Hearing and Communicative Development Checklist

Some babies are born with hearing problems. Other children are born with normal hearing and begin to have hearing problems as they grow older.

It’s important to know what to expect as your baby grows because hearing problems can delay the development of voice, speech, and language skills. The checklist below presents the average age by which most babies accomplish a variety of early speech and language skills. Typically, a child may not accomplish all the items in an age category until he or she reaches the upper age in the age range.

Find your child’s age range in the checklist. Check “yes” or “no” for each item. After you complete the checklist if any of the items are checked “no,” show it to your child’s doctor. Tell the doctor if you think your child has trouble hearing. A 4- to a 6-month-old baby with normal
hearing development will follow sounds with his or her eyes.

Talk to your doctor

If you think your child may have a hearing problem, here are some things that your doctor might ask you about:

  • Do others in the family, including brothers or sisters, have a hearing problem?
  • Did the child’s mother have medical problems in pregnancy or delivery (experienced a serious illness or injury or needed drugs or medications)?
  • Was the child born early?
  • How much did the child weigh at birth?
  • Did the child have physical problems at birth?
  • Does the child rub or pull on his or her ear(s) often?
  • Has the child ever had scarlet fever?
  • Has the child ever had meningitis?
  • How many ear infections has the child had in the past year?
  • How often does the child have colds, allergic symptoms, or ear infections?

Some words the doctor may use are:

  • Audiogram: a chart that shows how well you can hear.
  • Audiologist: a person who tests and measures hearing.
  • Earache: pain deep inside the ear.
  • Otitis media: middle ear infection.
  • Otolaryngologist: a doctor who treats diseases and problems of the ear, nose, and throat.
  • Otologist: a doctor who treats diseases of the ear.
  • Pediatrician: a doctor who takes care of infants and children and who treats their diseases.
  • Speech-language pathologist: a health professional trained to evaluate and treat people with speech or language disorders.

What are voice, speech, and language?

Voice, speech, and language are the tools we use to communicate with each other.

Voice is the sound we make as air from our lungs is pushed between vocal folds in our larynx, causing them to vibrate.

Speech is talking, which is one way to express language. It involves the precisely coordinated muscle actions of the tongue, lips, jaw, and vocal tract to produce the recognizable sounds that makeup language.

Language is a set of shared rules that allow people to express their ideas in a meaningful way. Language may be expressed verbally or by writing, signing, or making other gestures, such as eye blinking or mouth movements.

Your baby’s hearing and communicative development checklist

Birth to 3 Months

Reacts to loud sounds

  
Calms down or smiles when spoken to

  
Recognizes your voice and calms down if crying

  
When feeding, starts or stops sucking in response to sound

  
Coos and makes pleasure sounds

  
Has a special way of crying for different needs

  
Smiles when he or she sees you

  

4 to 6 Months

Follows sounds with his or her eyes

  
Responds to changes in the tone of your voice

  
Notices toys that make sounds

  
Pays attention to music

  
Babbles in a speech-like way and uses many different sounds, including sounds that begin with p, b, and m

  
Laughs

  
Babbles when excited or unhappy

  
Makes gurgling sounds when alone or playing
with you

  

7 Months to 1 Year

Enjoys playing peek-a-boo and pat-a-cake

  
Turns and looks in the direction of sounds

  
Listens when spoken to

  
Understands words for common items such as “cup,” “shoe,” or “juice”

  
Responds to requests (“Come here”)

  
Babbles using long and short groups of sounds (“tata, upup, bibibi”)

  
Babbles to get and keep attention

  
Communicates using gestures such as waving or holding up arms

  
Imitates different speech sounds

  
Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by the first birthday

  

1 to 2 Years

Knows a few parts of the body and can point to them when asked

  
Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s your shoe?”)

  
Enjoys simple stories, songs, and rhymes

  
Points to pictures, when named, in books

  
Acquires new words regularly

  
Uses some one- or two-word questions (“Where kitty?” or “Go bye-bye?”)

  
Puts two words together (“More cookie”)

  
Uses many different consonant sounds at the beginning of words

  

2 to 3 Years

Has a word for almost everything

  
Uses two- or three-word phrases to talk about and ask for things

  
Uses k, g, f, t, d, and n sounds

  
Speaks in a way that is understood by family members and friends

  
Names object to ask for them or to direct attention to them

  

3 to 4 Years

Hears you when you call from another room

  
Hears the television or radio at the same sound level as other
family members

  
Answers simple “Who?” “What?” “Where?” and “Why?” questions

  
Talks about activities at daycare, preschool, or friends’ homes

  
Uses sentences with four or more words

  
Speaks easily without having to repeat syllables or words

  

4 to 5 Years

Pays attention to a short story and answers simple questions about it

  
Hears and understands most of what is said at home and in school

  
Uses sentences that give many details

  
Tells stories that stay on topic

  
Communicates easily with other children and adults

  
Says most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th)

  
Uses rhyming words

  
Names some letters and numbers

  
Uses adult grammar

  

This checklist is based on How Does Your Child Hear and Talk?, courtesy of the American Speech–Language–Hearing Association.

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