Signs Your Toddler May Have a Hearing Problem

If your toddler does not turn when you call from behind, seems to hear beautifully one day and not the next, or is slow to start talking, a hearing problem is the first thing worth ruling out — not the last. Hearing difficulties in small children are quiet, common and easy to miss, and many of them are temporary or treatable when they are picked up early.

This page sets out the everyday signs of a hearing problem in toddlers, what your child’s response to sound should look like at each age, why hearing seems to come and go, and what you can do this week. If you want the mechanism behind it — which speech sounds go missing first and what actually happens at a hearing test — read our companion guide on how hearing problems affect your child’s speech. Listening is part of every developmental assessment we carry out here in Multan.

What are the signs my toddler may have a hearing problem?

The everyday signs of a hearing problem in a toddler are: not startling at sudden loud noises, not turning when you call their name from behind, wanting the television louder than everyone else, watching your face and mouth closely to understand you, saying “what?” or “haan?” very often, and speech that is late, unclear, or has stopped moving forward.

One sign on its own rarely means much. Plenty of two-year-olds ignore their parents magnificently. What matters is a cluster of signs, and a change over time. These are the patterns that most often bring families to us to explore hearing and speech difficulties, because the two are so tightly tied together.

The signs parents do not expect

• “He hears when he wants to.” This sentence is said in almost every first appointment, and it is a symptom rather than a personality. Hearing that fluctuates makes a child seem selective.
• Fine one to one, lost in a crowd. Your child follows you perfectly in a quiet room and switches off at a family gathering or in the classroom.
• Word endings going missing. The quiet, high sounds — s, sh, f, th, t, k — are the first to be lost, and they live on the ends of words in both Urdu and English.
• Being called stubborn, dreamy or naughty. A child who mishears answers the wrong question and gets told off for it.
• Speech that went backwards after a run of colds. Winter after winter, a child can lose ground and nobody connects it to their ears.
• A very loud or very flat voice. Children set their own volume by what they can hear.
• Watching everyone else before doing anything. Copying the other children is a clever way to hide a hearing problem, and it works for years.

What should my child’s response to sound look like at each age?

By six months a baby should startle at a sudden loud noise and go still or turn towards a familiar voice. By twelve months most children turn when their name is called. By eighteen months they follow a simple instruction without you pointing. By two years they answer when called from another room, and by three they can sit through a short story.

Use the age band your child has already passed, not the one they are in. And if your child was born early, count from their due date rather than their birthday. If several things on the list for their age are missing, the age-by-age guides are a useful next read: red flags at one year old, at two years old, and at three years old.

Why does my child seem to hear on some days and not others?

Because hearing loss in young children is often not constant. The commonest cause is glue ear — fluid that builds up behind the eardrum after colds and ear infections, making voices sound the way they do underwater. It comes and goes, and it takes the quiet speech sounds with it while it lasts.

Glue ear is very common and usually settles on its own within a few months. The catch is timing. A few muffled months mean little to an adult; to a toddler adding new words every week, they are a real gap — and a child who gets one bout often gets several through a winter of colds. The NHS notes there is no effective medicine for glue ear, which is why doctors usually watch and re-test rather than treat straight away.

Things worth mentioning to your doctor, because they often travel with glue ear: repeated ear infections, ear pain, ear discharge (کان بہنا, kaan behna), snoring, mouth-breathing, or a child who tugs at their ears. Ear pain or discharge is not a wait-and-see — that needs an ENT doctor now.

Is it a hearing problem, or something else?

Not every child who ignores their name has a hearing problem. Three other explanations come up constantly, and it is worth knowing how they differ.

• Autism. A child who does not turn to their name may be missing the sound, or may not be tuning in to people. A useful pointer: a child with a hearing problem usually responds well once they can see your face, and still points, shows and shares things with you. Read the early signs of autism if that sounds familiar. Both can also be true at once.
• Two languages at home. Growing up with Urdu, Saraiki, Punjabi and English does not cause a speech delay, and it never explains a child who cannot hear. Count your child’s words across all their languages together.
• Attention, not ears. Some children pass a hearing test and still cannot follow what is said — fine one to one, lost in a noisy classroom. That is a different problem with a different plan, and it still starts with a hearing test to rule the ears out.

Some children need watching more closely than others. Children with Down syndrome, for example, have narrow ear canals and get glue ear very often, so hearing is checked regularly as a matter of routine — we cover that in our guide to Down syndrome and communication. A family history of childhood deafness is another good reason not to wait and see.

What can I do at home this week?

• Do the “from behind” check properly. Stand two or three steps behind your child while they are calmly occupied, out of their line of sight, and say their name in your normal voice. No floor stomping, no shadow falling across them, no touching. Try it a few times across different days.
• Keep two weeks of notes. Good days, bad days, colds, ear pain, and what they did or did not respond to. Scribbled notes are worth more to an audiologist than anything you can remember on the spot.
• Turn the noise off before you talk. Television, fan, several people at once — background sound is the single biggest obstacle for a child whose hearing is patchy.
• Get to eye level and face them. Calling instructions from the next room is what every household does, and it is the hardest possible way for your child to hear you.
• Say it, then wait. Count silently to five. A child working harder to hear needs longer to answer.
• Raise the ears specifically at the next doctor’s visit. Say “I want his hearing checked”, and bring the colds, the snoring and the ear-pulling with you.

When should I stop waiting and get hearing checked?

Book a hearing test rather than waiting if your child does not respond to loud sound at any age, has no clear words by eighteen months, has lost words or clarity they previously had, gets repeated ear infections, has ear pain or discharge, or answers you face to face but not from behind. A test is quick, painless and does not need your child to talk.

Hearing tests are done by an audiologist or an ENT specialist, and both are available in Multan through the hospitals and private clinics here. Ask what your child is being tested with: for a toddler this is usually an OAE screen and tympanometry, which checks for fluid behind the eardrum, and for a baby or a child who cannot cooperate, a BERA test done while they sleep.

Two practical things. A test tells you about hearing on that one day, so where glue ear is suspected hearing is usually re-checked a few weeks later rather than signed off on a single visit. And nothing has to wait for the appointment — listening, understanding and talking can all be worked on straight away, with no diagnosis in hand.

How we help families in Multan

At Inclusive Developmental and Therapy Center on MPS Road, Block A Model Town, Multan, hearing comes up in the first conversation rather than as an afterthought. In a first session we watch the practical things: whether your child responds without seeing your face, whether they respond in a noisy room, which sounds are missing from their speech, and whether the pattern changes with a cold.

We do not carry out hearing tests ourselves — that is an audiologist’s job, and we will tell you exactly what to ask for. What we do is work alongside the result. Mahnoor Baloch, our Speech & Language Therapist, and the team start listening and language work while you wait for the appointment, and teach the missed sounds through speech and language therapy once hearing is stable. If a test shows something we cannot support, we will say so and point you to the right specialist.

If there is a quiet worry about your toddler’s hearing tucked at the back of your mind, it deserves ten minutes of somebody’s attention. Tell our Multan team what you have noticed, or call or WhatsApp us on +92 314 6040262, Monday to Saturday, 10am to 7pm. We will help you work out the next step — starting with whether a hearing test is the first thing to book.