Q&A: Can Mild Hearing Loss Contribute to a Learning Delay?

CME WebsitesChild Development

blockquote_bgMy son turned a year old a couple weeks ago. He was a few weeks early, but not technically premature. He is not yet clapping, pointing, waving, or playing peek-a-boo. He also really only says, “Dada.” However, at times he has sounded like he is saying “mama,” and “night, night” at bedtime. I’ve been trying to get him to use some musical toys to get him to use his arms. He held the drum sticks for a little while and hit the drum with both arms, but later I saw him mostly putting the various instruments in his mouth. I tried to get him to stack blocks and similar issue; he tried for a little with help, but then put them in his mouth. We are concerned that he has some type of developmental delay and wonder what we should do or if it is too soon to tell. He does pull to stand up, cruises, feeds himself with fingers, holds bottle but tilts head back, smiles, acknowledges when we enter the room, responds to “no,” and his “name.”
I’ve tried to use sign language, but he has not picked up on it yet. He was diagnosed a couple months ago with mild hearing loss and had tubes put in a couple weeks ago. This did seem to make a difference in how well he responds to sound. He is our second child. His sister tends to like to get all the attention. We’ve thought that this might be contributing to his learning delay at first, but now we’re very worried. We will be seeing his doctor next week for his 1 year old checkup. Any advice?

It sounds like your son is doing fairly typical things for a little boy who just turned one. It is certainly not uncommon for 12 month olds to continue to prefer to mouth toys over functionally playing with toys. It is great that you are continuing to encourage functional play by using specific toys like the drum and blocks. Usually at this age, anything with noise, lights and/or music as an incentive to keep repeating an action on a toy will hold a baby’s attention for a few minutes. Do not expect him to play with one toy for more than a minute or two, as even 2 year olds only have average attention spans of about 3 to 5 minutes per toy. At his age, you can encourage dropping toys into large buckets or cans (coffee cans with the edges taped to avoid sharpness make a nice loud noise when toys are dropped inside) and encourage a voluntary release of objects, which helps work on fine motor skills.

Encourage finger isolation for pointing by using buttons on pop up boxes. At snack time, drop a single Cheerio into each opening in an empty egg carton (hold the carton steady for him) and encourage him to use his thumb and fingers to get them out, moving toward a neat pincer grasp. Since he is making a variety of consonant-vowel sounds that is good too, and just continue to encourage him to make attempts at new sounds-environmental sounds and animal sounds are the most fun (moo, woof, ding-dong, wheee). Continue to practice with encouraging the gestures you mentioned-clapping, waving, pointing and also continue to practice daily with simple signs like “more”, “eat”, “drink”….you can use hand over hand to facilitate. Use music and finger plays such as Wheels on the Bus and Itsy Bitsy Spider, and enlist his sister as a helper.

Sometimes a baby will imitate a sibling more so than a adult family member. Encourage moving away from the bottle to a straw cup rather than a sipper cup for better oral motor practice needed for speech. Lastly, since you mentioned tubes and a diagnosis of a mild hearing impairment (was this conductive due to fluid in the ears and multiple ear infections?), it wouldn’t hurt to seek an early intervention evaluation since even a mild temporary hearing loss can have a great impact on speech development and later learning. If the diagnosis of the hearing impairment was permanent or sensorineural in nature, than do seek immediate services. Of course, go by your doctor’s advice at his one year check up, but sometimes doctors will take a “wait & see” approach and in early intervention we would rather assess a baby NOW and say “no he doesn’t qualify for services” rather than see a child at 18mos-2 years and says “why wasn’t this child referred earlier?”.