Health Information and Tools >  Hearing Loss in Children, Ages 2 to 4 Years

Main Content

Hearing Loss in Children, Ages 2 to 4 Years

Overview

You can watch your child's behaviour to check for hearing loss. If you notice a change, your child might have hearing loss. Also, pay attention to the quality of your child's speech. Children must be able to hear well for normal speech and language to develop.

Does your child:

  • Follow two requests, such as "Get the ball and put it on the table?"
  • Continue to notice sounds, such as a telephone ringing, television sounds, or knocking at the door?

Monitor your child’s hearing
Your child should continue to show that their listening and language skills are developing. Pay attention to the quality of your child's speech. Children must be able to hear well for normal speech and language to develop.

By 2 years of age, your child should:

  • Use more words than gestures.
  • Say at least 50 words, but understand many more.
  • Use 2-words together, such as “more milk” and “mommy eat.”
  • Ask simple questions like “what’s that?”
  • Understand 2-part sentences, like “get your ball and put it in the box.”
  • Start to use -ing (eating), plurals (boats), and possessives (baby’s bottle).
  • Use their own name


By 3 years of age, your child should:

  • Use words that name objects (ball, shoe), describe (big, hot), and talk about actions (kick, eat).
  • Learn new words quickly and know most common object names. Usually able to say between 150 to 200 words.
  • Speak clearly. Parents understand their child most of the time. Strangers can understand them about 3 out of 4 times.
  • Continue to follow simple requests, such as "put the book on the table".
  • Point to at least 7 body parts when asked.
  • Point to a picture of something when asked, such as "Where is the cow?" or "Show me the airplane."
  • Use common objects in pretend play. For example, they pretend to fill up a toy bottle and feed a baby doll.
  • Use words like me and you, but they often get them mixed up.
  • Make phrases. Often use at least 3 to 4 words together in sentences such as “I want more milk” and “Mommy is at work.”
  • Understand and ask questions often such as “Where is your coat?”, “Who’s that?”, and “What is soap for?”
  • Begin to use “s” at the end of word to mean more than 1, use words like “you”, “me”, “the”, and “on” more consistently.
  • Follow 3-part directions, such as “Go to your room, get your socks, and bring them to me.”
  • Include the beginning and ending sounds in words, which may have been unclear before such as “bus” vs “-us”, “cat” vs “ca-“.
  • Describe activities, feelings, problems, and tell simple stories.


By 4 years of age, your child should:

  • Pay attention to short stories and answer questions about the story.
  • Use more specific words, like fireman or policeman instead of man.
  • Use sentences that are more complete and of 5 to 6 words.
  • Use more grammar, like “s” on a word to mean more than 1, use words like mine, he, she; use past tense like walked, and question words like who, what, where, why. There will still be some mistakes.
  • Uses sentences that are longer and more complete, such as “I want to go out and play on the swing.” There are still some mistakes.
  • Understands most concept words like colours, textures, shapes, locations, and time.
  • Understand the difference between things that are the same and things that are different, such as the difference between children and grown-ups.
  • Continue to follow 3-step instructions, such as "Go to the sink, wash your hands, and dry them on the towel."
  • Describe something that has happened to them or tell a story.
  • Speak clearly enough so that people who don’t know them can understand them almost all of the time.

Talk to your family doctor or healthcare provider if you have concerns with how your child is responding to sound.

Credits

Adaptation Date: 2/25/2022

Adapted By: Alberta Health Services

Adaptation Reviewed By: Alberta Health Services

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.