A child who often asks you to repeat things, turns cartoons up loud or “doesn’t hear” when called from another room may have a hearing loss — or may simply be absorbed in play. The only way to tell is a hearing test, which in children is painless and possible at any age. If the signs keep recurring for a few weeks, it is worth checking.
Warning signs by age
Hearing loss in children is rarely obvious. More often it shows in behaviour, speech and learning.
Babies (under 1 year)
- no startle at loud sounds, not waking to noise,
- not turning towards a parent’s voice (around 6 months),
- babbling becoming less varied or stopping instead of developing,
- not responding to their name at around 9–12 months.
Pre-school children (2–6 years)
- speech developing late or being unclear,
- frequently saying “what?”, watching the speaker’s mouth,
- turning the television up, standing close to the speaker,
- not responding when called from another room, but responding to touch,
- “switching off” for a few weeks after an ear infection.
School-age children
- asking for instructions to be repeated, struggling in a noisy classroom,
- falling grades, tiredness after school,
- speaking louder than usual or, conversely, withdrawing from conversation,
- complaining of a “blocked” ear or ringing.
A single sign does not mean hearing loss. Several signs together, lasting longer than 2–3 weeks, are a reason to test.
Common causes of reduced hearing in children
- Glue ear (otitis media with effusion) — the most common cause in pre-schoolers. Fluid collects behind the eardrum and muffles sound. It does not hurt, so it is easily missed. It often follows a cold and can persist for weeks.
- Enlarged adenoids — swollen adenoids block the opening of the Eustachian tube and encourage fluid to collect. The child snores, breathes through the mouth and has a constantly runny nose.
- Recurrent ear infections — each infection can temporarily reduce hearing; with frequent recurrences the middle ear should be assessed.
- Earwax — a plug in the ear canal muffles hearing on one side.
- Sensorineural hearing loss — less common, affecting the inner ear or the auditory nerve; it can be congenital (sometimes appearing later) or acquired, for example after certain illnesses.
When to seek help urgently
Book a paediatric ENT appointment without delay if:
- hearing dropped suddenly, especially in one ear,
- your child has ear pain, fever or discharge from the ear,
- there is dizziness or loss of balance,
- the hearing loss followed a head injury or a very loud noise,
- a baby has stopped responding to sounds they used to respond to.
If hearing is worsening gradually without these symptoms, a routine appointment is fine — but in young children it should not be delayed for long, because hearing directly affects speech development.
Which tests, and from what age
The method is matched to the child’s age and ability:
- Otoacoustic emissions (OAE) — from the first days of life. A soft probe in the ear sends a quiet sound and records the response of the cochlea. It takes a few minutes and the child can be asleep.
- ABR (auditory brainstem response) — from infancy. Electrodes on the skin record the auditory nerve’s response to sound. It establishes the hearing threshold without the child’s cooperation; in small children it is done during sleep.
- Tympanometry — at any age. A probe measures how freely the eardrum moves and shows whether there is fluid in the middle ear. It is the basic test when glue ear is suspected.
- Play audiometry — at Sonar Clinic from around age 6. The child responds to sounds in headphones through a game, for example by dropping a block into a box. It produces a full audiogram.
- Pure-tone audiometry — in older children, as in adults.
What a child’s hearing test at Sonar Clinic looks like
Children’s hearing tests are carried out by Paulina Waloszek, MSc, audiologist and hearing aid specialist, who works with both children and adults every day. The test takes place in a quiet room at the child’s pace, with a parent present throughout. ABR tests for the youngest children are scheduled in the evening and on selected Saturdays to coincide with the child’s nap; the time is agreed in advance by phone.
If your child has a constantly blocked nose, snores or gets frequent ear infections, the right first step is a consultation with Patryk Manycz, MD, a doctor in specialty training in paediatric ENT. The visit includes a fibre-optic endoscopy (a thin scope allows the adenoids, among other things, to be assessed) and, where indicated, tympanometry.
The scope of testing is described on the child hearing test and ENT pages. Indicative prices: otoacoustic emissions 70 zł, tympanometry 50 zł, play audiometry 70 zł, paediatric ENT consultation 320 zł — the current price list is on the pricing page. You can book by phone (+48 880 018 703) or online on the specialist’s profile.
What to bring
- The newborn hearing screening result (it is in the child’s health record book).
- A list of past ear infections and the medicines used.
- Observations from home and from nursery or school: what exactly concerns you and since when.
- Whether your child snores, breathes through the mouth or has a persistently runny nose.
- Bring your child to the test healthy, rested and fed; for ABR, at the pre-agreed nap time.
If your child is nervous about tests, tell them beforehand that nothing will hurt and that they will be “hunting” for sounds in the headphones. That is usually enough.
This content is for information only and does not replace a medical consultation. If symptoms are sudden or getting worse, contact a doctor or call 112.