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Should I have my child's hearing tested?
Q: My 26-month-old daughter, who is our only child, can say only about 20 words, but seems to understand everything we say. When I say a word and ask her to repeat it, she sometimes tries but only gets out the beginning sound. I did not talk until I was 30 months old. Should I have my child tested? If yes, where? My school district requires that I bring my daughter to the school for testing, and I know she will be too shy to talk there. (She was born six weeks early and spent one week in the NICU.)
A: To have been born six weeks early and to have needed a week in the NICU, your daughter is doing just fine. Children always understand far more words—those used in everyday life—than they can say. Your daughter’s pattern of development is perfectly normal.

With any concern about language development, the first thing to do is to make certain that she the child is hearing you—though if your daughter understands what you say to her, as you indicate, she probably is. But before scheduling a formal hearing test administered by a professional, you can give her an informal one at home. Get behind her when she is concentrating on some toy and call her name softly. If she turns her head and looks at you or says something to you, you don’t need a formal hearing test at this time. If she doesn’t turn, try your “test” several times when she isn’t concentrating so hard. If she never turns her head, then you probably need to have a formal hearing test. As to where you should go if you do seek help, the first port of call should be your pediatrician. He or she could refer you to a local speech and hearing clinic if a formal assessment is needed.

One final suggestion. Check my earlier article on the Fisher-Price web site, “Word Processors Extraordinaire—How Babies Learn Language.” There are some good tips there for helping young children acquire language skills.
Dr. Bettye M. Caldwell Ph.D. Professor of Pediatrics in Child Development and Education