How well a child learns to read, write and communicate with others depends heavily on how well the little one hears.
Hearing is essential to speech development, and it is especially crucial from the moment a child is born until the age of 3. If a child has a hearing deficit and it goes untreated, he or she can face a multitude of challenges from delayed speech and communication skills to low academic performance and self-esteem issues.
With help, children with impaired hearing can live full and productive lives, but early detection leads to the best possible outcome.
“Hearing is a building block of speech and language,” said Luann Mezzatesta, a senior speech language pathologist at Tidelands Health Pediatric Rehabilitation Services at Georgetown. “If it is missing or impaired, speech and language are impacted.”
Important from birth
For proper speech and language development, an infant needs the ability to hear sounds and words. In the first year of life, babies begin building a foundation for speech by picking up on the voices and sounds around them.
Children who are unable to hear well will struggle to understand how to communicate verbally, Mezzatesta explains. If they can’t hear speech sounds being produced correctly by others, they will be unable to produce the same sounds properly themselves.
It’s often difficult to diagnose a hearing deficit unless there is an obvious medical explanation such as chronic middle ear infections that can result in speech delays.
Failing to respond to parents’ voices, a crinkled paper, a doorbell or when his or her name is called are other signs a child might have impaired hearing.
If your toddler fails to react to loud noises, speaks at a slower rate than other kids the same age or isn’t saying some words by about 18 months of age, talk to your child’s primary care provider about a speech test.
“The longer a child goes with hearing loss or a deficit, the less speech and language they are exposed to and the more ‘catching up’ they may need,” Mezzatesta says.
Testing
Tidelands Health Pediatric Rehabilitation Services performs standardized testing for speech and language skills for children from birth to 21 years. The evaluation examines the individual’s vocal quality, speech performance, oral motor skills and how the child responds to certain sounds, Mezzatesta explains. It is used to determine if a speech concern exists and to help pinpoint the cause.
In some cases, intervention by a physician may be necessary to correct an anatomic abnormality that is impeding hearing and causing speech delays.
Once an underlying cause is identified and addressed, customized treatment plans can be developed.
For example, children with chronic ear infections can benefit from pressure equalization tubes plus speech therapy, a common treatment approach.
Treatment
Children with inner ear or sensory-neural hearing loss might benefit from hearing aids or cochlear implants accompanied by speech therapy. A child with deafness or severe sensory-neural hearing loss will require the parent to decide whether to raise their child as “deaf” or as “hearing,” Mezzatesta explained.
“The amount and type of speech and language therapy would be dependent on this answer,” she said.
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To help a hearing-impaired youngster develop effective communication skills, sign language and augmentative communication strategies, which may include electronic devices, can be implemented as part of a “whole-language” therapy program.
“We always work toward spoken language as the ultimate goal, especially in young children,” Mezzatesta says. “Most importantly for any child with a communication deficit is to develop a functional understanding and use of language.
“How that happens is usually a blend of approaches,” she says. “The most important thing from a parent’s perspective is to pay attention to your child’s behavior from an early age to identify any hearing concern that may exist and, if necessary, pursue treatment as soon as possible.”

Luann Mezzatesta
Senior Speech Language Pathologist, Tidelands Health Center for Pediatric Development at Georgetown