U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ∙ National Institutes of Health 

NIDCD Fact Sheet | Hearing and Balance 

Your Baby’s Hearing 

and Communicative 

Development Checklist 

Some babies are born with hearing problems. Other 


children are born with normal hearing and begin to have 


hearing problems as they grow older. 


It’s important to know what to expect as your baby 


grows, because hearing problems can delay the 


development of voice, speech, and language skills. The 


checklist at the end of this fact sheet presents the average 


age by which most babies accomplish a variety of early 


speech and language skills. Typically, a child may not 


accomplish all the items in an age category until he or she 


reaches the upper age in the age range. 


Find your child’s age range in the checklist. Check “yes”
 

or “no” for each item. After you complete the checklist,
 

if any of the items are checked “no,” show it to your
 

child’s doctor. Tell the doctor if you think your child has
 

trouble hearing.
 

A 4- to 6-month-old baby with normal hearing development 

will follow sounds with his or her eyes. 

Talk to your doctor 

If you think your child may have a hearing problem, here 


are some things that your doctor might ask you about:
 

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Do others in the family, including brothers or sisters, 

have a hearing problem? 

Did the child’s mother have medical problems in 

pregnancy or delivery (experienced a serious illness or 

injury or needed drugs or medications)? 

Was the child born early? 

How much did the child weigh at birth? 

Did the child have physical problems at birth? 

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Does the child rub or pull on his or her ear(s) often? 

Has the child ever had scarlet fever? 

Has the child ever had meningitis? 

How many ear infections has the child had in the 

past year? 

How often does the child have colds, allergic symptoms, 

or ear infections? 

NIDCD...Improving the lives of people with communication disorders 
Some words the doctor may use are: 

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Audiogram: a chart that shows how well you can hear. 

Audiologist: a person who tests and measures hearing. 

Earache: pain deep inside the ear. 

Otitis media: middle ear infection. 

Otolaryngologist: a doctor who treats diseases and 

problems of the ear, nose, and throat. 

Otologist: a doctor who treats diseases of the ear. 

Pediatrician: a doctor who takes care of infants and 

children and who treats their diseases. 

Speech-language pathologist: a health professional 

trained to evaluate and treat people with speech or 

language disorders. 

What are voice, speech, and 

language? 

Voice, speech, and language are the tools we use 

to communicate with each other. 

Voice is the sound we make as air from our 

lungs is pushed between vocal folds in our larynx, 

causing them to vibrate. 

Speech is talking, which is one way to express 

language. It involves the precisely coordinated 

muscle actions of the tongue, lips, jaw, and vocal 

tract to produce the recognizable sounds that 

make up language. 

Language is a set of shared rules that allow 

people to express their ideas in a meaningful way. 

Language may be expressed verbally or by writing, 

signing, or making other gestures, such as eye 

blinking or mouth movements. 

Birth to 3 Months 

YES NO 

£ £ Reacts to loud sounds 

£ £ Calms down or smiles when spoken to 

£ £ Recognizes your voice and calms down if crying 

£ £ When feeding, starts or stops sucking in response 

to sound 

£ £ Coos and makes pleasure sounds 

£ £ Has a special way of crying for different needs 

£ £ Smiles when he or she sees you 

4 to 6 Months 

YES NO 

£ £ Follows sounds with his or her eyes 

£ £ Responds to changes in the tone of your voice 

£ £ Notices toys that make sounds 

£ £ Pays attention to music 

£ £ Babbles in a speech-like way and uses many 

different sounds, including sounds that begin 

with p, b, and m 

£ £ Laughs 

£ £ Babbles when excited or unhappy 

£ £ Makes gurgling sounds when alone or playing 

with you 

7 Months to 1 Year 

YES NO 

£ £ Enjoys playing peek-a-boo and pat-a-cake 

£ £ Turns and looks in the direction of sounds 

£ £ Listens when spoken to 

£ £ Understands words for common items such as 

“cup,” “shoe,” or “juice” 

£ £ Responds to requests (“Come here”) 

£ £ Babbles using long and short groups of sounds 

(“tata, upup, bibibi”) 

£ £ Babbles to get and keep attention 

£ £ Communicates using gestures such as waving or 

holding up arms 

£ £ Imitates different speech sounds 

£ £ Has one or two words (“Hi,” “dog,” “Dada,” or 

“Mama”) by first birthday 

2 
1 to 2 Years 

YES NO 

£ £ Knows a few parts of the body and can point to 

them when asked 

£ £ Follows simple commands (“Roll the ball”) 

and understands simple questions (“Where’s 

your shoe?”) 

