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Your Baby's Hearing and Communicative Development Checklist

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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 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 make up 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
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 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 on a regular basis
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 objects 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 upon How Does Your Child Hear and Talk?, courtesy of the American Speech–Language–Hearing Association.

Where can I find additional information about hearing development?

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

Use the following keywords to help you search for organizations that can answer questions and provide information on speech and language development:

For more information, contact us at:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055

NIH Publication No. 10–4040
Updated September 2010

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