Introduction — why a clear checklist matters
Hearing loss is common but often gradual and easy to miss. Early recognition — especially in infants and children — leads to faster diagnosis, better communication outcomes, and earlier access to treatments or hearing technology when needed. This article gives a practical, evidence-based checklist for families and caregivers, explains red flags, and tells you exactly when to book an appointment with an audiologist or see ENT.Common signs of hearing loss in adults
Use this checklist for adults (self or family observations):
- Difficulty understanding conversations, especially in noisy places (restaurants, family gatherings).
- Frequently asking people to repeat themselves, or misunderstanding words.
- Needing to turn up TV, radio, or phone volume higher than others.
- Trouble hearing on the telephone.
- Sound seems muffled, or consonants (s, t, f, th) are hard to hear.
- Avoiding social events or feeling fatigued from concentrating to hear.
Why these matter: These symptoms commonly indicate age-related or noise-related sensorineural hearing loss and should prompt a hearing screening or audiology assessment. Screening can identify people who need full diagnostic testing.Red flags — when to seek urgent care
Seek immediate medical attention (ENT or emergency) if you or a family member experiences any of the following:
- Sudden hearing loss — hearing decreases rapidly over hours to a few days. This is an emergency because early treatment improves outcomes.
- Ear pain with fever, pus/drainage, bleeding from the ear, or severe imbalance. These may indicate infection or other urgent conditions.
- Hearing loss affecting one ear much more than the other, or sudden asymmetrical hearing loss. This requires prompt ENT/audiology evaluation.
Signs of hearing loss in babies and infants
Newborns and infants have specific milestones clinicians watch for. If you notice any of these signs, act early:
- Newborn hearing screening fails: schedule a full diagnostic test before 3 months. Early diagnosis is essential for language development.
- Baby does not startle at loud sounds or does not turn toward sounds/voices by expected ages.
- Not reaching speech and language milestones (e.g., cooing, babbling, saying first words) on time.
- Appears to watch faces and lips intently to follow conversations or pulls at ears frequently.
Action: If a screening was failed or milestones are delayed, arrange diagnostic testing and early intervention as soon as possible — early support improves long-term language and learning outcomes.Signs of hearing loss in children and school-age kids
Common clues parents or teachers may notice:
- Difficulty following classroom instructions, asking for repetition, or misunderstanding questions.
- Poor academic performance or trouble with reading and speech that seems unrelated to attention or teaching quality.
- Frequently asking to sit near the teacher, or relying on visual cues (watching lips).
- Behavioral changes: withdrawal from social play, frustration, or appearing tired after school because listening is effortful.
Action: Any persistent difficulties should prompt a hearing test and review by a pediatric audiologist; early support improves language and school outcomes.Simple at-home checks you can do now
These home observations are not a substitute for formal testing, but they help decide whether to seek professional assessment:
- Does the person respond to normal conversational speech at a short distance?
- Does speech sound muffled or “swallowed”?
- Can the person hear high-pitched sounds (e.g., birds, doorbells) compared to before?
- Can the person follow a two- or three-step spoken instruction without reading lips?
- Is the TV/phone volume set much higher than family members prefer?
If you answer “no” or “not sure” to any of these consistently, book a screening with an audiologist or primary care provider.How hearing loss is diagnosed (what to expect)
When you see an audiologist or ENT, typical diagnostic steps include:
- Case history — questions about symptoms, noise exposure, infections, medications, and family history.
- Otoscopy — visual inspection of the ear canal and eardrum to look for wax, infection, or structural issues.
- Pure-tone audiometry and speech testing — the standard audiogram measures hearing thresholds across frequencies and helps quantify the degree and type of hearing loss.
- Tympanometry / middle-ear tests — assess middle ear function (useful for children and suspected conductive loss).
- Otoacoustic emissions (OAE) or Auditory Brainstem Response (ABR) — often used in infants or when objective measures are needed.
A diagnosis will determine if hearing aids, medical/surgical treatment, or monitoring are appropriate. Management recommendations are provided by professional audiology and ENT teams.Common causes of hearing loss
- Age-related (presbycusis) — gradual sensorineural loss with age.
- Noise exposure — prolonged loud noise or a single very loud event.
- Ear infections / middle ear effusion — common in children; often conductive and sometimes reversible.
- Ototoxic medications — some antibiotics, chemotherapy agents, and other drugs can damage hearing.
- Sudden sensorineural hearing loss — typically unexplained and treated as urgentTreatment and management options (overview)
- Hearing aids — primary option for many types of permanent sensorineural loss; modern devices include rechargeable options and smartphone apps. Audiology teams fit and verify devices.
- Medical or surgical treatment — for conductive causes (e.g., chronic ear disease, otosclerosis) ENT assessment and possible surgery or medical therapy may help.
- Cochlear implants — option for severe-to-profound sensorineural loss when hearing aids provide limited benefit.
- Rehabilitation & support — counselling, auditory training, school support and communication strategies. Early intervention for children is critical.
When to see an audiologist vs. ENT
- See an audiologist for non-urgent hearing concerns, screening, diagnostic audiometry, hearing aid fitting and rehabilitation. Audiologists manage hearing devices and therapy.
- See an ENT (ear, nose & throat specialist) if there is sudden hearing loss, ear pain, drainage, bleeding, visible structural problems, or when medical/surgical intervention is likely needed.
- Practical tips for families — communicating while you wait for an appointment
- Face the person and get their attention before speaking.
- Reduce background noise; speak clearly at a moderate pace and volume.
- Rephrase rather than repeat the same sentence.
- Use visual cues: gestures, writing or text messages for important information.
- For children, inform teachers and ask for classroom seating near the teacher and access to captioned media where possible.
Local next steps — what to book now
- If newborn screen was failed or child is missing speech milestones → book diagnostic pediatric audiology now.
- If adult has persistent difficulty hearing in quiet/noise or social withdrawal → book a hearing screening with an audiologist.
- If sudden hearing loss, severe ear pain, or ear discharge → seek emergency ENT.