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Hearing Impairment in Children

Updated: Sep 14, 2021

Article Written By: Victoria Mannella-Gupta

Did you know that some children’s toys can be as loud as a rock concert or a jet flying over? Infants and children will often bring toys close to their faces as part of the learning process, even though some toys are designed to be held further away from the body during play. Very loud noises such as that from a whistle or cap gun can instantly and permanently damage a child’s hearing, especially if held close to the ear*. Continue reading to learn about hearing impairments in children, how you can protect your child’s hearing, and the role of the Speech-Language Pathologist (SLP).

As part of the Infant Hearing Program in Ontario, all newborns in the hospital and community settings receive a universal hearing screening, which identifies whether infants require a more in-depth test for hearing loss. Most babies will pass the newborn hearing screening, meaning their hearing is fine at the specific time. However, although approximately 2 out of 1000 babies have hearing loss at birth, and 2 more out of 1000 develop hearing loss by the age of five. The children with hearing loss may hear some sounds but miss others, making it difficult to learn speech and language which may lead to behavioural or learning challenges in the future**.

Signs of hearing loss in children***:

Birth- 4 months

• Newborn doesn’t startle at loud sounds

• Doesn’t respond to your voice by smiling, calming down, or cooing

4-9 months

• Does not smile when spoken to

• Does not notice toys that make sounds

• May not turn head toward familiar sounds

• Is not babbling

• Does not seem to understand hand motions like waving “bye-bye”

9-15 months

• Infant still is not babbling or attempting to repeat simple sounds

• Does not use his/her voice to get your attention

• Does not respond to his/her name

15-24 months

• He/She is not using many simple words

• Does not point to body parts when you ask

• Cannot name common objects

• Does not listen with interest to songs, rhymes, and stories

• Cannot follow basic commands

Toddlers and School-Aged Children

• He/She has difficulty understanding what people are saying

• Speaks differently than other children his or her age

• Doesn't reply when you call his or her name

• Responds inappropriately to questions (misunderstands)

• Turns up the TV volume incredibly high or sits very close to the TV to hear

• Has problems academically (especially if they weren't present before)

• Has speech or language delays or problems articulating sounds

• Watches others in order to imitate their actions, at home or in school

• Complains of ear pain, earaches or noises

• Cannot understand over the phone or switches ears frequently while talking on the phone

• Says "what?" or "huh?" several times a day

• Watches a speaker's face very intently (sometimes children’s hearing loss can go unnoticed because they are successful lip readers)

Hearing Loss Prevention****

Sound levels are measured in decibels (dB). The higher the decibel level, the louder the sound. The louder the sound and time exposed to the noise, the more likely it will harm your child's hearing.

Common Sounds

• Normal conversation 50 dB

• Vacuum 63-88 dB

• Blow-dryer 70 dB

• Telephone Ringing 75 dB

• Alarm Clock 97dB

• Subway train entering station 100 dB

• Concert 105 dB

• Balloon Bursting 150 dB

Noise levels above 85 dB will harm hearing over time. Noise levels above 140 dBA can cause damage to hearing after just one exposure.

Popular Noisy Toys (held 25cm from the body!):

• Toy Cap Gun 105-110 dB

• CD player 97-103 dB

• Whistle 106 dB

• Police car 96 dB

• Piano Keyboard 104 dB

• Xylophone 92 dB

• Drum 103 dB

• Rattle 102 dB

Toys that emit a noise over 100 dB are banned by Health Canada under the Hazardous Products Act. However, toy manufacturers are not required to label toys with the decibel.

What can you do to prevent hearing loss? ****

• Purchase toys that have on/off switches

• Purchase toys with volume control

• Check for noise level labels on toys

• Listen to the toy yourself before making a purchase

• Teach your children about the potential danger to their ears from noisy toys and noisy activities

• Reduce the amount of time your child spends playing with noisy toys

• Remove the batteries (infants and children will most likely be unaware that the toy is supposed to have batteries!)

• Supervise young children when they play with toys that emit sounds

• Discuss with children the proper way to handle their toys

• Toys should be played with at arm’s length, not at face/ear level

• Turn down the volume of toys with headsets (personal stereos etc.)

• Purchase alternate toys such as books and puzzles that target language and literacy skills

• Share these tips with friends and relatives that may be purchasing toys for your child

The Role of the Speech-Language Pathologist*****:

• SLPs understand how hearing loss affects communication development

• SLPs can assess speech, language, voice etc. relative to hearing loss

• Provide speech therapy services to those with hearing loss, their families and caregivers, including auditory rehabilitation, listening checks, speechreading etc.

• Develop and choose appropriate communication techniques and strategies

• Observe and measure communication parameters using instrumentation informed practices.

• Evaluate and establish appropriate communication devices

What should I do if I suspect my child has a hearing loss?

• Discuss suspicion with child’s pediatrician

• Book a hearing test with an Audiologist

Early detection is very important for your child’s speech, language, and literacy development! If you suspect any concerns with your child’s hearing, please reach out to an Audiologist to book an appointment- no referral is needed. At Empower Communication Services, we look forward to working with your child on speech, language, and literacy which may have been affected from hearing loss.


*Ontario Infant Hearing Program (2021).

** Noisy Toys are Not for Delicate Ears. Speech-Language and Audiology Canada (2021).

*** Healthy Hearing. (2021). Hearing Loss in Children. as outline by ASHA.

****Noisy Toys Safety Tips. Speech-Language and Audiology Canada (2021).

*****ASHA. (2021). Hearing Loss (Ages 5+).

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