A Checklist to Help You Spot Hearing Loss

Although most states now have mandatory requirements for hearing tests while a newborn is still in the hospital, one in four hearing-impaired children slips by the safeguards and isn't diagnosed by age 3, says the National Foundation for the Deaf.

The reason: A lot of parents don't know the signs of hearing loss. Hearing loss also can accompany other disabilities and could be overlooked.

"The first three years of a child's life are the most important in the development of communication, so parents and pediatricians should know how to detect hearing problems at various stages during that time," says Lynn Luethke, Ph.D., program director for the National Institute on Deafness and Other Communications Disorders (NIDCD).

Hearing impairment can occur in the frequencies detected and in loudness of sound detected. Early detection and treatment can head off problems later. The NIDCD offers the following checklist.

Birth to 3 months

At birth to 3 months, does your child:

• React to loud sounds?

• Seem soothed by your voice?

• Turn his or her head when you speak?

• Smile when spoken to?

3 to 6 months

At 3 to 6 months, does your child:

• Look up or turn toward a new sound?

• Respond to "no" and changes in tone of voice?

• Imitate his or her own voice?

• Enjoy rattles and other sound-making toys?

• Begin to repeat sounds (like "ooh" and "ba-ba")?

• Seem scared by loud sounds?

6 to 10 months

At 6 to 10 months, does your child:

• Respond to his or her name, a ringing phone, or someone's soft voice?

• Know words for common things ("cup," "shoe") and sayings ("bye-bye")?

• Make babbling sounds, even if alone?

• Start to respond to requests such as "come here"?

• Look at things or pictures when someone talks about them?

10 to 15 months

At 10 to 15 months, does your child:

• Play with his or her voice, enjoying the sound and feel of it?

• Point to or look at familiar objects or people when asked to do so?

• Imitate simple words and sounds, and use a few single words meaningfully?

• Enjoy games like peek-a-boo?

15 to 18 months

At 15 to 18 months, does your child:

• Follow simple directions, such as "give me the ball"?

• Use words he or she has heard often?

• Use two- to three-word sentences to talk about and ask for things?

• Know 10 to 20 words?

18 to 24 months

At 18 to 24 months, does your child:

• Understand simple "yes-no" questions such as "Are you hungry?"

• Understand simple phrases ("in the cup," "on the table")?

• Enjoy hearing you read to him or her?

• Point to pictures when asked?

24 to 36 months

At 24 to 36 months, does your child:

• Understand "not now" and "no more"?

• Choose things by size (big, little)?

• Follow simple directions such as "get your shoes" and "drink your milk"?

• Understand many action words ("run," "jump")?

If you answered no to items at any age, talk with your pediatrician, says Dr. Luethke. "Even if it's not a hearing loss issue, there may be another medical problem that is hindering your child's language development."