If hearing loss is from birth, child's speech is likely to be delayed or defective syntax, limited vocabulary, imperfect speech production and an atonal voice quality. If the child has no amplification, conversation must be very loud to be understood. Pre-reading skills impossible to master without special resource help. Child likely to have delayed language skills, syntax, reduced speech intelligibility and atonal voice quality. Child may be judged by peers and teachers as a less competent learner.
Child is often a social outcast due to the difficulty to communicate easily.
Self concept and feelings of rejection likely. Child lacks access to common information known easily by hearing peers such as names of school personnel. Without amplification, the child may hear loud voices about one foot from ear. When amplified optimally, children with hearing ability of 90dB or better should be able to identify environmental sounds and detect all the sounds of speech. Teachers and parents often investigate alternative methods of communication like sign language or cued speech to facilitate communication.