£ £ Enjoys simple stories, songs, and rhymes 

£ £ Points to pictures, when named, in books 

£ £ Acquires new words on a regular basis 

£ £ Uses some one- or two-word questions (“Where 

kitty?” or “Go bye-bye?”) 

£ £ Puts two words together (“More cookie”) 

£ £ Uses many different consonant sounds at the 

beginning of words 

2 to 3 Years 

YES NO 

£ £ Has a word for almost everything 

£ £ Uses two- or three-word phrases to talk about and 

ask for things 

£ £ Uses k, g, f, t, d, and n sounds 

£ £ Speaks in a way that is understood by family 

members and friends 

£ £ Names objects to ask for them or to direct 

attention to them 

3 to 4 Years 

YES NO 

£ £ Hears you when you call from another room 

£ £ Hears the television or radio at the same sound 

level as other family members 

£ £ Answers simple “Who?” “What?” “Where?” and 

“Why?” questions 

£ £ Talks about activities at daycare, preschool, or 

friends’ homes 

£ £ Uses sentences with four or more words 

£ £ Speaks easily without repeating syllables or words 

4 to 5 Years 

YES NO 

£ £ Pays attention to a short story and answers simple 

questions about it 

£ £ Hears and understands most of what is said at 

home and in school 

£ £ Uses sentences that give many details 

£ £ Tells stories that stay on topic 

£ £ Communicates easily with other children and adults 

£ £ Says most sounds correctly except for 

a few (l, s, r, v, z, ch, sh, and th) 

£ £ Uses rhyming words 

£ £ Names some letters and numbers 

£ £ Uses adult grammar 

This checklist is based upon How Does Your Child Hear and Talk?, 

courtesy of the American Speech–Language–Hearing Association. 

3 
Where can I find additional 

information about hearing 

development? 

The NIDCD maintains a directory of organizations that 

provide information on the normal and disordered 

processes of hearing, balance, taste, smell, voice, 

speech, and language. Visit the NIDCD website at 

http://www.nidcd.nih.gov to search the directory. 

Use the following keywords to help you find organizations 

that can answer questions and provide printed or 

electronic information on hearing development: 

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Audiologist 

Early identification of hearing loss in children 

Speech-language pathologists 

More NIDCD fact sheets on Hearing and Balance: 

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Communication Considerations for Parents of Deaf 

and Hard-of-Hearing Children 

Communication Problems in Children with Autism 

Spectrum Disorder 

Speech and Language Developmental Milestones 

Specific Language Impairment 

What to Do if Your Baby’s Screening Reveals a Possible 

Hearing Problem 

Visit the NIDCD website at http://www.nidcd.nih.gov

to read, print, or download fact sheets. 

For more information, additional addresses and phone 

numbers, or a printed list of organizations, contact us at: 

The NIDCD Information Clearinghouse 

1 Communication Avenue 

Bethesda, MD 20892-3456 

Toll-free Voice: (800) 241-1044 

Toll-free TTY: (800) 241-1055 

Fax: (301) 770-8977 

Email: nidcdinfo@nidcd.nih.gov 

http://www.nidcd.nih.gov

 Follow the NIDCD on Twitter at @NIDCD 

The NIDCD supports and conducts research and 

research training on the normal and disordered 

processes of hearing, balance, taste, smell, voice, 

speech, and language and provides health information, 

based upon scientific discovery, to the public. 

Your Baby’s Hearing and 

Communicative Development 

Checklist 

NIH Pub. No. 13-4040 

September 2010 

Reprinted February 2014 

NIH...Turning Discovery Into Health®