My child doesn’t listen to me! Hearing and listening difficulties explained

As Speech Pathologists we often have parents telling us that their kids have difficulties listening to them. Children of all ages may have hearing problems, difficulties understanding language, or auditory processing difficulties and these can be caused by a whole range of different things. Read on to find out more about hearing milestones, what to do if your child has issues with hearing or listening, and tips for helping your child understand you.

Parents tell us that their child “doesn’t listen” “doesn’t remember instructions” or “doesn’t do what I say”. The first thing we check is if they can hear properly. Many younger children have recurrent ear infections, which can lead to glue ear, a build up of sticky fluid in the middle ear. Glue ear can last for several months and can affect your child’s speech and language development, because of a period of time with less ability to hear.

If your child has recurrent ear infections or has a speech or language delay, we strongly suggest that they have a hearing test done by an audiologist. You can get a referral from your GP or book an appointment with a local audiology clinic. Babies born in Australia all have a new-born hearing screen (called the SWISH test). It is important to get an up-to-date hearing test which is more comprehensive to understand if your child is able to hear all the speech sounds clearly.

Once glue ear or hearing impairment is ruled out as a cause of your child’s listening difficulties, we then look at their understanding of language, also known as receptive language. A full speech and language assessment will look at a child’s receptive and expressive language (talking) skills. This allows us to work out if your child’s hearing difficulties are because of the way their mind processes and remembers language that they hear, rather than difficulties relating to their sense of hearing.

Hearing milestones:

• At 3 months your baby will recognise your voice
• At 4-6 months they will attend to music
• At 5-7 months your baby will start to recognise their own name and may pause or look up when they hear their name. At 6-12 months your baby will begin to understand simple words, often these are ones they are highly motivated by such as ‘dog’, ‘car’, ‘teddy’ or ‘spoon’. Children will look at the correct object when you name it
• At 7-10 months your baby will turn and look at the direction of sound
• At 8-12 months they will look at their favourite toy when you say the name of it
• At 12 months they will respond to simple commands such as ‘this way’
• At 24 months they will be able to point to pictures in a book, follow simple commands such as ‘where is your nose?’, ‘blow the bubbles’, ‘kick the ball’.
• At 36 months (3 years) they will follow 2-part instructions such as ‘get your water and sit at the table’, use 3 words in a sentence, will answer simple questions such as ‘what is that?’ ‘Who is that?’ ‘Where are we going?’
• At 48 months (4 years) they will listen and follow stories, attend for longer, and take part in back-and-forth conversations

If you have concerns about your child’s hearing, listening or understanding, contact us for advice, support or assessment.

Auditory Processing Disorder

Another possible cause of your child’s listening difficulties is Auditory Processing Disorder (APD). Some researchers are currently debating if APD is a true diagnosis, or if it describes parts of other known diagnoses like ADHD and receptive language difficulties. Generally, APD is currently accepted as a diagnosis. In Australia, audiologists can diagnose APD.

APD describes difficulties with interpreting the different sounds that we hear. Kids with APD often have difficulty listening and concentrating when there is background noise.

Symptoms of APD:

• Your child has difficulty following instructions
• Your child doesn’t always respond when they hear their name
• Your child can get confused and may misinterpret instructions
• Your child has poor attention skills
• Your child has problems distinguishing similar sounds
• School teachers may see behavioural difficulties such as poor attention and lack of understanding

Tips to help your child’s listening skills:

• Get rid of all background noise such as the TV, Radio, music or outside environmental noises (close the window). This will help your child to hear what you say much more clearly
• Get down to their level so they can see your face, when children to see your lips move and your facial expressions, this helps them understand your message.
• Use gestures to support your message – point and use your hands to show concepts like ‘big/little’ or ‘long/short’
• Break down instructions into single or smaller steps, keep instructions simple. e.g. don’t say ‘find your blue starred socks, then get your lunch box which is on the kitchen table and fill your dinosaur water bottle up with water’. Break this down into each step: ‘get your blue starred socks’ and then wait… ‘get your lunch box on the kitchen table’ and wait… ‘fill your dinosaur bottle up’.
• If your child has difficulties understanding instructions, show them what you want them to do, this is a very powerful way to teach them. Talk to them while you do it ‘fill the water bottle up with water’.

Activities to improve your child’s listening skills:

• Simon says – This is a classic game that can improve a child’s ability to follow instructions. You can make it easier by saying and showing the instructions. You can make it harder by using longer instructions with more complex vocabulary ‘Simon says draw a diagonal line on the paper in front of you and take 3 deep breaths’.
• Shopping game – you can set this up at home or do it in real life. Ask your child to find items in the shop. In your instructions you can use numbers, concepts (e.g. large, little, medium, dark, light), colours, less familiar items (E.g. dragon fruit, butternut squash or kale).
• Describing game – Get your child to listen to you describe an item and guess what it is. You can make this easy by having some objects in front of them to choose from, or make it harder by describing something they can’t see. Take turns and ask your child to imagine something from the house they can describe. You can help them by asking questions such as ‘Does it feel smooth?’ ‘How big is it?’.
• Increase book reading – Take your child to the library let them choose books they want you to read so they are motivated to listen. Talk about what happened in the story, re-read the same book a few times to help your child learn new vocabulary from the story.

Speech Pathologists can guide you to specific goals and activities to support your child’s listening skills. Contact us at Clear Communicators Speech Therapy if you have concerns about your child’s hearing, listening, or understanding skills.