By Yishane Lee

As a parent, I constantly think that my children aren’t listening. The number of times I repeat myself endlessly (usually accompanied by an escalation in volume) before I get an answer is enough to drive me bonkers. But a child who isn’t listening to you can be a sign of something more than a clash of wills.

If you find that your child doesn’t respond to repeated entreaties—especially when you’re not facing her—it could be a sign of a hearing loss.

It is one sign that Hearing Health magazine staff writer Barbara Jenkins, Au.D., BCABA, includes in her list of the most common signs of hearing loss in children of different ages, from infants to teenagers.

Despite universal newborn hearing screening in hospitals—an effort that HHF spearheaded in the 1990s that has been critical for early intervention treatment—hearing loss can be progressive and appear in children after you go home from the hospital and into the school years.

For instance, a baby who doesn’t react to a sudden noise, such as a toy dropping to the floor, may have a hearing loss. Evolutionarily speaking, humans (and all animals) make sounds in reaction to hearing sounds, so a hearing loss can be indicated when a baby does not make word-like sounds, such as “gaga” or “dada” by 10 months of age.

In fact, speech milestones are critical for making sure your child’s development—and hearing—are on track. (Also important is talking directly to your toddler, too, according to a new Stanford University study.) Talk to your pediatrician if you have any concerns, no matter how slight. A study in JAMA Otolaryngology-Head and Neck Surgery found that parental concern and school hearing screens helped diagnose hearing loss after passing the newborn hearing screening.

As your child ages, there’s more opportunity for social interaction as well as picking up illnesses. Ear infections (otitis media, or infection of the middle ear) are one of the most common childhood infectious diseases requiring antibiotics. In young children the Eustachian tube has not fully developed, leaving the middle ear more likely to retain fluid that in the ears of older children gravity flushes out.

Since infections can last one to three months, with fluid blocking the ear, during that time hearing and speech both become impaired.

This can delay language acquisition and lead to learning issues. Left untreated, children who are prone to chronic ear infections are at risk of permanent hearing loss. Some of our 2013 Emerging Research Grant recipients (Ravinder Kaur, Ph.D.; Ani Manichaikul, Ph.D.; and Merri J. Rosen, Ph.D.) are working on developing a vaccine, identifying genetic predispositions, or otherwise mitigating the effects of this serious health issue in children.

Placing ear tubes in the ear are a common remedy for children with chronic ear infections. It’s a simple surgery, but requires general anesthesia, and repeated surgeries may be required if the tubes fall out. Our otolaryngologist recommended that my son, then just over a year old, get tubes to help with chronic fluid in the ear (without infections). But I couldn’t bring myself to do surgery when the ailment was something he would eventually grow out of. That said, it is a common, safe surgery that many children have benefited from.

Ear infections can be an obvious sign of potential hearing loss. So can needing the TV or stereo volume turned up, tilting the head forward, or having difficulty at school. Your child may even tell you straight out that he can’t hear you. As Jenkins writes, “This may seem obvious, but many parents assume that their children are not paying attention when in fact there may be an unidentified hearing loss.”

Review the signs your child may have a hearing loss here, and share your experience parenting a child with hearing loss below.