Speech is so very important to a child that every effort should be made to be sure each child has an optimum chance to have good speech. Dr. Perri Klass discussed delayed speech in yesterday's New York Times (2/9/10). However, she placed little emphasis on hearing which is of prime importance for normal speech. 1-2 babies/1000 have some hearing loss and 400,000 children are reported to now have hearing loss.
Unfortunately, not every newborn has hearing checked in the nursery. Fourteen states allow parents to refuse the hearing, other hospitals do hearing testing only if it is covered by the parents' insurance and there is, of course, always the test that is improperly done. If a child is not making sounds by three months, hearing should be checked in an accredited pediatric hearing center. Hearing tested in a family doctor or pediatrician's office is not satisfactory.
If a small child has repeated ear infections treated by multiple courses of antibiotics and the child is not referred to a pediatric ear-nose-and throat doctor, marked hearing loss can occur. Myringotomies are a thing of the past in most pediatric offices, so children can develop thickened ear drums with repeated ear infections or develop what is called "glue ears". Both of these can cause diminished hearing.
I vividly remember the call I received from a pediatrician who cared for the children of many of the town's affluent families. He wanted the name of a good speech therapist for a two-year-old child who was not talking. I said, "Have you checked the boy's hearing?" "Oh," said the pediatrician, "that's a good idea!". Two years is far too late to start worrying about a child's speech delay.