How Children's Hearing Develops

Children begin learning about sound from the very start of life. As they grow, their listening skills develop alongside their speech, language, communication and learning.

Every child develops differently, so hearing and listening milestones are best viewed as a guide rather than a checklist. However, understanding what you might expect at different ages can help you recognise when a hearing assessment may be helpful.

Birth to 6 months

During the first few months, babies begin noticing and responding to sounds around them.

You may notice your baby:

• reacts or startles to some sounds
• quietens or responds to a familiar voice
• begins looking or turning towards interesting sounds
• enjoys hearing you talk, sing and play
• starts making cooing and other early vocal sounds

Responses at this age can vary depending on whether your baby is awake, tired, hungry or interested in something else.

6–12 months

Listening becomes increasingly purposeful during the second half of the first year.

Your baby may:

• turn towards voices and sounds
• respond to their name
• search for where a sound has come from
• recognise some familiar words
• enjoy songs, rhymes and interactive games
• babble using repeated sounds such as "ba-ba" or "ma-ma"
• begin copying sounds

Towards the end of the first year, some children will also begin using their first meaningful words.

1–2 years

During the toddler years, children increasingly connect what they hear with meaning.

They may:

• recognise the names of familiar people and objects
• understand an increasing number of words
• follow simple spoken instructions
• enjoy listening to songs and stories
• point to familiar objects when asked
• use a growing number of words themselves

2–4 years

As children's language develops, they are using their hearing for increasingly complex communication and learning.

You may notice your child:

• follows increasingly complex instructions
• listens to stories and conversations
• learns new words quickly
• asks and answers questions
• joins in songs and rhymes
• communicates using longer sentences
• listens and interacts with other children during play

Starting school and beyond

School places much greater demands on children's hearing and listening. A child now needs to listen to a teacher from a distance, follow instructions, learn new vocabulary and understand speech while other children and classroom noise are happening around them. Sometimes this is when more subtle hearing or listening difficulties become noticeable.

You may notice that your child:

• frequently asks for repetition
• misunderstands spoken instructions
• seems to hear better when looking directly at you
• turns the television or devices louder
• struggles particularly in background noise
• seems to hear well sometimes but not at other times
• becomes tired or frustrated after lots of listening
• has difficulties with speech, language, phonics or learning
• is described as distracted or inattentive during spoken activities

"But my child passed their newborn hearing screen…"

A clear newborn hearing screen is very reassuring, but it does not mean that a child's hearing can never change. Some hearing difficulties develop later in childhood, and temporary hearing changes caused by conditions such as glue ear are common.

If you have concerns about your child's hearing, speech, language or listening behaviour, it is appropriate to have their hearing checked even if they passed their newborn screen.

When should I consider a hearing assessment?

Consider seeking advice if your child:

• does not consistently respond to sounds or their name
• has delayed or unclear speech
• frequently asks for repetition
• has difficulty following spoken instructions
• experiences recurrent ear infections or glue ear
• struggles to hear in background noise
• turns the television or devices unusually loud
• has concerns raised by nursery or school
• seems to find listening unusually tiring or difficult

Further information

• NHS — Hearing tests in children

  https://www.nhs.uk/conditions/hearing-tests-children/

• NHS — Glue ear

  https://www.nhs.uk/conditions/glue-ear/

• GOV.UK — Newborn hearing screening: programme overview

  https://www.gov.uk/guidance/newborn-hearing-screening-programme-overview

• MED-EL — LittlEARS® Auditory Questionnaire

  https://www.medel.com/en-gb/about-hearing/hearing-test/little-ears-auditory-questionnaire