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The relation between speech and hearing loss in children.

Updated: Jun 11, 2021


Hearing loss is one of the major reasons for speech delay in children. According to a study, conducted in 2015, published in the Bahrain Medical Bulletin, five infants were identified with hearing impairment out of 1,834 or 272 per 100,000. Another study reports that 3 out of every 1000 children are born with some degree of hearing loss.

A child is diagnosed to have hearing loss if they can't hear sounds below a certain level of volume in either one ear (known as unilateral) or both ears (bilateral). Genetic factors contribute to 50% of all hearing loss in children, and non-genetic factors such as birth complications, infections, nervous system disorders or brain disorder, drug-induced hearing loss etc. account for another 25% of hearing loss; another 25% are due to anonymous reasons. Also, note that hearing loss can be temporary, mostly due to ‘build-up wax’ or ‘ear infection.’ Irrespective of the fact whether the hearing loss is temporary or permanent, you must seek professional help at the earliest.

Identification of hearing loss.

Most hearing losses are identified through screening at birth. Some children are not diagnosed until later when speech or language skills are not progressing. However, studies prove that children identified with hearing loss by six months and who received treatment (Hearing aid, cochlear implant, and rehabilitation services) have similar speech and language skills to those of children of the same age without hearing loss. Following are the hearing tests usually performed to diagnose a hearing loss.

· Newborn hearing screening- newborn babies have their hearing screened before leaving the hospital

· Visual reinforcement audiometry from six months of age to two years

· Play audiometry for toddlers and pre-school children.

· Tympanometry and acoustic reflex tests for school-aged children.

Signs of hearing loss that a parent could notice in a child as per ASHA:

0- 1 year: Not paying attention to sounds.

7 months- 1 year: Not responding when you call their name.

1- 2 years: Not following simple instructions.

0- 3 years: Shows speech delay.

If you notice any of these signs, the most important thing to do is to have your child's hearing tested by an audiologist, then visit a doctor and further consult a speech therapist.

So, how does hearing loss affects speech and language skills?

Hearing is primary to the development of speech in a child. Even a mild hearing loss can affect a child’s speech and language skills. When a child has difficulty in hearing, quite naturally, the areas of the brain associated with communication may not develop appropriately. Hearing helps in acquiring knowledge of words and sounds; missing out on these cause problems related to skills such as speaking, reading, school success, and social skills. For example, a child with hearing loss may hear like this “I toh im toe um ro” (the actual sentence is “I told him to get some rocks”); this is due to the following scientific reasons as per ASHA:

  • Not use sounds like s, sh, f, t, or k. These are quiet sounds that are hard to hear.

  • May learn concrete words like cat, jump, five, and red. However, they may have trouble with abstract words like before, equal to, and shy. They may not use words like the, an, are, and a.

  • Have trouble knowing the different meanings of a word. Think about the word bat. It can mean a flying animal or what we use to play baseball. A child with hearing loss may not understand these meanings.

  • Understand and use shorter sentences than children with normal hearing, but have problems with more complex sentences. They may not use clauses in their sentences. An example of a clause is "When I get home, I will eat dinner." They may not use passive voice. An example of this is "The ball was thrown by Mary."

  • Have trouble hearing word endings, like -s or -ed. They may not understand or use plural words, like cats. They may not use past tense like walked. And possessives, like Bob's, can be hard to hear or use.

Children with hearing loss are also subjected to disturbing social issues such as,

  • Difficulty in paying attention, expressing themselves, and understanding what others say.

  • Unable to follow and understand directions and rules.

  • Listening and learning in the classroom.

  • Getting misunderstood by others, for instance, since they don’t hear properly their own voices, they may either speak too loud or soft and people may misunderstand that they are either rudely behaving or mumbling.

I Hope, this knowledge gives you an idea of how hard it could be for a child with hearing loss.


First, check the requirement for a hearing aid or a cochlear implant and then start speech therapy from a licensed speech therapist; remember, to accomplish both steps, at the earliest. Following are some of the aspects on which your speech therapist will work on:

1. Visually inspect the amplification equipment ( hearing aid or cochlear implant).

2. Develop early communication skills, such as eye contact, initiation, turn-taking).

3. Develop social and interaction skills, such as non-verbal communication, discourse skills, social communication skills, and compensatory strategies for communicative deficits.

4. Development of receptive and expressive language skills.

5. Environmental modifications, auditory training, and enhancing speech or sign intelligibility.


Hearing loss has a direct and serious impact on the development of speech and language skills in children. Early identification and appropriate treatment are vital in minimizing the adverse effects of hearing loss on the communication skills of a child.




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