Receptive Language Delays
Receptive language refers to the words and gestures that your your toddler understands, even before she speaks. Most toddlers will not always do as they are told, but toddlers who are unable to follow simple verbal instructions might be doing so because they cannot hear you properly. You might also notice that your toddler seems to hear better when she is looking at your face, because she can use the visual cues of your lips moving to help her figure out what you are saying. Selective hearing, which again can be a normal toddler trait, might also indicate that your toddler is only hearing a certain frequency of sounds or hears better from one ear than the other.
Speech development falls in a broad range, but if your toddler is not saying single words such as "mama" or "dada" by the age of 12 to 15 months old, or if an older toddler's language is particularly hard to understand or significantly delayed, it might be a sign of a hearing loss, according to HealthyChildren.org. Your toddler might also show verbal signs of hearing loss by focusing mostly on making vibratory sounds instead of other vowels or consonants.
The inner ear plays an important role in regulating balance, so some types of hearing problems involving an inner ear deformity or nerve damage can manifest as balance problems. While some unsteadiness is normal as a toddler is learning to walk, watch your child to see whether she routinely has difficulty holding her head steady. Walking or sitting later than normal without assistance can also indicate that a toddler is having trouble hearing when associated with other symptoms.
Some pediatricians will perform regular hearing assessments at checkups, but you should always visit your doctor and ask to see a specialist, such as an audiologist or otolaryngologist, if you suspect your child has a hearing problem. Your child will have her hearing assessed with a short and painless test, either the auditory brain stem response test, which uses soft noises and electrodes to test hearing, or the otoacoustic emissions test, which uses a probe placed inside your child's inner ear canal. Early intervention is always beneficial because your doctor might then be able to refer your to hearing specialists, along with resources in your community and at school should your toddler require assistance later on due to hearing loss.