Parents might not notice any problems with their baby's hearing in the first few months of life. Babies are often in quiet areas at home and are held close when spoken to. 

Signs that a baby might have hearing loss include:

• not turning towards noise or being startled by loud noises by four months of age
• not noticing your presence when you are not directly in front of them
• only making sounds like gargles and other vibrating noises they can feel.

As your child starts to walk and explore their surroundings, they might have difficulty with:

• hearing you if they are further away or in a noisy room
• hearing you talk when they cannot see your face
• hearing well when they have a cold or blocked ears
• identifying the direction sounds are coming from.

Older children with hearing loss might:

• have trouble listening or paying attention
• need the TV volume higher than usual
• have difficulty hearing with background noise, such as the TV or a noisy game
• hear well in a quiet area
• have unclear speech
• struggle to communicate at the same level as other children their age
• have difficulty learning to read or spell
• become disinterested or disruptive in class
• find it hard to hear you when they cannot see your face

At school, teachers might notice that your child:

• seems to ignore the teacher when there is background noise
• has trouble concentrating
• copies what another child is doing rather than admit they didn’t hear the instructions
• misses important instructions during noisy times, like going-home time or before lunch
• has difficulty hearing soft sounds in the classroom, such as 's', 'f', and 'th', which affects their ability to break words into sounds for reading and spelling
• struggles with subjects that involve following processes or sequences, like maths
• finds it hard to understand and talk to other children in noisy environments

Many babies born with hearing loss are diagnosed with the NSW Statewide Infant Screening - Hearing (SWISH) test in their first month.

The test is done in the hospital after your baby is born. If your baby wasn't born in a hospital, the local child and family health centre or hospital will contact you to arrange the test.

During the SWISH test, a soft sound is played near your baby's ears, and the baby's response is recorded. Passing the test means they can hear quiet noises in both ears. 

If your baby doesn't pass, the test will be done again in a few days. If your baby still doesn't pass, they will be referred for further checks at the nearest hospital.

Your local doctor can refer your child to a specialist for a hearing check. Specialists include:

• paediatric audiologist – a health professional who tests hearing
• ear, nose, and throat (ENT) specialist
• paediatrician – child specialist

It is important to continue checking your child's hearing and speech as they grow since hearing loss can occur at different ages. If you think your child is having issues or has experienced sudden changes in hearing and listening, see your local doctor as soon as possible.

Temporary hearing loss, also called conductive hearing loss, is common in children. It occurs when sound has trouble travelling from outside the ear to the outer or middle ear. This can be caused by:

• glue ear – fluid buildup in the middle ear
• earwax buildup
• otitis media – middle ear infection
• otitis externa or swimmer’s ear – outer ear infection

If your child has hearing loss for over a month, see your local doctor as soon as possible.

Hearing loss can be present at birth or develop later. 

Your child may be at risk of hearing loss if they:

• were born prematurely, before 37 weeks of pregnancy
• weighed less than 1500g at birth
• have a family history of hearing loss
• were born to a parent who had a viral infection during pregnancy, like rubella or cytomegalovirus
• have had meningitis or encephalitis - infections of the brain or its coverings
• have a condition linked to hearing loss, like Down syndrome or Usher syndrome
• were born with a difference in how the ear, nose, face, or neck has developed, like a cleft palate
• have experienced trauma or damage to their head or ears
• have had long or repeated exposure to loud noises.

Hearing loss can impact your child's speech and language development, especially if not managed well. Early intervention services can help your child learn to:

• communicate in different ways
• use their remaining hearing more effectively
• interact with family and the community.

Options for managing hearing loss and communication in children include:

• learning and using Australian Sign Language - Auslan
• hearing aids
• cochlear implants
• communication devices like mobile phones, tablets, interactive whiteboards, hearing loops, the National Relay Service, and closed captioning services.

Every child is different, and the best way to manage communication is the one that works best for your child. Tools and strategies may change as your child grows and learns more about how they want to communicate.

To support your child’s communication, you can:

• choose a quiet environment for talking and listening
• stand closer to make your speech louder without shouting
• make sure your face, lips, and hand gestures are visible when communicating
• be aware of lighting in different environments
• repeat and emphasise key words

To support your child's communication and language development at school:

• tell the school and teacher about any learning support your child needs
• check in with the teacher about your child's hearing loss in the classroom
• ask for your child to be seated with their better ear close to the teacher
• check homework in a quiet area at home
• talk to the school and your child’s treatment team about extra support for language and learning.

Protecting your child’s ears and any remaining hearing is important to prevent further damage. You can protect their ears by:

• treating ear infections and glue ear as soon as possible
• using noise protection for both ears around loud noises, like at concerts
• reducing exposure to loud noises
• setting volume limits on your child’s phone or headphones.

Talk to your child’s treatment team about:

• regular hearing checks to monitor changes in hearing levels
• equipment options for reducing background noise, like Field FM or personal FM units
• any future treatment or surgery for your child’s hearing ear, if relevant.