Key points to remember about hearing and communication

• hearing is a critical part of a child's communication development
• any degree of hearing loss can make learning to speak more difficult

Why is hearing important for my child's communication development?

Hearing is a critical part of a child's communication development. Even a mild or fluctuating hearing loss can affect a child's communication development so it's important to identify any loss as early as possible.

What are the different types of hearing loss?

There are 2 main types of hearing loss. One is temporary (conductive) and the other permanent (sensori-neural).

Temporary hearing loss can mean that the child is able to hear well one day but not the next. This is sometimes referred to as fluctuating hearing loss, which can be difficult to identify. People may talk about the child having 'middle ear' problems, fluid in their ear or sometimes glue ear. See the pages on ear infections [1] and glue ear [2]. 

Permanent hearing loss may be in one or both ears and can be different in each ear.

Any type or degree of hearing loss can make learning to talk more difficult.

Signs of hearing difficulties include:

• not always noticing everyday sounds
• needing to have volumes louder than you'd expect
• taking longer to learn to talk
• often asking others to repeat themselves
• unfocused attention
• difficulty waiting for and taking turns
• staring at people's mouths when they talk
• speaking very loudly

Who should I talk to if I am concerned about my child's hearing?

If you have any concerns about your child's hearing you should talk to your child's doctor who may refer them for a hearing test.

What's involved in a hearing test?

All babies in New Zealand have a hearing test soon after they are born.

Families/whānau are also offered a hearing check for their child, by nurses employed to do Well Child checks, on several occasions before they start school. When children turn 4 they will be offered a hearing test as part of their B4 School Check. If there are concerns they will be referred to an audiologist, a specialist in hearing loss, for further hearing testing.

Audiologists mainly work in hospitals and community-based clinics. They make the experience as easy as possible for the child, and are skilled in testing young children's hearing from birth.

It may be necessary to get children's hearing tested a few times, as it can be difficult to pick up a hearing loss with the first test.

For more information about hearing testing, see the section on Hearing, vision and newborn screening [3] on this website.

How can I support my child with hearing loss?

Depending on the degree of hearing loss there may be a range of supports available, including access to New Zealand Sign Language (NZSL) for those with permanent hearing loss.

The following are general strategies for all children with hearing loss but mainly focus on those using spoken language:

• gain your child's attention before speaking to them; for example, say their name before speaking
• try to keep background noise down when talking to them; for example, turn the TV volume down
• check that your child understands any instructions by asking a question that doesn’t require a yes/no response; for example, "What will you do now?" rather than "Did you hear me?" or "Do you understand?"
• make sure your child can see your face when you are talking to them so that they can hear your voice more clearly and see your facial expressions
• use a clear, everyday voice. Try not to speak too loudly as this distorts the sound
• be aware of anything that can make it difficult for them to see your face, such as lighting or shadows, hands, books
• at the early childhood education centre, encourage the child to sit close to the person speaking; for example, if the teacher is reading a story then the child should be seated close to them
• try not to exaggerate your facial expressions or lip patterns