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Hearing Loss in Children, Age 4 Years and Older

Overview

By the age of 4, your child may tell you they are having trouble hearing or understanding others. You can ask your child questions about their hearing.

You can also watch your child's behaviour to check for hearing loss. If you notice a change, your child might have hearing loss. Does your child:

  • Follow complicated instructions, such as "Take your coat to your bedroom and bring a book to read"?
  • Respond to sounds appropriately, such as a telephone ringing, television sounds, or knocking at the door?

Your child's teacher may notice behaviour that would mean your child is not hearing well, such as talking in a loud voice or not following instructions.

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 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 contain 5 to 6 words.
  • Use more grammar, (such as an “s” at the end of a word to show they mean more than 1, words like mine, he, she), past tense (such as walked), and question words (such as who, what, where, why). There likely will still be some mistakes in how these words are used.
  • Uses sentences that are longer and more complete, such as “I want to go out and play on the swing.”
  • Understand 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.


By 5 years of age, most children should:

  • Be able to define words such as "spoon" and "cat."
  • Use different types of words, like action words (such as eat, play) and describing words (such as fast, cold).
  • Use sentences that are more like an adult’s but there may still be a few mistakes.
  • Use language to solve problems, make plans, and to play pretend with other children.
  • Ask questions that start with ‘when’ and ask more difficult questions, like ‘why’ and ‘how’.
  • Say most speech sounds correctly. Some may still have trouble saying the sounds sh, ch, j, s, z, v, r, and th.
  • Speak clearly and have siblings, friends, parents, and people who don’t know them easily understand them.
  • Take turns in a conversation, interrupt less, and making eye contact with other children and adults.
  • Be able to carry on a conversation with another person.
  • Understand most adult conversation, including sayings that are common in their household (for example, “Time to hit the sack” as meaning it’s time to go to bed).
  • Retell a story by naming the characters and talking about what happened.
  • Often refer to people (or objects) by their relationship to others, such as "Bobby's mom" instead of "Mrs. Smith."
  • Understand relationships between things, such as "the girl who is playing ball" and "the boy who is jumping rope."
  • Use the present, future, and past tenses (such as she walks to the park. She will walk to the park. She walked to the park.).
  • Understand opposite and comparing words such as above and below, loud and louder.
  • Put things into basic groups, such as fruits, animals, and toys.
  • Like to listen to rhymes and make up their own rhymes.

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.