Hearing & speech development – what’s the connection?

It is a well-known fact that the relationship between hearing and speech development is critical in the early years of a child’s life. Hearing has been known to develop as early as the second trimester in utero. Children learn to use language by imitating sounds and listening to the speech of those around them. Therefore, any kind of hearing impairment in children can be detrimental to speech and language development.

The earlier hearing loss occurs in a child’s life, the more serious the effects on the child’s development. Similarly, the earlier the problem is identified and intervention begun, the less serious the ultimate impact. The effect of hearing loss on speech and language development does depend on the severity of the loss. When an impairment prevents a child from hearing sound consistently, the child’s ability to learn language may be hindered in the following ways:

1. Speech

Children with a hearing loss struggle to hear soft or quiet speech sounds, for example “sh”, “f”, “k”, “t”, “s” and therefore may not use these sounds correctly or at all, while communicating. This is the reason why a hearing-impaired child’s speech may be difficult to understand.

Children with a hearing loss may not hear their own voice when they speak. They may speak too loudly or not loud enough. They may also have a speaking pitch that is too high or may sound like they are mumbling.

“The most important thing you can do is to have your child’s hearing tested by an audiologist.”

2. Vocabulary and sentence structure

Children with hearing loss develop vocabulary slower than children with normal hearing. The gap in vocabulary between children with normal hearing and those with hearing loss does widen with age; however, this can be minimised with appropriate intervention. They may also struggle to comprehend words with multiple meanings, proper use of tenses and more complex sentence structure. Hearing-impaired children are more likely to use short, simple sentences to communicate.

3. Scholastic performance

Children with hearing loss are more likely to struggle with reading and maths.

4. Social interaction

Communication difficulties can often lead to social isolation and poor self-esteem among other children.

What can I do?

As the parent or primary caregiver, you know your child better than anyone else and will likely be the first to notice their developmental milestones.

There are several signs that may indicate whether your child has a hearing loss. If your baby or child does not appear to have reached one or more of these developmental milestones at the age indicated, talk to your family doctor or audiologist about having their hearing tested.

Developmental hearing milestones

0 – 1 month:

  • Hearing is fully mature
  • Recognises some sounds
  • May turn toward familiar sounds and voices
  • Startles or jumps when there are loud sounds
  • Stops sucking or crying when there is a new sound

1 – 3 months:

  • Smiles at the sound of your voice
  • Begins to babble
  • Begins to imitate some sounds
  • Turns head toward direction of sound

3 – 7 months:

  • Responds to own name
  • Begins to respond to “no”
  • Distinguishes emotions by tone of voice
  • Responds to sound by making sounds
  • Uses voice to express joy and displeasure
  • Babbles chains of consonants
  • Turns head toward a sound source

7 – 12 months:

  • Pays increasing attention to speech
  • Responds to simple verbal requests
  • Responds to “no”
  • Uses simple gestures, such as shaking head for “no”
  • Babbles with inflection
  • Babbles chains of consonants
  • Says “dada” and “mama”
  • Uses exclamations, such as “Oh-oh!”
  • Tries to imitate words

1 – 2 years:

  • Points to object or picture when it’s named for them
  • Recognises names of familiar people, objects and body parts
  • Says several single words (by 15 to 18 months)
  • Uses simple gestures, such as shaking head for “no”
  • Uses simple phrases (by 18 to 24 months)
  • Uses two- to four-word sentences
  • Follows simple instructions
  • Repeats words overheard in conversation

2 – 3 years:

  • Follows a two- or three-component command
  • Recognises and identifies almost all common objects and pictures
  • Understands most sentences
  • Understands physical relationships (“on,” “in,” “under”)
  • Uses four- and five-word sentences
  • Can say name, age and sex
  • Uses pronouns (I, you, me, we, they) and some plurals (cars, dogs, cats)
  • Strangers can understand most of their words

3 – 4 years:

  • Understands the concepts of “same” and “different”
  • Has mastered some basic rules of grammar
  • Speaks in sentences of five to six words
  • Speaks clearly enough for strangers to understand
  • Tells stories

4 – 5 years:

  • Recalls part of a story
  • Speaks sentences of more than five words
  • Uses future tense
  • Tells longer stories
  • Says name and address

Children with a hearing loss who have intervention or therapy early may be able to develop language on a par with their hearing friends. The most important thing you can do is to have your child’s hearing tested by an audiologist. He or she can discuss the best way to treat your child’s hearing loss, which may include medical treatment, hearing aids, or speech and language therapy

Also read:

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How do I know if my baby has an eyesight problem?

Kelly Nathan is a registered audiologist and currently owns and works at Kelly Nathan Audiology in Johannesburg. She is also an active member on various committees of the South African Association of Audiologists and provides clinical supervision and guidance to Audiology students at the University of the Witwatersrand. Kelly has an interest in hearing healthcare in children and adults, and believes in providing her clients with individualised service for all their hearing needs in a warm and caring environment.