May is Better Hearing and Speech Month – Talking about hearing and Down syndrome

Audiogram – Speech Banana

May is Better Hearing and Speech Month! In celebration I’m dedicating my May posts to hearing and speech in children with Down syndrome.

So, what about hearing? We know that hearing plays a huge part in learning to talk. Just like other infants, babies with Down syndrome should undergo a newborn hearing screening. An auditory brainstem response (ABR) or otoacoustic emission (OAE) test is recommended for all babies with Down syndrome by three months of age or if there is a concern of hearing loss (1).

How frequently does my child need a hearing test?

Once your child turns one the Down Syndrome Health Care Guidelines recommend behavioral hearing tests every six-months until they turn three.  This involves sitting your child on your lap in a sound proof booth while they respond to sounds. There are only a two things difficult about this test, 1. The child’s cooperation – as parents we all know it can vary minute by minute, 2. Your cooperation – it’s really hard not to look yourself when the sounds are activated. I know this from experience, as my son Louis had 12 ear infections in 18 months and we did hearing testing before and after his pressure equalization tube surgery. At Cincinnati Children’s they have two audiologists performing the test who helpfully remind parents to look straight ahead. This is so your child doesn’t pick up on your body movements giving a false-positive during testing.

After three years old and through adolescence hearing tests are recommended annually (2, 3). Why? It is so important to ensure proper hearing. If there is a fluctuating loss, constant fluid, or even a mild loss in one ear – speech development can be negatively impacted. Hearing loss can also impact early reading skills and processing skills needed to follow oral directions. A mild loss can significantly impact a child’s ability to perceive sounds and produce them correctly. It becomes even more difficult to hear in background noise – like in a classroom. This can cause a child to miss a lot of information and can be detrimental to children who already have difficulty learning auditorally.

My child always had good hearing, why do I need to continue testing after age 18?

My sister went through a phase at age 19 – she ignored everybody. She was a real pain and our family was really annoyed by her attitude. Then she went for an updated hearing evaluation – her first in about 3 years. It turned out she had a moderate sensorineural hearing loss requiring hearing aids. It explained a lot – she’s wasn’t ignoring us. She really didn’t hear us! Her attitude was partly justified – she was tired of us accusing her of ignoring us. The other part was just being a moody teenager. Fluctuating hearing loss is common in individuals and can have a profound impact on a person’s quality of life.

Hearing loss can masquerade as many different issues in people with Ds.Whenever I evaluate an adolescent or adult with Ds with a change in function – depressed moods, loss of language, etc. I always have them undergo hearing assessment first. In adulthood, hearing tests are recommended every 2 years (4).

 My doctor says she can’t see my baby’s ear drum with her otoscope.

Sometimes those ear canals are just too tiny for a pediatrician to see down. When this happens a referral to a pediatric otolaryngologist or ENT (Ear, Nose, and Throat) doctor is usually the next step. They have the equipment necessary to see the tympanic membrane (ear drum).

Schedule your child’s annual hearing evaluation today in celebration of Better Hearing and Speech Month!


  1. http://www.ndss.org/images/stories/NDSSresources/healthcareguidelinesnfant.pdf
  2. http://www.ndss.org/images/stories/NDSSresources/healthcareguidelineschildhood.pdf
  3. http://www.ndss.org/images/stories/NDSSresources/healthcareguidelinesadolescence.pdf
  4. http://www.ndss.org/images/stories/NDSSresources/healthcareguidelinesadulthood.pdf